You are discharging a patient from the observation chest pai…
You are discharging a patient from the observation chest pain unit. A 47 year old male presented with chest pain this morning. ECG: sinus rhythm, no ST changes, rate 89, normal axis. Troponins are normal. A treadmill stress test is performed and found to be normal. You diagnose the patient with GERD and esophageal spasms. What is the most appropriate prescription at discharge?
Read DetailsYou are caring for a patient who has been hospitalized for 3…
You are caring for a patient who has been hospitalized for 3 days secondary to new onset congestive heart failure with exacerbation. The patient is also a type II diabetic. On admission the patient’s home insulin regimen was continued: Lantus 20 units subcutaneous HS, lispro (Humalog) 6 units subcutaneous before meals. You are reviewing the patient’s glucose trend shown below: Tuesday Wednesday Thursday Before Breakfast 62 58 65 Before Lunch 158 128 165 Before Dinner 201 199 205 Bedtime 198 212 188 What insulin adjustment is most appropriate for this patient?
Read DetailsA 19 year old type I diabetic female has been in the intensi…
A 19 year old type I diabetic female has been in the intensive care unit for 2 days secondary to diabetic ketoacidosis (DKA). The insulin drip is infusing at 2units/hr. Suddenly the nurse notifies the AGACNP intensivist that the patient appears to be having a seizure. The seizure resolves after IV administration of a benzodiazepine. The nurse obtains a point of care glucose which results as 32. What is the most appropriate treatment?
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