Rationale development exercise - Essay Example

According to Lehne et al. (2011, p. 580), if there is little or not enough insulin to ease the glucose through the cell membranes of the cell, patients with T2DM will still be at risk for DKA. The finding of the DKA laboratory is that a higher BGL in excess of 14 mmol/L is an indication of insulin deficit. Her BGL ranged from 18-23 mmol/L. Continuous mobilization of fatty acids and hyperglycemia occur as a result of deficiency of insulin. Utilization of the fatty acids allows the development and buildup of ketones that can cause acidosis.

It is therefore, incorrect to assume that Mrs. Langerhan’s diagnoses on discharge will include T1DM because she will now be classified as insulin dependent. Although she is categorized as insulin dependent, she will not be diagnosed as T1DM because the features and cataloguing of both T2DM and T1DM are different. When classifying T2DM, we use relative insulin deficiency and for the case of T1DM we use absolute insulin deficiency (LeMone et al. 2011, p. 578). In Mrs. Langerhans case, the insulin produced in her body is not enough; therefore there is likelihood for hyperglycemia to develop.

The development will be due to lack of control of her T2DM, earlier non-compliance with diabetic history, hypoglycemic medication procedure, and also the usage of IV solution comprising dextrose on admittance. However, since her body can still produce insulin, though in small portions she cannot be diagnosed with T1DM. The RN administers Mr. Nexium IV metoclopramide that is the first anti-emetic given according to most post-operative nausea and vomiting procedures. IV metoclopramide is given to most post-operative patients in to reduce abdominal swelling postoperatively, to reduce strain on the wound and assist respiration.

It also helps to expand the stomach, during surgery particularly the upper abdominal surgery when a bloated stomach obstructs the operation. The justification she