Derek Bonner, a 72 year old Aboriginal male, has been on you

Derek Bonner, a 72 year old Aboriginal male, has been on your ward… Derek Bonner, a 72 year old Aboriginal male, has been on your ward for the past day with Acute on Chronic Kidney Injury secondary to a recent vomiting and diarrhea after food poisoning.  Derek has a past history of CKD, Type 2 Diabetes Mellitus, ex smoker, increased BMI, and hypertension.  In your morning handover it is revealed that he hasn’t had anything to eat for a few days and his IVT insitu of 5% Dextrose (1 Litre) at an 8/24 rate was changed to a normal saline flask at the same rate at 0300 hours.  According to Derek’s Electronic Medical Record his last episode of vomiting and diarrhea was at 0100 hours and he received his oral hypoglycaemics at 0600 together with his daily subcutaneous enoxaparin.It is 0730 hours and when you go to Derek’s room he complains to you of a headache, weakness and blurred vision.Your initial primary assessment reveals:A: Airway clearB: Equal chest movement, no use of accessory muscles, RR 22C: Diaphoretic, tachycardiaD: Drowsy, GCS 13/15E: Not performedVital signs reveal:HR: 126 bpm; irregularBP: 140/85RR: 22 breaths/minT: 36.8SpO2: 96% Room Air Utilising best practice research, contemporary evidence and the nursing standards to assist, students are encouraged to link any relevant Cultural considerations, Pathophysiology and Pharmacology to the case study patient to compliment any suggested nursing care and management. Based on your initial impression what do you think is now wrong with Derek? In your answer please provide relevant pathophysiology.What clinical impression, together with signs and symptoms, is Derek presenting with that formed your impression of the condition you believe he is now suffering from and why do these signs & symptoms occur (underlying pathophysiology)?Discuss the nursing care and management, using evidence-based literature, required for managing and maintaining Derek’s potential diagnosis (what you think is now happening),  in a culturally safe manner, with rationales as to why this care is provided. Include relevant medical and pharmacological treatment options.List two ACUTE potential problems that Derek is at risk of due to this current condition that you think is occurring.  Provide rationales as to why this is a potential risk and three nursing management preventative strategies for each of these problems.Health Science Science Nursing NURSING HNB2001

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