Client Profile Ronald Sherbino is a 73 year old male

Client Profile
Ronald Sherbino is a 73 year old male. Recently widowed from his wife of 52 years. He has one son who
lives close by and a daughter who lives in Vancouver. He was diagnosed 3 years ago with diabetes which
prior to his wife’s passing was well controlled. He also suffers from chronic pain after a knee
replacement in 2017. He lives alone in the family home and does not have visitors often due to the
social distancing advisement and his son’s work schedule. He visits the Emergency Department on the
urging of his son who is worried about his welfare after stopping in to check on him and finding him
confused and disheveled. The son reports that his dad had not been acting like himself on the phone
and has discovered he has not filled his prescriptions in over a month. Ronald is admitted to the general
medicine department to get his blood sugars under control.
Case Study
Ronald’s initial presentation to the ED revealed a blood glucose level of 26 mmol/L and he was positive
for ketones. Confused to date and place. After a 5 day admission Ronald’s blood sugars have stabilized
and discharge planning has begun. During a health teaching session about a new insulin that has been
added to his regime Ronald discloses “I don’t see the point in learning this. I’m going to stop checking
my blood sugars when I get home. I just want to die.” Later on in the day Ronald asks the RPN
administering his evening insulin “how much insulin would it take to put me in a coma?” The nurse asks
if he has thoughts of harming himself. Ronald replies that he doesn’t want to manage his life alone and
states next time he won’t answer the phone when his son calls. He also expresses anger towards his son
for taking him to the hospital. Chris, Mr. Sherbino’s son, is extremely upset when talking with the nurses
expressing guilt that he didn’t realize his dad wasn’t doing well sooner and that he should have made
him move into his home when his mother passed.
Additional Information
Patient Data: 73 years old, height 179 cm, weight 75 kg
Signs and Symptoms: Concerning statements about potential self-harm, suicidal ideation
Allergies: NKDA
Medication: Humalog 10 u subcutaneous AC TID, Lantus 12 u subcutaneous QHS, ASA 81 mg PO OD,
Ramipril 5 mg PO OD, Tylenol ES 500 mg PO BID PRN for pain
Past medical history: HTN, DM, Left knee replacement
Diet restrictions: Diabetic diet with reduced sodium
Events Preceding: Recent death of spouse, Diagnosis of diabetes

Question: List 3 priority nursing interventions. Why are each of these important?