Georgie Smith 64 year old woman

Type 2 Diabetes
1. BGL: 18.5-25.6 mmol/L
  1. How well is this being controlled?
    1. Does diet need to be altered?
  2. Why is this high?
    1. Poor diet
2. Uses Insulin
  1. 52 units of Lantus/day, short acting
    1. Is this sufficient?
      1. Is there an alternative?
        Sliding scale insulin
        Is a medication review necessary?
        Can this be used at home?
3. Level of Education
  1. Does Georgie know what her BGL level should be?
4. Alternative treatments?
  1. Exercise
    1. Is this appropriate for someone short of breath
  2. Alter diet
    1. Does Georgie need a nutritional review?
Social Welfare
1. Lives with husband
  1. Full time builder
  2. Not willing to assist with treatment
  3. 4 children, all live overseas
    1. What other networks does Georgie have?
Cataract in left eye
1. To be removed in 3 months
2. Is this detrimental to Georgie's ADL's?
3. Is this a consequence of consistently high BGL's?
Chronic Heart Failure
1. Frusemide 40mg BD
  1. Loop diuretic that inhibits sodium and chloride reabsorption
  2. Used in Acute pulmonary oedema, oedema and hypertension
2. BP 140/80
  1. Lisinopril 20mg BD
  2. Atenolol 50mg daily
3. Respiratory Rate= 26
4. Pulse 100bpm
  1. Digoxin 250mcg daily
    1. Reduces heart rate
  2. Amiodarone 300mg
    1. Use cautiously in people with heart failure
    2. Prevention and treatment of serious atrial & ventricular arrythmias
5. Oxygen Saturation 96% on room air
6. Short of breath on exertion
Height 170cms, 110 kgs
1. BMI= 38=obese
  1. How can this be addressed?
    1. Weight loss
      1. Diet
      2. Exercise
Rheumatoid Arthritis
1. Ibuprofen 400mgs TDS
  1. Adverse reactions
    1. Peripheral Oedema
      1. Frusemide helps avoid this
    2. Fluid retention
      1. Frusemide helps avoid this
    3. Acute Renal Failure
2. Aspirin 100mg daily

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Georgie Smith 64 year old woman

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