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Task
Joseph Okojie Case Study
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Joseph Okojie is a 19-year-old university student who was brought to ED by his flat mates because he was slurring his words and they know he is a diabetic. The group had been attending O week celebrations.
Biography
Joseph is the second child of Gabriel and Enohor. His parents met while they were studying pharmacy at university in Australia in the early 1990s. They manage a Chemworld franchise in Nowra. They became permanent residents in 2000 and citizens in 2010. His older sister, Adoobi, is 23 and has just started working as a registered nurse at Wollongong hospital. Joseph recently moved out of home into university accommodation and will begin a civil engineering degree next week.
Health history
Joseph had an uneventful childhood before being diagnosed with insulin dependent diabetes when he was 12. He has no other medical history except for a broken collar bone when he was 8 while playing soccer. He has learnt to manage his diabetes with his parents help and has only had 3 episodes of hypoglycaemia over the past 7 years. He transitioned to an insulin pump late last year and his Glycosylated Hb 4 weeks ago was 4%.
History of presenting illness
Joseph has been experiencing flu-like symptoms for several days (RAT – COVID negative) but was encouraged to go to O-week celebrations with his flat mates. They had spent the whole day at the Celebrations yesterday. The following day his flatmates were concerned as Joseph had not gotten up for breakfast or lunch. When they went into his room, he was slurring his words however when they checked his BGL it was high. Subsequently they loaded him into the car and brought him to ED.
Situation
Its 0130, your colleague, Uma, has asked you to answer a buzzer from one of her patients while she gives an IV medication to another patient. When you walk into the 2-bed room you notice that Joseph seems to be choking and when you go over to him, he does not respond to voice.
Close observation Ward environment
• Patients – 16 (increased to 18 with new admissions)
• Staff – 3 RNs + 1 EEN + 2 AIN (usually should be 3 RNs + 3 EENs) plus 1 AIN specialling patient with delirium
• Staff-Patient – Each team has 6 patients. Uma is also in charge
- Team 1 Uma RN (also in charge) + EEN: starts with 5 & gets an admission from OT
- Team 2 Yourself + AIN (+ AIN specialling patient with delirium): 6 patients
- Team 3 RN 3 + AIN: starts with 5 and gets admission from ED
• All patients with close observation needs (2 hourly obs + telemetry) and high intensity needs (could include ICC + USWD; tracheostomy; NG feeds; central venous catheters; high flow oxygen)
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