This was a case I reviewed with my new grad NP mentee recently, that was complicated on SO many levels and unfortunately happens quite a bit.
It's a patient case where it's not just about the complex medical management, but also the pieces of stepping into this role as a nurse practitioner to navigate the health care system and our patients' lives.
The premise is that it's a 40-year old cis-male patient presenting for hospital follow-up after admission for pneumonia and hyperglycemic hyperosmolar syndrome (severely elevated blood sugar in someone with type 2 diabetes), as well as a complex leg wound and possible necrotizing fasciitis.
Medicine in the real world can be messy, and I discuss the case, pearls of practice to keep in mind, and what supports to seek and what to watch out for.
Note - I didn't address every single aspect of this case - including principles of mealtime insulin, the wound assessment and pneumonia, but these were improving! Hopefully, this is a helpful overview of the general approach and pearls of practice.
Check it out here:
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