Evolve.

Adapt.
Overcome.
CEFI is now ready.

DIABETES MELLITUS TYPE 2

BSN-3B

Presented by
GROUP 3
BSN III-B SY: 2024- 2025
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

MEMBERS:

CALVARIO, JHAMAICA ANGELA A.

IMPERIAL, MA. ALECKZANDRA NERISSE C.
LUSANTA, LEONORA D.
ROQUEZA, JERCY WAYNE P.
SALES, ANDREA MAE F.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

FOREWORD

To be able to accomplish an Intervention, we, as nursing

students should be able to understand the patient’s condition
very intricately so we can form better ideas to manage such
disease. We are hoping that this study will bring knowledge and
information to our fellow nursing students, as well as to our
seniors.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

DEDICATION

We dedicate this study to our patients’ families who

trusted us, to our fellow nurses and students who could learn
so much about this research study, and especially to our
Clinical Instructor who guided us throughout the Surgery
ward rotation.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Case Introduction

PRESENTED BY:
IMPERIAL, MA. ALECKZANDRA NERISSE C.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

DIABETES MELLITUS TYPE 2

A 66-year-old female from Lucena City was admitted last September
11,2024 at Mount Carmel Diocesan General Hospital with chief complaint
of Dizziness and Diagnosis of DM poorly controlled.
Type 2 Diabetes Mellitus is a chronic condition where the body
either doesn’t use insulin effectively or doesn’t produce enough of it,
leading to high blood sugar levels. This can make people more vulnerable to
infections, especially in areas like the skin, feet, and urinary tract. For those
living with diabetes, managing blood sugar levels is crucial not just to feel
better day-to-day but also to prevent complications like slow-healing
wounds or recurrent infections. Taking steps like regular check-ups,
maintaining a healthy diet, and practicing good hygiene can make a big
difference in staying healthy and reducing the risk of infections.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Patient’s Data, History

and
Physical Assessment
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Patient’s Data
Name: Patient X Occupation: None
Sex: Female Civil Status: Widowed
Birth date: July 28,1958 Birthplace: Lucena City
Age: 66 years old GTPAL:
Educational Level : Highschool Graduate G- 8
Religion: ROMAN CATHOLIC T- 8
P- 0
Date Admitted: September 11,2024 (8:31 pm) A- 0
Chief Complaint: Dizziness L- 8
Diagnosis: DM Poorly Controlled
Attending Physician: Doctor X
GCS: 15
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PRESENT HEALTH HISTORY:

● The patient was the only member of the family with type 2 diabetes.
PAST HEALTH HISTORY:
CHRONIC ILLNESS:
● The patient was the only member of the family with Diabetes Mellitus.
SURGERIES:
● The patient has never undergone surgery before.
HOSPITALIZATION:
● She was diagnosed with Type 2 Diabetes Mellitus last May 2024.

Other Medical History:

Social History:
● Non-Alcoholic
● Non-Cigarette Smoker
Allergies:
● Food Allergy (Seafoods)
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PARAMETERS NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION

(-) pain in the head (-) pain in the head

(-) baldness (-) baldness
(-) hair fall (-) hair fall Normal
HAIR
VITAL SIGNS Evenly NORMAL
distributed ACTUAL
Evenly distributed INTERPRETATION
Thick and silky Thick and silky hair
Temperature 36.5 - 37.5 35.5°C Normal

Pulse rate (-) bruise

60 - 100 64(-)bpm
bruise Normal
(-) jaundice (-) jaundice
Respiratory rate (-) cyanosis
12 - 20 17(-)bpm
cyanosis Normal
SKIN
(-) rashes (-) rashes Normal
(-) swelling (-) swelling
Blood pressure 120/80
Normal skin turgor
110/70 mmHg
Normal skin turgor
Normal
Normal, even temperature Normal, even temperature
O2 Saturation Soft and95warm
- 100%
to touch 98%
Soft and warm to touch Normal

(+) equally distributed (+) equally distributed Abnormal

(-) discharge (-) discharge sunken eyeballs
(-) sunken eyeballs (+) sunken eyeballs Pale conjunctiva
EYES
(+) Clear corneas (+) clear corneas
Pinkish conjunctiva Pale conjunctiva
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PARAMETERS NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION

(-) dryness and peeling skin on the (-) dryness and peeling skin on
EAR pinna the pinna Normal
(-) decreased hearing abilities (-) decreased hearing abilities
(-) drainage (-) drainage

NAILS (-) clubbing of nails (-) clubbing of nails Abnormal

(-) dry areas surrounding nails (+) dry areas surrounding nails (+) dry areas surrounding nails
Normal Capillary refill Normal Capillary refill

(-) dry tongue (-) dry tongue

MOUTH (-) dry mouth (-) dry mouth Normal
(-) tongue creases (-) tongue creases

Symmetric nose Nose are symmetric Normal

NOSE Uniform in color Uniform in color
(-) discharge and flaring (-) discharge and flaring
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PARAMETERS NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION

(-) Shortness of Breath (-) Shortness of Breath Normal

(+) relaxed respirations (+) relaxed respirations
(+) normal respiratory and pulse (+) normal respiratory and pulse
CHEST AND LUNGS
VITAL SIGNS rate NORMAL ACTUAL
rate INTERPRETATION

Temperature 36.5 - 37.5 35.5°C Normal

Pulse rate (-) heartburn

60 - 100 64(-)bpm
heartburn Normal Normal
(-) diarrhea (-) diarrhea
Respiratory rate (-) constipation
12 - 20 17(-)bpm
constipation Normal
ABDOMEN
(-) Dehydration (-) Dehydration
Blood pressure 120/80 110/70 mmHg Normal

O2 Saturation 95 - 100%
(-) bleeding 98%
(-) bleeding Normal Normal
(-) edema (-) edema
(+) normal skin temperature (+) normal skin temperature
LOWER EXTREMITIES
(-) bruises (-) bruises
(-) tenderness (-) tenderness
(-) swelling (-) swelling
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PHYSICAL ASSESSMENT

VITAL SIGNS NORMAL ACTUAL INTERPRETATION

Temperature 36.5 - 37.5 35.5°C Normal

Pulse rate 60 - 100 64 bpm Normal

Respiratory rate 12 - 20 17 bpm Normal

Blood pressure 120/80 110/70 mmHg Normal

O2 Saturation 95 - 100% 98% Normal

 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Laboratory Results
and
Diagnostic Test
Presented by:
SALES, ANDREA MAE F.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Anatomy
and
Physiology
Presented by:
CALVARIO, JHAMAICA ANGELA A.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Pathophysiology

Presented by:
LUSANTA, LEONORA D.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Medical Management

Presented by:
ROQUEZA, JERCY WAYNE P.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

I. MANAGEMENT
Type 2 Diabetes Mellitus (T2DM) is a long-term condition where the body
doesn’t use insulin properly, leading to high blood sugar levels. It happens
because the body either resists insulin or doesn’t make enough of it. Managing
T2DM focuses on keeping blood sugar within a healthy range, preventing
complications, and improving the patient's quality of life.

In the hospital, managing T2DM can be more difficult due to added stress,
infections, surgeries, or changes in diet. Because of this, a team approach is
needed. This involves regularly checking blood sugar, adjusting medications,
providing the right nutrition, and managing other health problems the patient
may have.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

I. MANAGEMENT
MANAGEMENT RATIONALE
Monitoring Blood Sugar: Check your Monitoring lets you see how well your diet, exercise,
blood sugar regularly using a and medications are working to control your blood
glucometer, especially before meals sugar. It helps prevent your sugar levels from going
and at bedtime. too high or too low.
Insulin Therapy: When pills aren’t Medications help control blood sugar levels when
enough, insulin injections may be needed. lifestyle changes aren’t enough. Insulin therapy helps
There are different types of insulin that your body use sugar properly and prevents high blood
sugar.
can be used depending on your needs.
Dietary Changes: Eat a balanced diet A balanced diet helps keep your blood sugar levels
with controlled portions of carbohydrates. steady and reduces sudden spikes. Eating healthy also
Focus on whole grains, fruits, vegetables, helps with weight control, which is important because
lean proteins, and healthy fats. Avoid being overweight is a big risk factor for T2DM.
sugary and processed foods.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

I. MANAGEMENT
MANAGEMENT RATIONALE
Oral Medications: Oral medications may be Some oral drugs can cause low blood sugar or have side
stopped temporarily and reintroduced when effects in hospital settings.
appropriate.
Weight Management: Aim to lose weight Even a small amount of weight loss (about 5-10% of your
slowly by eating fewer calories, making body weight) can make a big difference in controlling your
healthier food choices, and staying active. blood sugar and improving insulin sensi tivity.

Education and Self-Management: Learn Being informed helps you take control of your health and
about the condition, how to follow the stick to your treatment plan, leading to better long-term
treatment plan, and how to recognize the results. T2DM increases the risk of heart disease, nerve
symptoms of low or high blood sugar. Go to damage, and kidney problems. Regular visits help detect and
regular checkups to monitor your blood manage these complications early.
sugar levels (A1C), blood pressure,
cholesterol, and kidney health.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

II. MEDICATIONS
DRUG/ DOSAGE/ ROUTE/ FREQUENCY THERAPEUTIC CLASSIFICATIONS

Potassium Chloride (Kalium Durules) 2 Electrolyte Supplement

tabs 750 mg TID
Supracid (Sodium Bicarbonate) 650 mg Alkanizing Agent/ Antacid
tab BID
Gemigliptin (Zemiglo) 50 mg OD after Dipeptidyl Peptidase-4 (DPP4) Inhibitor
bfast

Sangobion (Multivitamin and Minerals) 1 Iron Supplement

tab
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

II. MEDICATIONS
DRUG/ DOSAGE/ ROUTE/ FREQUENCY THERAPEUTIC CLASSIFICATIONS

Tranexamic Acid (Hemanex) 500mg/1cap q8 Antifibrinolytic Agent

Jardiance Duo (Emagliflozin-Metformin Antidiabetic Combination

HCI) 12.5mg/1g

Toujeo 14 units (Insulin Glargine Injection) Long Lasting Insulin

Dapagliflozin (Forxiga) Sodium-glucose constransporter-2 (SGLT2) inhibitor

COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

IV.DIET

DM DIET
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Course in the Ward

Presented by:
ROQUEZA, JERCY WAYNE P.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

Sept 11, 2024 Please admit room of choice, under the service of Dr. Luna, The patient is admitted under Dr. Luna's
8:27 PM - secure consent for admission and management care, with consent obtained for all
- monitor vital signs I&O Q4 record treatments. Close monitoring of vital signs,
RBS high - IVF PNSS FD 500cc now then regulate to 140cc/hr after fluid balance, and blood sugar is essential
- Diet- dm diet due to the diagnosis of diabetic
- Diagnostics; abg, k, rbs, chest x ray, urinalysis, rbs in AM ketoacidosis (DKA), a serious condition that
- complete lipid in profile AM requires frequent checks. IV fluids will help
- crea, ALT, CBC, Na, Ca, 12 L ECG with hydration, and the diabetic diet will
help manage blood sugar. Regular insulin is
Therapeutic: given to lower blood sugar, with close
- give 8 units regular insulin SQ now monitoring to adjust the dose as needed.
- cbg q1 monitoring Blood tests, including ABG, CBC,
- AP inform of this admission electrolytes, and a chest x-ray, are ordered
- refer accordingly to monitor the patient's overall condition.
ICU admission is recommended due to the
severity of the illness.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

9:30 PM - phone order of Dr. Luna to NOD

- imp; DKA
- start regular insulin drip 100units in 100cc PNSS 5cc/hr
- CBC q1 hour
- hold drip for cbg less than 150mg per dl or decrement of more
than 100mg per dl,
- NAHCo3 650mg 1 tab bid, first dose now
- serum K, monitoring q6hrs while on a regular insulin drip
- ABG tom AM
- ideally for ICU please advise
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

Sept 12, 2024 Text order of Dr. N.Luna increases insulin drip to 14cc per This increase is needed for better control of the patient's blood
12:08 am hr. sugar levels in diabetic ketoacidosis (DKA). Continuous monitoring
of blood glucose and potassium levels is essential to prevent
12am = 351mg/dl
complications.

6:34 am Text order of Dr. Luna to NOD, maintain insulin drip to Continuing the insulin drip helps maintain blood sugar control in
14cc per hour diabetic ketoacidosis (DKA). Potassium chloride (KCL) tablets are
Rbs @ 6am 235mg/dl prescribed to prevent or treat hypokalemia, which can occur with
- KCL tab TID
insulin therapy.

11 am Text order of Dr. Luna to NOD Stopping the insulin drip indicates that the patient's blood sugar
With ongoing insulin drip - OFF HR DRIP levels are stabilized. Advising a diet as tolerated allows the
RBS at 11am – 78mg/dl - advice to DAT patient to resume eating based on their appetite and condition.

11:48 am Text order of Dr. Luna to NOD Administering 500ml of PNSS is essential for rehydration and
Decrease after fast drip Run 500ml PNSS maintaining fluid balance, especially in patients with conditions
BP= 100/70 like diabetic ketoacidosis (DKA) or dehydration. This helps ensure
the patient receives adequate hydration and supports overall
metabolic function.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

1:09 pm Text order of Dr. Luna to NOD This is needed to control blood sugar levels after
Rbs= 352mg/dl reassessment, ensuring effective management of
-resume insulin drip at 8cc/hr hyperglycemia.
3:33 pm Text order of Dr. Luna to NOD Maintaining the insulin drip at 20cc per hour ensures
Rbs= 428mg/dl - continue HR drip at 20 ccc/hr ongoing blood sugar control while flushing the IV site
Do IV site flushing on HR drip prevents blockage and maintains proper infusion flow.
History of vaginal Referred to obgyne This referral is made to ensure specialized assessment
bleeding moderate in - Dr. Arias for evaluation and management per relatives req. and treatment by an OB-Gynecologist, addressing the
amount for almost concerns raised by the patient's relatives.
months
5:30pm Text order of Dr. Luna to NOD Following Dr. Nosce's orders ensures consistent
Consent for referral to -carry out orders of Dr. Nosce management of the patient's hydration and insulin
OBGYNE Same IVF to follow PNSS 1L X 140CC/HR needs. The specified IV fluid rate maintains hydration,
RBS=466 mg/dl -Insulin drip to 25 cc/hr while the increased insulin drip helps control blood sugar
levels effectively.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

GYN-ONCOLOGY NOTES PWI. Cervical mask probably malignant P/ consent The cervical biopsy is necessary to confirm whether the
66y/o G8P8 (8008) referred because of for cervical biopsy cervical mass is malignant, guiding further treatment. A
vaginal bleeding 2 mos -repeat cbc now include blood typing (same blood) repeat CBC with blood typing helps assess for anemia due
No site of abdominal dredge difficulty -start tranexamic acid 500mg/cap, 1 capsule q6 to the prolonged vaginal bleeding and prepares for
in bowel/ bladder habits. -for ultrasound of whole abdomen possible transfusion. Tranexamic acid is prescribed to
PE breast ? (+) pallor -transvaginal ultrasound tom. control bleeding. Ultrasounds of the abdomen and
Unpalpable -Specimen for histopath transvaginal area will evaluate the extent of the mass and
Abdomen flabby soft marked no mass -(cervical biopsy done) check for any abnormalities. Histopathology from the
IE cervix friable enlarge to 4 x 5cm -Thank you for this referral biopsy will provide a definitive diagnosis and help
Right parameter determine the next steps in managing the patient's
Left parameter shorted -Will follow up condition.

8:08 pm Text order by Dr. Luna to NOD Resuming the insulin drip at a lower rate (3cc/hr) helps
maintain stable blood sugar levels after it was temporarily
RBS @ 8pm= 185mg/dl with insulin -Resume at 3cc/hr stopped, preventing a rebound increase in blood glucose
drip at 25cc/hr while allowing gradual adjustment.
Off @8pm
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

8:48 pm Repeat Na on the next blood draw This ensures proper electrolyte monitoring, adjusts insulin
-temporarily discontinue regulate insulin drip at therapy, and coordinates care while investigating possible
10pm tonight. infection.
- CBG 12mn and 2am
-Start tom regulate insulin 8 units SC Tid pre meals
-Co-management with Dr. Nosce
Sputum gen expert
-add omit 9pm K monitoring
-proceed with 3am blood draw
Sept 12 Text order of Dr. Guzman to NOD Rechecking CBC monitors the patient’s blood status, while
9:53 pm -Repeat CBC on next blood extraction for 02 oxygen inhalation ensures proper oxygenation if needed
inhalations at 2-3lpm per to maintain adequate respiratory function.

Sept 13 Text order by Dr. Luna to NOD start ceftriaxone Initiating ceftriaxone is essential for treating or preventing
6:35am (vexon) gms in 90cc NSS x 1-2 hrs now then q24 infection. The specified infusion over 1-2 hours ensures
safe administration, and the follow-up dosing every 24
hours maintains effective antibiotic levels.
D/c o2 Discontinuing O2 therapy indicates improved respiratory
-continue tranexamic acid if bleeding for 5 days status. Continuing tranexamic acid helps manage
-may follow up as outpt with histopath result bleeding. Scheduling an outpatient follow-up ensures
-relay ultrasound result timely review of histopathology results. relaying
ultrasound results keeps the patient informed about their
condition.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Date and Time Doctor’s Order Rationale

1:26 pm - discontinue K monitoring Discontinuing K monitoring reflects stability. Increasing

- increase (?) to 18u/SC 8am insulin aids blood sugar control, while KCl supports
Not in distress fully awake - Give Kcl tab for 3 more doses then d/c potassium levels. Dapagliflozin helps manage glucose, and
K 3.60 off HR anp - dapagliflozin 10mg/tab 1tab OD after lunch holding premeal insulin avoids unnecessary dosing. The
BP 90/60 (forxiga) discharge plan indicates improvement, and holding
HR 66 - hold premeal insulin diphenhydramine prevents unnecessary medication.
Na 137 - regular insulin scale
CBGs improved - 160-200mg/dl 2un/sc
- 201-250mg/dl 4un/sc
- More than 251 6un/sc
For possible discharge tom.

- Hold diphenhydramine 25mg IV STAT DOSE

 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Nursing Care Plan

Presented by:
SALES, ANDREA MAE F.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Drug Study

Presented by:
CALVARIO, JHAMAICA ANGELA A.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
COLLEGE OF NURSING
Calayan Educational Foundation, Inc.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Discharge Planning

Presented by:
IMPERIAL, MA. ALECKZANDRA NERISSE C.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

Discharge Planning
(M.E.T.H.O.D.S)
Discharge planning for patient with Diabetes Mellitus Type 2 . Key components of the plan include:

1.Medication:

● Take medications as prescribed by the Physician

● Do not change the amount of dose of the given medication

● Continue insulin intake (JARDIANCE DUO) to reduce glucose reabsorption and to increase glucose excretion in urine

2. Exercise:

● Provide adequate rest as needed

● Encourage gentle exercises such as walking to promote blood circulation

● Promote resistance exercises at least two times a week to improve muscle strength and glucose metabolism
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

3. Treatment:
Seek hospital care immediately if:
● Dizziness and Hyperglycemia

4. Health Teaching
● Explain what Type 2 Diabetes is and how it affects blood sugar levels.
● Discuss the role of insulin and glucose in the body.
● Teach how to use a glucometer, including proper technique for blood sampling.
● Explain when and how often to check blood glucose levels.
● Encourage keeping a log of blood glucose readings to identify patterns and triggers.

5. Outpatient Follow-up:

● During follow-up care, educate the patient on the value of routine check-ups to track their health's improvement and make any treatment
adjustments.

6. Diet

● Eat fruits and vegetables

● Whole grains like brown rice and wheat bread
● Lean protein such as fish and low-fat dairy products
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

7. Spiritual Support:

● Assess and respect the patient's spiritual beliefs and practices.

● Suggest keeping a spiritual journal to reflect on personal experience

● Discuss how their beliefs influence their health decisions and coping mechanisms.

● Introduce techniques such as meditation, prayer, or deep breathing exercises to help manage stress and improve emotional
well-being.
 Evolve.
Adapt.
Overcome.
CEFI is now ready.

Prognosis

Presented by:
LUSANTA, LEONORA D.
 COLLEGE OF NURSING
Calayan Educational Foundation, Inc.

PROGNOSIS
A 66 years old female was admitted to mt Carmel Hospital with chief complaint of Dizziness and diagnosed with Diabetes
Mellitus type 2 poorly controlled.

The woman overall health is good as demonstrated by absence of any further complaints. Following nursing interventions,
medication delivery and health education regarding on her home medication rendered. Patient has managed her blood sugar in stable
level that posed no risk of further problem. She was discharge without further complaint.

Vital Signs
T: 35.5
P: 64bpm
RR: 17breaths per min
BP: 110/70mmhg
O2sat:98 %
Evolve.
Adapt.
Overcome.
CEFI is now ready.

THANK YOU