Hypoglycemia: blood glucose 52 with diaphoresis and tremor — treated with 15 g of fast-acting carbohydrate per protocol, rechecked in 15 minutes at 88 with resolution of symptoms; the next insulin dose held per parameters pending review, SBAR to the provider, the cause (a missed meal) identified, and the responsible party notified. Will reassess glucose and intake; supports the Section N update. Skilled recognition and treatment required — a daily SNF-level need.
Model abnormal 2
Hyperglycemic crisis concern (DKA/HHS): glucose 480 with polyuria, thirst, lethargy, and, on the ordered check, positive ketones — concerning for evolving DKA. Correction insulin administered per the ordered scale, hydration encouraged, labs obtained per order, the provider notified, and the resident monitored for DKA/HHS signs (mental status, Kussmaul respirations, vital signs). Escalation criteria reviewed; will reassess. Skilled recognition and escalation required.
