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Original Question

Kath Jones is 78yo. She has early stage dementia and T2 diabetes, but still manages to live at home. She has a support worker come in once a day in the mornings to help her. Kath still likes to go to bowls with her friends and yesterday she attended a function at the club. She enjoyed some green salad from the lunch-time buffet but developed some nausea after she got home and didn’t have any dinner. She took her T2 diabetes medications, metformin and gliclazide (a sulfonylurea drug) with a large glass of water and went to bed. (Note: gliclazide is a drug which stimulates the pancreas to increase insulin secretion.) Her care worker found her semi-conscious in the morning and called an ambulance. Collect cues: Vital Signs RR=19bpm SpO2 = 100% BP = 135/85 mmHg (MAP 102 mmHg) HR=120bpm Temp = 36.2 degrees Peripheral blood glucose monitoring BGL = 3.7 mmol/L Ketones = 0 mmol/L (ref range < 0.1 mmol/L) Neurological assessment • GCS12 • Pupils = EQUAL, ROUND, REACTIVE to LIGHT & ACCOMMODATION (PERRLA) Other data skin is pale and clammy to touch skin turgor - normal peripheral pulse - bounding

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