Sarah, who is 54-years-old, has had type 2 diabetes for the last two years

Sarah, who is 54-years-old, has had type 2 diabetes for the last two years. She presents to

the diabetes clinic for her regular follow up appointment. You are the clinic nurse today. When

you ask her how she has been, she says she has noticed she is voiding more than in the past

several weeks. You note that her breath smells fruity, and lips are visibly dry. She also tells you

she feels tired all the time, with little energy, and often feels sick to her stomach. She

complains of intermittent abdominal pain. She mentions when she was driving to this

appointment, she noticed that her vision was blurry which worries her. She reveals that she

has not been checking her blood sugar recently because she could not afford the test strips.

She also tells you that her car broke down and she had been without a vehicle for over 2

months. She tells you life is difficult on social assistance.

Questions:

1. Using Tanner's Model of Clinical judgement (

Thinking like a nurse: article is posted in the

Content section

):

a. What do you notice about Sarah? List 3, but may only include 1 medical-surgical/

pathophysiology answer to this.

(/3)

b. Using Tanner's Model, what is your interpretation of this scenario?

(/3)

c. Based on your interpretation, what do you need to ask Sarah? List 3 questions

and provide your rationale (which is the data to support the questions you are asking)

(/6)

d. What assessment data (or information) do you need to communicate to the diabetes

team (or Physician? Nurse Practitioner? Social worker?)

(/2)

2. List 3 social determinants of health that could influence Sarah's health and explain how

these determinants could influence her health.

(/4)

3. If Sarah were Indigenous, why would it be important for you as the nurse to understand the

TRC calls to action?

(/2)