URN QUT752| PATIENT Josephine Hayes

URN: QUT752| PATIENT: Josephine Hayes
DOB: 30/06/2005 | Room: ED
Josephine Hayes is an 15 year old girl who has just arrive in emergency department after
falling off her bicycle on the way to school. Josephine has a history of type 1 diabetes which
was diagnosed when she was 12 years old. Josephine normally manages her diabetes herself
and states that she understands how to look after. She seems defensive in the way she says
this.
Josephine has sustained a fractured right radius, which will require to be set in a cast for 6
weeks. Her right arm is her dominant arm. She states 6/10 pain on rest and 8/10 on
movement.
On examination, all vital signs are within normal limits except for her blood glucose level (BGL)
which is 18mmol/L and her temperature which is 38.4 deg C.
You also notice a small wound on Josephine’s left toe which looks to be old, purulent, red and
a little swollen. It is infected. When you ask Josephine about it, she states she has never
noticed it before and must have got it when she fell of her bike.
When Josephine’s mum arrives to collect her, she asks to speak to you privately and voices
concerns that Josephine’s diet is not as good as it could be for someone with her condition and
she is frequently eating unhealthy snack food with her schoolfriends. Josephine has gained a
significant amount of weight in the last 6 months

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