This might have been the reason why Nancy was more irritated and agitated. It can be seen that Nancy had to remain awake at night for completing her thesis for which she had to take resort to soft drinks and caffeine. Sweetened beverages are digested fast and thus have high glycemic index (Jiang et al. 2014). According to Ducat et al.(2014), too high levels of diabetes can lead to diabetic seizures, that canlead to confusion in the patient. Experimental studies have shown that a threshold concentration of glucose is required for supporting the synaptic transmission (Zochodne 2016). The GCS scale showing confusion might have been due to the diabetic seizures. Predict: What may happen to your patient if you take NO action and why? (100 words)If Nancy is left untreated then life threatening condition like diabetic coma can occur. People lapsing in to a diabetic coma might not awake or respond to any stimulation such as sounds or sights. Diabetes is also associated with high heart rate, kidney damage and cardiovascular risks. High blood glucose levels may contribute to the deposition of the fats in the coronary arteries leading to stroke (Goldstein and Müller-Wieland, 2016). Furthermore diabetic ketoacidosis can occur in Nancy, due to which the fat reserves of the body are broken down to ketone bodies that can be found in the urine of patients with type 1 diabetes.Identify the Problem/sList in order of priority at least three key nursing problems (not included in word count)The three key nursing problems related to this case study are:- Risk for unstable blood glucose level.Risk for disturbed sensory perfection.Risk for impaired skin integrity.Establish Goals & Take ActionFrom the above (identify problems), use the top 2 nursing problems identified and for each of these establish one goal and thenlist related actions you would undertake, including detailing any relevant nursing considerations (350 words)Problem 1GoalRelated actionsRationaleRisk for the unstable blood glucose level To make the blood glucose level less than 180 mg/dL, and hemoglobin level <7%.Monitoring the blood glucose level before and after the meal. To report if the blood pressure is more than 160 mm and accordingly hypertensive medicationscan be applied (Gan et al. 2012).Assess for anxiety, slurring tremors and speech. The normal blood glucoseshould range between 140 to 180 mg/dL. Hypertension is quite common in diabetes and is normally associated with high risks of cardiovascular diseases. Confusion, tremors and seizures may indicate towards serious complication in diabetes 3

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