FNP NR507 - Week 6 CS - Diabetes
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Chamberlain University College of Nursing *
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507
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Nursing
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Apr 29, 2024
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Week 6 Case Study - Diabetes
Pathophysiology & Clinical Findings of the Disease
1.
Based on the review of the history, physical and lab findings what is the most likely diabetes
diagnosis for this patient? Based on the review of the case study information regarding the history, physical and lab findings outline for this patient, the most likely diabetes diagnosis for this patient is Type 2 diabetes based on:
Age: 48 yrs.
PMH: HTN, HDL, Obesity
familial history (brother)
OGTT = 220
HbA1C = 7.2
Glucosuria
Signs and symptoms: weight loss, fatigue, extreme thirst, fruity breath
2.
Explain the pathophysiology associated with the chosen diabetes diagnosis.
Since diabetes type 2 develops slowly and gets worse over time, it is known as "adult diabetes" (Galicia-Garcia et al., 2020). The pancreas is prompted to create and release more insulin when
blood glucose levels are high. By attaching itself to the receptors on organ cells, insulin tries to lower blood glucose levels. The insulin does not enter the cells or function properly through the insulin receptors that typically bind to the insulin. The prolonged period of elevated blood glucose levels stems from this phenomenon, as the glucose is not absorbed and transferred to the cells (ElSayed et al., 2023; Galicia-Garcia et al., 2020). The pancreas receives this information and begins producing and secreting even more insulin. The kidneys will then eliminate the glucose that is in the blood, resulting in glucosuria, which can lead to osmotic diuresis. Frequent urination (polyuria) leads to dehydration. The brain has been primed to indicate the need for more fluid if this persists. Less energy is being produced in the muscle cells as a result of the circulating glucose that typically supplies the organs. The brain receives signals from the organs when they are deficient in nutrition and energy. This makes you feel exhausted and extremely hungry. The pancreas eventually stops reacting to the cue to produce
more insulin as this cycle continues, which causes the blood's level of glucose to keep rising (Galicia-Garcia et al., 2020).
3.
Identify at least three subjective findings from the case which support the chosen diagnosis.
The case study presents the following three of the many subjective findings to support the chosen diagnosis:
Fatigue
Weight loss
Polyuria (> 4 X per night)
(Galicia-Garcia et al., 2020)
Week 6 Case Study - Diabetes
4.
Identify at least three objective findings from the case which support the chosen diagnosis.
The case study presents the following three of the many objective findings to support the chosen diagnosis:
Fruity breath odor
Urinalysis: Glucosuria
A1C: 7.2
(Galicia-Garcia et al., 2020).
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
1.
Identify two (2) “Evidence A”
recommended medication classes
for the treatment of this condition and provide an example (drug name) for each.
The goal of “Evidence A” recommended pharmacological treatment regimen should include medications with adequate efficacy that will reduce cardiorenal risk and be seamless to maintain. One of the drug classifications is glucagon-like peptide 1 (GLP-1), either oral form or injection. Another drug classification is sodium-glucose co-transporter-2 (
SGLT2
inhibitors) (ElSayed et al., 2023; Practice guidelines resources, 2023
)
The GLP-1 agonist drug example is Ozempic (semaglutide) and the SGLTs inhibitors drug example Empagliflozin (Jardiance w/metformin) (ElSayed et al., 2023;
Practice guidelines resources, 2023
).
2.
Describe the mechanism of action
for each of the medication classes identified above.
The mechanism of action for the GLP-1 agonist drug Ozempic (semaglutide) works by binding to the
GLP-1 receptors in the pancreas and then stimulating the pancreas to release
insulin,
reduced glucagon release-responses which lowers blood sugar. These effects can help manage blood sugar and decrease blood sugar spikes by inhibiting gastric motility and secretion (
Practice guidelines resources, 2023
).
SGLT-2 inhibitor drugs are administered in oral form and its mechanism of action depends on the individual’s kidney function. This drug class reduces the amount of glucose being absorbed in the kidneys by preventing the action of SGLT2 cotransporters in the kidney. Further explanation, SGLT-2 reduces renal tubular
glucose reabsorption,
which produces a reduction in blood glucose without stimulating
the pancreas to produce and release insulin (ElSayed et al., 2023;
Practice guidelines resources, 2023
)
3.
Identify two (2) “
Evidence A
” recommended non-pharmacological treatment
options for this
patient.
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Presentation on type 2 diabetes
1 introduction and cause
2. Causes and diagnosis
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Case study #4
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Assessment of Patient 3
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1.) Which of the following statements identifies the cause and some symptoms of diabetes insipidus?
A.) Lack of insulin results in high blood glucose levels and excessive urination
B.) Lack of glucagon results in low blood glucose levels and fainting
C.) Lack of ADH results in extreme thirst and excessive urination
D.) Lack of ADH results in water retention and high blood pressure .
2.) A lack of insulin production by the pancreas leads to various symptoms such as excess urination, thirst, lack of energy and fatigueThe direct cause of a lack of energy and fatigue is that
A.) body cells do not absorb glucose from the blood
B.) body cells burn glucose supplies too rapidly
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6 of 24
Summary
Post test 1: Multiple Choice
Direction: Read the questions comprehensively and write the letter of your choice in your
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1. It refers to any activities which involves movement of the muscles of our
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a. Physical change
b. Physical Body
c. Physical Activities
d. Physical appearance
2. The following are examples of physical activities EXCEPT?
a. Eating and Drinking
b. Running
c. Pilates
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3. These are Physical activities that were planned and more structured it also
gives us the opportunity to embrace healthy and active lifestyle by doing so.
a. Physical fitness
b. Exercise
c. Yoga
d. Physical education
4. These type of Physical Activities are also known as "cardio exercise" it
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breathe harder our heart pumps blood more vigorously, causing oxygen to
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a. Aeronautic activities
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Case study #2
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16-The nurse is instructing the parents of a child with iron deficiency anemia
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2.Administer the iron through a straw.
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2. Headache
3. Gradual onset
4. Skin is pale, cool, and clammy
5. Drowsiness
6. Thirst is intense
7. Fruity odor from the mouth
8. Pulse is full and pounding
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