Develop discharge instructions specific to this case. Mr. Cyron, 40 years old, arrives at the eye clinic for a routine eye exam. He has had a history of NIDDM (Non-insulin-dependent Diabetes Mellitus) for 10 years. He complains of progressive blurring of vision since his last visit a year ago. He is unable to say which eye seems to be worse. He verbalized difficulty in reading street signs while driving. He has no other complaints like eye pain, floaters, or diplopia. He admits that he was going through tough times with disrupted marriage and divorce issues, due to which he was unable to concentrate on his diabetes management. He feels that his recent family disputes and stress have made his blood sugar levels worsen. He tries to cope with stress by overeating and taking in a lot of junk food. He reports missing diabetes medications many times. He has a recent history of hospitalization with diabetic ketoacidosis 3 months back with a blood sugar level of 410 mg/dl on admission. He is a known case of hyperlipidemia, type 2 DM, obesity, and hypertension. His current medications include lisinopril, metformin. He has been a chain smoker for almost 15 years and reports occasional social drinking. There is no family history of any ocular diseases like blindness or diabetic retinopathy. He has no past history of eye trauma or eye surgeries. There have been no previous diabetes- related eye manifestations. On eye assessment, his pupils are round and equally react to light. Visual acuity is 20/40 in both eyes. Intraocular pressure is normal (15 mmHg in both eyes). A fluroscein angiography was recommended by the doctor. The results showed abnormal vasculature (microanuerysm with leakage). Neovascularization of the disc of the right eye was also reported. He was diagnosed with proliferative

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Develop discharge instructions specific to this case. Mr. Cyron, 40 years old, arrives at the eye clinic for a routine eye exam. He has had a history of NIDDM (Non-insulin-dependent Diabetes Mellitus) for 10 years. He complains of progressive blurring of vision since his last visit a year ago. He is unable to say which eye seems to be worse. He verbalized difficulty in reading street signs while driving. He has no other complaints like eye pain, floaters, or diplopia. He admits that he was going through tough times with disrupted marriage and divorce issues, due to which he was unable to concentrate on his diabetes management. He feels that his recent family disputes and stress have made his blood sugar levels worsen. He tries to cope with stress by overeating and taking in a lot of junk food. He reports missing diabetes medications many times. He has a recent history of hospitalization with diabetic ketoacidosis 3 months back with a blood sugar level of 410 mg/dl on admission. He is a known case of hyperlipidemia, type 2 DM, obesity, and hypertension. His current medications include lisinopril, metformin. He has been a chain smoker for almost 15 years and reports occasional social drinking. There is no family history of any ocular diseases like blindness or diabetic retinopathy. He has no past history of eye trauma or eye surgeries. There have been no previous diabetes- related eye manifestations. On eye assessment, his pupils are round and equally react to light. Visual acuity is 20/40 in both eyes. Intraocular pressure is normal (15 mmHg in both eyes). A fluroscein angiography was recommended by the doctor. The results showed abnormal vasculature (microanuerysm with leakage). Neovascularization of the disc of the right eye was also reported. He was diagnosed with proliferative diabetic retinopathy of both eyes.

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