Chamberlain University College of NursingNURSING NR602NR601 _WK5 case study

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METABOLIC CASE STUDY 1 Chamberlain University NR601: Primary Care of the Maturing and Aged Family Practicum April 5, 2020 Mrs. G. It is paramount to accurately and safely diagnose and treat all p... atients, especially those who fit within the maturing population. The following pages demonstrate the diagnosing and creation of an appropriate treatment plan for Mrs. G. by utilizing evidence-based literature and 2 METABOLIC CASE STUDY clinical practice guidelines. A primary diagnosis with a secondary diagnosis and associated pertinent findings, tests and treatment plans will be included. Assessment Primary Diagnosis: Diabetes Mellitus II (E11.0) Pathophysiology: Type 2 diabetes is present when the pancreas recognizes the need for insulin production in due to increased level of glucose but over time has become insulinresistant as its ability to force glucose into the cell ceases causing hyperglycemia (Skyler et al., 2016). Thirst, fatigue, excessive hunger, and increase in frequency of urination are results of an increase in free glucose (ADA, 2019a). Pertinent Positive Findings: In addition to fatigue, Mrs. G. possesses the three trademark signs of type 2 diabetes: polyuria, polyphagia and polydipsia. Mrs. G. also has a HgBA1C of 6.9%, glucose 95, 1+ glucose in her urine, BMI of 32.8. Although Mrs. G. has a fasting glucose of 95 mg/dL, the ADA (2019a) states that a HgBA1c greater than 6.5 % is within diabetic range. Pertinent Negative Findings Negative findings include nocturia, weight gain, and a nonsedentary lifestyle (ADA, 2019a), as well as a negative family or past medical history of diabetes. Rationale for the Diagnosis: Mrs. G.’s weight gain regardless of participating in an exercise regimen, increased hunger, exhaustion and disproportionate thirst are subjective indications for having type 2 diabetes. Objectively Mrs. G. is an obese 55-year-old Hispanic female with a BMI of 32.8 (Calculate Your BMI - Standard BMI Calculator, 2019), with a 50% greater chance of becoming diabetic due to her ethnicity at a younger age than other ethnicities (CDC, 2019c). 3 METABOLIC CASE STUDY Although she has a fasting blood glucose of 95 mg/dL, her HgbA1C of 6.9% is indicative of type 2 diabetes. Lab work also revealed glucose in her urine which is telltale of diabetes (Dunphy et al., 2015/2019). These findings increase Mrs. G.’s likelihood of being a diabetic (ADA, 2019a). Secondary Diagnosis: Secondary Hyperlipidemia (E78.2) Pathophysiology: According to Onwe et al., (2015), secondary hyperlipidemia results from underlying diseases such as diabetes, occurs due to the postprandial absorption of chylomicrons (small fat globules comprised of lipid and protein) 30-60 minutes after ingestion of a meal containing fat that raise plasma triglycerides for 3-10 hours. Hyperlipidemia does not generally produce symptoms but can lead to atherosclerosis or coronary heart disease in adults. [Show More]

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