Why should medications other than glipizide or glyburide be considered for management of diabetes in this patient? List four sighs of dehydration in this patient? What is the significance of xerosis and cracking of the feet in this patient?
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- 50-yr-old, female: Dx: Diabetes Insipidus 1. Define/describe the disease. 2. Explain the Anatomy and physiology involved in the disorder. 3. Show a short you tube video that explains the disease process.Patient C., 32 y/o, complains of excessive weight, shortness of breath, defective memory, performance decrement, feeling cold, emotional retardation. It is known from the case history that the patient is suffering from primary hypothyroidism. Objectively: the skin is dry, waxlike, swollen, periosteal reflexes are lowered, body mass index: 33.5 kg/cubic meter, TSH (thyroid-stimulating hormone) – 25 µU/dL (norm 0.5 -5.0). Obesity is homogenous. Arterial pressure: 150/100 mm column ob mercury. What type of obesity can be suspected?A. Endocrine hypothyroidB. Endocrine accompanying dysfunctions of hypothalamopituitary systemC. Alimentary constitutionalD. HypothalamicE. Androidal with the developed symptoms of metabolic syndromeCase Study #3 Pationt History "A week before perlod starts, I experience lower abdominal pain that radiates into the lower back and both legs. I have been trying to get pregnant for the past two years with no suCcess. Modical History T.R. Is 29 years old white female who is at the OB/Gyn office. She has painful Ireqular perlods that start a week before menstruation starts. The menstrual tlow is heavy (need to change pads every 2 hours) with clots. She explained that she has been trying to get pregnant for the past Physical Exam Abdomen Exam 兼 LLQ and RLO palpation: Tenderness Female exam No tears, swelling of vaginal canal Normal cervical mucous, cervix of normal length, and no obstruction to cervical opening No signs of infection internally/externally of vagina and labia Questions 1 Research: What is the most common cause of chronic pehvic pain and infertility in women of reproductive-age? How frequent is this disease? 2 Is this disease eatropen dependent? What tissue is. stimulated…
- John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome? Identify 2 IntraOp nursing diagnoses for Mr. Doe teaching does Mr. Doe require in order to prevent complications? Give 3-4 examples)Case study diabetes mellitus Eric is a 52-year-old High school principal, who presented with a 2-week history of polyuria, polydipsia, polyphagia, weight loss, fatigue, and blurred vision. A random glucose test performed 1 day before presentation was 352 mg/dl. The patient denied any symptoms of numbness, tingling in hands or feet, dysuria, chest pain, cough or fevers. He had no prior history of diabetes and no family history of diabetes. Admission of non-fasting serum glucose 248 mg/dl (N=<180 mg/dl), HbA1c 9.6% (N=4-6.1%). Electrolytes, BUN and creatinine were normal. Physical examination revealed weight of 180 pounds, height 5'5.5" (IBW 140-145). The rest of the examination was unremarkable,i.e., no signs of retinopathy or neuropathy. The patient was taught self-monitoring of blood glucose and began on 5 mg glyburide once a day. He was instructed in diet (1800 cal ADA). Blood glucose levels ranged from 80 to120 mg/dl within 2 weeks of starting glyburide, his symptoms…Patient K., 34 y/o, complains of excessive body weight, shortness of breath, disruption of the ovarian menstrual cycle, she has been ill since childhood. Family anamnesis is burdened by obesity on the mother’s side. Objectively: BMI – 35.8 kg/cubic meter, dysplastic obesity prevailing in the abdominal area, hypertrichosis. In the abdominal and groin areas there are multiple stretch marks from pearl to burgundy colour. Arterial pressure – 160/100, pulse – 96 beats/minute. What is the treatment for this condition?A. Dietotherapy, sibutramine (influencing the center of hunger and satiation), xenical (blocking GI lipases) B. DietotherapyC. Dietotherapy, thyroxine (thyroid medicines) D. Dietotherapy, furosemide (diuretic medicines)E. Dietotherapy, vitamin therapy
- A.S , 50 y.o male, presents to her family physician with a 3 month history of back painHISTORYPMH : Patient states that she has enjoyed excellent healthMother and brother have been diagnosed with Type 2 Diabetes MellitusFamily history negative for heart disease / hypertensionOn Metformin (decreases hepatic glucose productionSocial History : Married with three children - ages 20, 15, and 10, driver, denies smoking or use of drugs . Inactive lifestyleDiet History:Estimate energy intake of approximately 2800 kcal/day with approximately 1400 kcal from carbohydrates .Patient states that he consumes sandwich with sweetened pop (24 oz)-as Dinner, ice cream and chocolate candy dailyANTHROPOMETRICSHeight 5’9’’Current Weight 225 #Usual weight 200 # ( for the past five years )Lowest adult weight was 170 pounds at the age of 25Waist Circumference 54 inchesPHYSICAL EXAMINATIONBlood Pressure 130/85 mm HgReview of systems normalLABORATORY VALUES…Presentation on type 2 diabetes 1 introduction and cause 2. Causes and diagnosis 3. Nursing intervention and conclusionsN.H. is a 76-year-old male admitted to the hospital through the emergency department. He fell outside his home. It appears that he may have sustained a fracture to his left hip. He has a history of type 2 diabetes mellitus and has a 40 pack-year smoking history that is now complicated by chronic obstructive pulmonary disease. Data Collected (use only those that apply) Complains of excruciating pain and tenderness in left hip Pain not relieved with morphine BP 166/94 mmHg Diaphoretic and pale skin Respiratory rate 36; crackles, expiratory wheeze X-ray of left hip reveals extracapsular fracture Hematocrit 30%; hemoglobin 15g/dL; WBC 15,000/uL Discussion Questions: Considering the nursing process, list in order the steps in transferring patient from bed to chair post operatively.
- Case study 2. pregnant (if you are male). Because of great advances in technology, your institution has granted you free access to amniocentesis and genetic testing for your unborn child; to test for genetic disorders and to avail of genetic counselling. Your test results show that your unborn child has a severe genetic disorder, osteogenesis imperfecta II or III, or what you call “brittle bone disease", wherein, very minimal pressure and exertion can result to multiple bone fractures. If Type II, bone malformities are extremely severe, which may lead to early prenatal You are 3 months pregnant (if you are female); or your wife is 3 months death. If Type III, other complications are stunted growth, possible mental retardation if the fracture occurs in the skull, progressive bone malformities. However, during gestation, it cannot be confirmed whether the disorder is Type II or Type III. The genetic counselling team has given you an option for termination of pregnancy. Will you terminate…Case Scenario: Mrs. J. is a 25-y/o gravida 2, para 1, who was admitted at full term at 5:00 p.m. She stated that she had been having contractions at 8 to 10-minute intervals since 4 p.m. They lasted 25 seconds. She also stated that she had been having "a lot of false labor" and this makes her still able to feed and able to maintain a conversation and is getting excited. But now she hoped that this was "the real thing". Her membranes were intact. Mrs. J.'s temperature, pulse, and respirations were normal and her blood pressure was 115/70. The fetal heart tones were 140 and regular. The nurse examined Mrs. J. and found that the baby's head was at +1 station, and the cervix was 4 cm. dilated and 70 percent effaced. As the labor progresses, there will be some discomforts Mrs. J will experience. By accomplishing the table below, you will be able to anticipate these discomforts then may be able to apply measures to alleviate or assist Mrs. J to have a safe delivery. Stages of Labor Other…Case Scenario: Mrs. J. is a 25-y/o gravida 2, para 1, who was admitted at full term at 5:00 p.m. She stated that she had been having contractions at 8 to 10-minute intervals since 4 p.m. They lasted 25 seconds. She also stated that she had been having "a lot of false labor" and this makes her still able to feed and able to maintain a conversation and is getting excited. But now she hoped that this was "the real thing". Her membranes were still intact. Mrs. J.'s temperature, pulse, and respirations were normal and her blood pressure was 115/70. The fetal heart tones were 140 and regular. The nurse examined Mrs. J. and found that the baby's head was at +1 station, and the cervix was 4 cm. dilated and 70 percent effaced. By accomplishing the table below, you will be able to determine the progress of labor of Mrs. J. Give a short and concise description of each stage of labor using the attached table. Stages of Labor Other Name Description Duration 1st Stage Latent Phase Active…