CLASS NAME: PRIMARY CARE CHRONIC CONDITIONS ACROSS THE LIFESPAN
LESSON 1: Endocrine and metabolic disorders
DISCUSSION: Treating diabetes
DISCUSSION POST INSTRUCTIONS:
Introduction
At the end of this discussion, you will be able to demonstrate advanced skills in the physical assessment, pharmacology, and nursing interventions in the treatment of endocrine disorders. (CO7)
Discussion Guidelines
Initial Post
Complete the following case study regarding a diabetic patient. After completing the activity, develop a treatment plan for the patient. Be sure to give rationales for your plan and support your decisions using reliable resources. Your plan will serve as your initial post. Cite your references using APA style.
Treating Diabetes Transcript
Treating Diabetes Transcript
Slide 1
Assess patient’s symptoms and identify the disorder. Examine the patient and diagnosis issues. Create a plan of care for him using the notes gathered throughout the media piece.
Slide 2
You are a nurse practitioner at a clinic that treats many different types of patients. When you look at your schedule of patients for the day, you realize there is a new patient on your list. He made the appointment because he was complaining about certain issues that had been transpiring. Your task is to review his medical history and set up a treatment plan for him before he leaves the office.
Slide 3
When you ask the front desk for the files that his previous doctor was supposed to send over, the secretary tells you that their computers are down and that she cannot retrieve that information because that is stored in the office’s mailbox. She tells you that she has called the other doctor’s office and has asked them to fax the patient’s medical history, but she does not know how long that will take. The patient is sitting in the room waiting for you to come in and discuss his issues. You walk into the room without reviewing his file because he has been waiting for over 30 minutes.
Slide 4
Your task is to ask the patient these questions so that you can gather enough information to diagnose his disorder and set up a treatment plan. Please select question to get started.
Question: What brought you in today?
Answer: Well, I am 86 years old and I rarely feel 100% anymore, but lately I have been really tired, and I am constantly hungry and very thirsty.
Question: How often do you have these symptoms?
Answer: It has been occurring very often over the last month.
Question: What symptoms are you experiencing?
Answer: I also have a problem seeing things well. I never had issues with sight in the past, but lately my sight is very blurry.
Question: How long have you have the symptoms?
Answer: Like I said, I have been experiencing these symptoms over the last month.
Question: Are you on any medications?
Answer: I have been taking a multivitamin, a statin, and an aspirin every day.
Question: Do you follow a special diet? If so, explain.
Answer: I am not on any special diet. I tend to eat out a lot since I live alone.
Question: Are you having pain right now? If so, where?
Answer: I have pain in my feet. Every time I lay down, my feet go numb. I also cut my hand a few weeks ago and it still has not healed properly.
Question: Is there anyone else in your family who has medical issues?
Answer: Both of my parents have type 2 diabetes.
Question: Have you had other tests before to see if it could possibly be diabetes?
Answer: I have had blood drawn before, and my previous doctor said I had high cholesterol. They recommended a statin and that is what I have been taking every day.
You ask the patient to schedule an appointment to have blood work done to try to see what the underlying issue could be.
Slide 5
You are waiting to receive the patient’s blood test results. In the meantime, you receive the patient’s history from his previous doctor.
Patient: SJ.
Race: African American.
Age: 86 years old.
History: Has a life expectancy of less than five years, hypertension, chronic kidney disease, history of CVA, and MI.
Two days have passed, and you receive a call from the lab with his blood results.
Results from the blood test: Fasting glucose is 204 mg/dl and his A1c is 8.4%.
Slide 6
Results from the blood test: fasting glucose is 204 mg/dl and his A1c is 8.4%.
Slide 7
What is your diagnosis? Select one from the list below: Type 1 diabetes, metabolic syndrome type 2 diabetes, hyperthyroid.
Type 2 diabetes is the correct response. His glucose is high, he has kidney disease, and both of his parents have type 2 diabetes.
Slide 8
After looking at all of the labs and reviewing his medical history, what treatment plan would you recommend? Why? Review your notes in reply to the discussion thread about your treatment plan for this patient.
Slide 9
If you would like to go through this activity again, simply click the Replay button, and will be returned to the beginning.
Before attempting to complete your learning activities for this week, review the following learning materials.
Read the following in your Advanced Health Assessment & Clinical Diagnosis in Primary Care textbook:
Chapter 39, “Weight Loss/Gain (Unintentional)”
Read the following in your Primary Care: Interprofessional Collaborative Practice textbook:
• Chapter 186, “Diabetes Mellitus”
• Chapter 191, “Lipid Disorders”
• Chapter 192, “Metabolic Syndrome”
• Chapter 194, “Thyroid Disorders”
The book used for this class and for this assignment is cited here:
Buttaro, T., Trybulski, J., Bailey, P., & Sandberg-Cook, J. (2021). Primary care: Interprofessional collaborative practice (6th ed.). St. Louis, MO: Elsevier Mosby.
Dains, J., Baumann, L., & Scheibel, P. (2019). Advanced health assessment & clinical diagnosis in primary care (6th ed.). Elsevier Mosby.
RUBRIC
CRITERIA EXPECTATION
Relevance of post Posts are consistently related to the discussion topic; posts bring readings into discussion, cite required texts appropriately, and demonstrate significant critical thinking related to the question or case.
Reference and support Uses at least two references to literature, readings, or personal experience to support comments.
Expression within the post Expresses opinions and ideas in a clear and concise manner with obvious connection to topic.
Mechanics Consistently uses grammatically correct posts with rare misspellings. Adheres to all APA guidelines, format, and requirements if needed.
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