Diabetes-related history

Case Study APA paper minimum of 5 pages

History of present illness

A 32-year-old African American female was admitted to the hospital with shortness of breath, nausea, vomiting, and abdominal pain. The patient reports that she was fired from her job approximately 3 months ago and has been unable to afford her supply of medications.

Past medical history

Type I diabetes mellitus, hypertension, hyperlipidemia, pancreatitis, and peripheral neuropathy

Social history

Patient smokes five cigarettes daily, denies drug use, and drinks approximately a six-pack of beer a week.

Diabetes-related history

The patient states that at the time of her initial diagnosis with type 1 diabetes, she was hospitalized with a glucose value >1200 mg/dL and she was experiencing nausea, vomiting, rapid breathing, sweet smelling breath, polyuria, polydipsia, and polyphagia. She reports that she has been on insulin since she was 15 years old, and she has never been prescribed oral agents for diabetes management.

Most recently, she has been using Lantus 70 units once daily, and Novolog 10 units with meals three times daily. Patient was also taking medications for hyperlipidemia and hypertension, but cannot recall the names or dosage she was taking. When asking about patient’s diet, the patient relates that since she lost her job, she does not have enough money to purchase healthy foods and eats when food is available, often snacking on high carbohydrate foods.

On examination, she was tachypneic, her temperature was 36.8° C (98.2° F), pulse rate 132 beats per minute, respiratory rate 34 breaths per minute, blood pressure 92/53 mmHg; she also had dry mucous membranes, poor skin turgor, nausea, and vomiting. She was slightly confused. Rapid hematology and biochemical tests showed hematocrit 48%, hemoglobin 14.3 g/dl (143 g/L), white blood cell count 10,000/ μ l, glucose 950 mg/dl, urea 60 mg/dl (10.2 mmol/L), creatinine 1.4 mg/dl (123.7 μ mol/L), Na+ 152 mEq/L, K+ 3.8 mEq/L, PO4 2.3 mEq/L (0.74 mmol/L), and Cl− 110 mmol/L. Arterial pH was 6.9, PO2 95 mmHg, PCO2 28 mmHg, HCO3 9 mEq/L, and O 2 sat 96%. The result of the strip for ketone bodies in urine was strongly positive. Urinalysis showed glucose >1000 mg/dl and specific gravity 1.050. Lipid panel: Total Cholesterol 223, LDL 117, Triglycerides 238.

Address the following in your Paper :

What are your top three differential diagnoses for this patient?
What is your final working diagnosis for this patient?
What further testing is needed to confirm the diagnosis?
How will you manage this patient to include pharmacologic and non-pharmacologic treatments for complete diabetic management?
What education would you provide this patient regarding their diagnosis and treatment?
What community resources are available to assist this patient?
Which online websites/apps assisted you in providing care to this patient?
This Assignment must be submitted in an APA format with a minimum of 5 pages not including title page and reference page

Be sure and support your answers or actions with EVIDENCE based on guidelines, research and/ or other authoritative sources.

References should include AT LEAST one original research article, one guideline or standard of practice and 3 peer reviewed articles.

Support your arguments with appropriate evidence from the literature, citing and referencing in APA 7th edition style. Be sure to first view the Unit 3 Assignment Grading Rubric (found in the Grading Rubrics section under Course Resources) and use it to guide your completion.

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);
consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as original and insightful;
display superior content, organization, style, and mechanics; and
use APA 7th edition

This week, your focus is on musculoskeletal disorders to include arthritis, subluxations/dislocations, soft tissue injuries, and fractures. As you learn about the acute care management strategies for the musculoskeletal disorders being discussed this week, also consider the role of the nurse practitioner in preparing the patient for their role in self-management at home.

After completing this unit, you should be able to:

Analyze treatment and management plans for patients with musculoskeletal disorders in acute care.
Analyze strategies for educating patients on the treatment and management of musculoskeletal disorders in acute care.
Evaluate the impact of sociocultural factors on the treatment and management of musculoskeletal disorders in acute care.
Apply key terms, principles, and concepts related to musculoskeletal disorders in acute care.
Course Outcomes covered in this unit:

MN654-1: Choose a consistent approach to the evaluation of illnesses and conditions for patients in the acute care setting.

MN654-2: Formulate a complete management plan for patients in the acute care setting with acute, episodic, and chronic illness, with considerations regarding age, gender, culture, ethnicity, and socioeconomics.

* MN654-3: Explore effective strategies to promote relationships with patients, family, and other health providers to provide optimal patient-driven health care in the acute care setting. *