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Chamberlain College of NursingNR 601NR 601 Case study assignment

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Introduction The purpose of this paper is to examine the subjective and objective information using the national diabetes guidelines to diagnose and formulate a management plan for a case study pat... ient.Week 5 Case Study 2 Assessment Primary Diagnosis: Type 2 Diabetes Mellitus (ICD- 10 E11). I chose DM type 2 as my primary diagnosis based on the American Diabetes Association’s Guidelines (ADA). DM2 is a decline in insulin secretion because of impaired B-cell function (ADA, 2018) a diagnosis of diabetes can be made contingent on s criterion of the fasting glucose, the 2-h plasma glucose value in a glucose tolerance test or an A1C criteria (ADA, 2018). My patient’s fasting blood glucose of 126 (H) and her Hgb A1C of 6.9 (H), confirmed the diagnosis because they are two definitive values that are over the threshold (ADA, 2018). My reason for selecting DM2 also included the patient’s signs and symptoms, risk factors such as her age (56), ethnic background (Hispanic) and she previously delivered a nine-pound two-ounce baby which is indicative of gestational diabetes. Diabetes signs and symptoms include fatigue, frequent urination, blurred vision, feeling hungry, pain and tinging in hands and feet as well wounds and cuts that heal slowly (ADA, 2018). Those living a sedentary lifestyle, older age, obesity women previously diagnosed with gestational diabetes, Hispanics and blacks and those with high cholesterol and hypertension are all at a higher risk for type 2 diabetes (ADA, 2018). Mrs. R has been experiencing fatigue, weight gain, hung and thirst and frequent urination, she is overweight with a BMI of 29.7 which places her in the overweight category. Many individuals with non-insulin dependent diabetes are overweight and extra weight effects insulin resistance (ADA,2018). This patients abnormal lab values are as follows a blood glucose of 126(H), Hgb A1C 6.9 (H), LDL 144 (H), HDL 38 (L), Triglycerides 232(H) , and aWeek 5 Case Study 3 small amount of protein in her urine with 1+ glucose , warrants further investigation into her health need. Plan Diagnostics I am going to order a Hgb A1C for the DM2 diagnoses. Hgb A1C is a test that measures an individual’s blood glucose level for 3 months it is a measure of glycemia average (ADA, 2018). This test is also a prediction of value and detects glycemic targets (A1C is most effective when used along with CGM), (ADA, 2018). My patient’s A1C is 6.9 (H), individuals not previously diagnosed with DM with an A1C greater than 5.7, an abnormal glucose tolerance and an abnormal fasting glucose are ideal for diabetes prevention (ADA, 2018). This test should be obtained on the first visit and should continue throughout treatment (ADA, 2018). American Diabetes Association (ADA) Guidelines recommend that A1C levels be obtain every three Months until optimal levels have been reached or sustained (ADA, 2018). Results of the Hgb A1C will provide me with the opportunity to treat as indicated. Glycemic targets vary depending on patient’s specific needs (ADA, 2018). I am also going to order a Fasting Glucose because it is a predicting factor of DM2 (ADA, 2018). [Show More]

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