Question

Module 06 Written Assignment - Diabetes Cas

Module 6: Endocrine pathophysiol

Using the case study below, prepare a 2-3 page paper.

Diabetes case study

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, her skin is warm and flushed, and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.

You get more information from A.M. and learn the following:

• She had some readings on her glucometer which were reading ‘high’
• She vomits almost every time she takes in fluid
• She hasn’t voided for a day but voided a great deal the day before
• She’s been sleeping long hours and finally woke up this morning and decided to seek care

Current labs and vital signs: BP 88/46 MMHG, HR 132bpm, RR, 36/min. deep, T, 101.3 F(tympanic). Additional data: Glucose 657mg/dl , potassium 6.2mEq/l

1. What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
2. Describe the etiology of the disorder A.M. is experiencing.
3. Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
4. Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.

Instructions:

Summarize the questions above and formulate what may be happening with A.M. and the expected treatments to improve her condition.

Answer 1

1. The process of identifying a disease, condition, or injury from its signs and symptoms. A health history, physical exam, and tests, such as blood tests, imaging tests, and biopsies, may be used to help make a diagnosis.The committee concluded that the diagnostic process is a complex, patient-centered, collaborative activity that involves information gathering and clinical reasoning with the goal of determining a patient's health problem.

Steps to diagnosis

• taking an appropriate history of symptoms and collecting relevant data.
• physical examination.
• generating a provisional and differential diagnosis.
• testing (ordering, reviewing, and acting on test results)
• reaching a final diagnosis.
• consultation (referral to seek clarification if indicated)
• The process of identifying a disease, condition, or injury from its signs and symptoms

A health history, physical exam, and tests, such as blood tests, imaging tests, and biopsies, may be used to help make a diagnosis

2; Here etiology focusing to the disease

• Hyperglycemia
• Hyperkalemia

these are the condition now existing, and these all are create some sign and symptoms for the patient.The present diagnosis can de done to prevent further problems.and patient shows some sign and symptoms.

3. A. M. experiencing symptoms are

• Vomitting
• Nausea
• Diarrhoea
• fever

Nausea is an uneasiness of the stomach that often comes before vomiting. Vomiting is the forcible voluntary or involuntary emptying ("throwing up") of stomach contents through the mouth.

Causes

Nausea and vomiting are not diseases, but they are symptoms of many conditions such as:

• Motion sickness or seasickness
• Early stages of pregnancy (nausea occurs in approximately 50%-90% of all pregnancies; vomiting in 25%-55%)
• Medication-induced vomiting
• Intense pain
• Emotional stress (such as fear)
• Gallbladder disease
• Food poisoning
• Infections (such as the "stomach flu")
• Overeating
• A reaction to certain smells or odors
• Heart attack
• Concussion or brain injury
• Brain tumor
• Ulcers
• Some forms of cancer
• Bulimia or other psychological illnesses
• Gastroparesis or slow stomach emptying (a condition that can be seen in people with diabetes)
• Ingestion of toxins or excessive amounts of alcohol
• Bowel obstruction
• Appendicitis

The causes of vomiting differ according to age. For children, it is common for vomiting to occur from a viral infection, food poisoning, milk allergy, motion sickness, overeating or feeding, coughing, or blocked intestines and illnesses in which the child has a high fever.

The timing of the nausea or vomiting can indicate the cause. When appearing shortly after a meal, nausea or vomiting may be caused by food poisoning, gastritis (inflammation of the stomach lining), an ulcer, or bulimia. Nausea or vomiting one to eight hours after a meal may also indicate food poisoning. However, certain food- borne bacteria, such as salmonella, can take longer to produce symptoms.

A fever is a body temperature that is higher than normal. A normal temperature can vary from person to person, but it is usually around 98.6 F. A fever is not a disease. It is usually a sign that your body is trying to fight an illness or infection. Infections cause most fevers.

Diarrhea is characterized by loose, watery stools or a frequent need to have a bowel movement. It usually lasts a few days and often disappears without any treatment. Diarrhea can be acute or chronic. Acute diarrhea occurs when the condition lasts for one to two days.

4. Treatment options for the patient is

Nausea & Vomiting: Care and Treatment

1. Drink clear or ice-cold drinks.
2. Eat light, bland foods (such as saltine crackers or plain bread).
3. Avoid fried, greasy, or sweet foods.
4. Eat slowly and eat smaller, more frequent meals.
5. Do not mix hot and cold foods.
6. Drink beverages slowly.
7. Avoid activity after eating.
8. Avoid brushing your teeth after eating.

Relief for Nausea and Vomiting

• Bismuth subsalicylate. This medicine may help treat some types of nausea and vomiting, such as from gastroenteritis (stomach flu). ...
• Antihistamines. Certain types may help prevent nausea and vomiting caused by motion sickness.Rest and drink plenty of fluids. Medication isn't needed. Call the doctor if the fever is accompanied by a severe headache, stiff neck, shortness of breath, or other unusual signs or symptoms. If you're uncomfortable, take acetaminophen (Tylenol, others), ibuprofen.

Treatment for diarrhoea

• plenty of fluids to prevent dehydration.
• oral rehydration drinks to replace lost salts and minerals. ...
• intravenous replacement of fluids in severe cases.
• medications such as antibiotics and anti-nausea drugs.
• anti-diarrhoeal medications, but only on the advice of your doctor.

Sodium polystyrene sulfonate (e.g.Kayexalate) - This medication works to lower blood potassium levels by binding with the potassium in your stomach or gut. You may take this medication by mouth, or by enema.

Drinking too much water can cause side effects that range from mildly irritating to life-threatening — and overhydration can lead to an imbalance of electrolytes in the body. Electrolytes such as potassium, sodium, and magnesium help regulate everything from your kidneys to your heart function.

ow-Potassium Foods
Apple (1 medium)	Alfalfa sprouts	Rice
Apple Juice	Asparagus (6 spears raw)	Noodles
Applesauce	Beans, green or wax Broccoli (raw or cooked from frozen)	Pasta
Apricots, canned in juice	Cabbage, green and red Carrots, cooked	Bread and bread products (Not Whole Grains)

Treatment

1. Get physical. Regular exercise is often an effective way to control your blood sugar. ...
2. Take your medication as directed. ...
3. Follow your diabetes eating plan. ...
4. Check your blood sugar. ...
5. Adjust your insulin doses to control hyperglycemia.

These include:

• Exercise: Physical activity can use excess glucose in the blood. However, if a person with severe hyperglycemia finds ketones in their urine, they should avoid exercise, as this breaks down more fats and might speed up ketoacidosis.
• Moderating the diet: Eating less during mealtimes and snacking less, as well as focusing on low-sugar foods, helps keep the amount of glucose at a level that the body can handle. A dietitian can help a person adapt their diet in gradual and healthful ways.
• Altering medications: A doctor may recommend changing the timings or types of medication and insulin a person is taking if they are not reducing blood sugar as they should.