Question

Please answer all the questions and in details as well on how a nurse would take care of the patient and what would be the steps the nurse would take.

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

1.

Mrs. Peterson is an African American female that is complaining of persistent pedal edema and fatigue. She is an uncontrolled type II diabetic. Her bloodwork reveals the following:

GFR 55

BUN 102

Cr 3.5

WBC 9.5

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

2. Mrs. Sanders complains to the doctor that she feels burning on her skin in distinct areas. Large circular areas on noted on her scalp. Skin has sloughed off in these areas and they are reddened. Hardened scales are present. She states that she has tried different creams and shampoos but the condition is worsening. She reports that she has had this condition since she was a teenager.

Answer 1

1)ans ) based on these sym are due to pulmonary edema that is caused by pooling of the blood In the vessels of the lungs.

"Pedal edema is a build up of flu in the body(water retention) which causes swelling."

_diabetes is a group of metabolic diseases characterized hyperglycemia resulting from defect in insulin secretion,insulin action.

_the chronic hyperglycemia of diabetes associated with long term damage dysfunction and failure of Various organs,especially the eyes , kidneys,nerves,heart

and blood vessels.

_diabetes affects the kidneys in stages.at onset of diabetes,the kidneys grows large and GFR become disturbed.

Pathophysiology :based on patient condition

1) peripheral insulin resistance.

2) impaired regulation of hepatic glucose production

3)declining beta cell function.

treatment:

Restore fluid balance,replace electrolytes

Lower blood glucose with regular insulin.

Monitor levels of vital signs, consciousness,intake and output,and electrolytes

Provide emotions support.

Medications are:oral agents:meglitinide_stimulates insulin secretion by pancreas.

Thiazolidenediones_decrese peripheral insulin resistance

Biguanides_decrease amount of glucose produced by liver.and improve insulin sensitivity.

Nurse responsibilities:

Advice patient about meal plan

Demonstration and explain the procedure for insulin self injection.

Assess feet and legs for skin temperature,sensation,soft,tissue injuries,corns,dryness

Maintain skin integrity.

Maintain intakes and output chart.

Assess patient cognitive or sesory impairment.

Provide emotional support.

2)ans )based on symptoms the condition is SCALP PSORIASIS.

It is a common skin disorder that makes raised,reddish,often scaly patches.

Medications are:

Anthralin,antimicrobials_to treat bacterial and yeast infections,calcipotriene_ strong derivatives,and other steroids.

UV light sometimes delivered with a hand held device called UV comb. Can be used to treat the entire SCALP.

Other medications are.:

Corticosteroid,cyclosprine,methotrexate,a strong form of vitamin A called a derivatives.

Nursing care:

Maintain skin integrity

Provide knowledge related to condition.

Avoid anxiety.

Assess skin condition.

Maintain personal hygiene.