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NUR 265: DIABETES MELLITUS TYPE 2 CASE STUDY 76 WITH ANSWERS/2023.Qualified.DOWNLOAD TO S, Thesis of Nursing

NUR 265: DIABETES MELLITUS TYPE 2 CASE STUDY 76 WITH ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

Typology: Thesis

2021/2022

Available from 07/24/2023

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NUR 265: DIABETES MELLITUS TYPE 2 CASE STUDY 76 WITH
ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+
Y.L., a 34-year-old Southern Asian woman, comes to the clinic with complaints of chronic
fatigue, increased thirst, constant hunger, and frequent urination. She denies any pain,
burning, or low-back pain on urination. She tells you she has a vaginal yeast infection that she
has treated numerous times with over-the- counter medication. She works full time as a clerk
in a loan company and states she has difficulty reading numbers and reports, resulting in her
making frequent mistakes. She says, “By the time I get home and make supper for my family,
then put my child to bed, I am too tired to exercise.” She reports her feet hurt; they often
“burn or feel like there are pins in them.” She has a history of gestational diabetes and reports
that after her delivery she went back to her traditional eating pattern, which is high in
carbohydrates.
In reviewing Y.L.'s chart, you note she last saw the provider 6 years ago after the delivery of her
last child. She has gained considerable weight; her current weight is 173 pounds. Today her
blood pressure (BP) is 152/97 mm Hg, and a random plasma glucose level is 291 mg/dL. The
provider suspects that Y.L. has developed type 2 diabetes mellitus (DM) and orders the
laboratory studies shown in the chart.
1. Interpret Y.L.'s laboratory results.
Her fasting glucose and A1C are elevated, which suggests she has diabetes. She also has
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Download NUR 265: DIABETES MELLITUS TYPE 2 CASE STUDY 76 WITH ANSWERS/2023.Qualified.DOWNLOAD TO S and more Thesis Nursing in PDF only on Docsity!

ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

Y.L., a 34-year-old Southern Asian woman, comes to the clinic with complaints of chronic fatigue, increased thirst, constant hunger, and frequent urination. She denies any pain, burning, or low-back pain on urination. She tells you she has a vaginal yeast infection that she has treated numerous times with over-the- counter medication. She works full time as a clerk in a loan company and states she has difficulty reading numbers and reports, resulting in her making frequent mistakes. She says, “By the time I get home and make supper for my family, then put my child to bed, I am too tired to exercise.” She reports her feet hurt; they often “burn or feel like there are pins in them.” She has a history of gestational diabetes and reports that after her delivery she went back to her traditional eating pattern, which is high in carbohydrates. In reviewing Y.L.'s chart, you note she last saw the provider 6 years ago after the delivery of her last child. She has gained considerable weight; her current weight is 173 pounds. Today her blood pressure (BP) is 152/97 mm Hg, and a random plasma glucose level is 291 mg/dL. The provider suspects that Y.L. has developed type 2 diabetes mellitus (DM) and orders the laboratory studies shown in the chart.

  1. Interpret Y.L.'s laboratory results. Her fasting glucose and A1C are elevated, which suggests she has diabetes. She also has

ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

glucose in her urine, which is a sign of diabetes.

  1. Identify the three methods used to diagnose DM. Two hour plasma glucose level of 200 mg/dl or higher, a fasting plasma glucose of 126 mg/dl or higher, and a HbA1c of 6.5% or higher Case Study Progress Y.L. comments, “I've heard many people with diabetes lose their toes or even their feet.” You take this opportunity to teach her about neuropathy and foot care.
  2. Which of the symptoms that Y.L. reported today led you to believe she has some form of neuropathy? She stated that her feet were burning or felt like there were pins in them.
  3. What other findings in Y.L.'s history place her at increased risk for developing neuropathy? She has hypertension and elevated cholesterol levels.
  4. What would you teach Y.L. about neuropathy? That this is common in people with diabetes and that it can feel a lot like the pain she described. I would encourage her that it is important to pay attention to her feet and take good care of them. It’s also important that she monitors her glucose levels to make sure they aren’t getting to high to damage any more nerves.

ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

  1. Describe the major pathophysiologic difference between type 1 and type 2 DM. People who have type 1 don’t produce insulin. People with type 2 produce insulin, but don’t respond to it as well as they should. Later in the disease, type 2 diabetics often don’t make enough insulin as well.
  2. Name six risk factors for type 2 DM. Place a star or asterisk next to those that Y.L. exhibits. She’s Asian, says her feet hurt, she had GDM, she has an elevated BMI, HTN, and she also has a history of gestational diabetes.

ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

Case Study Progress Y.L. is diagnosed with type 2 DM. The provider starts her on metformin (Glucophage) 500 mg and glipizide (Glucotrol) 5 mg orally each day at breakfast and atorvastatin (Lipitor) 20 mg orally at bedtime. She is referred to the dietitian for instructions on starting a 1200-calorie diet using an exchange system to facilitate weight loss and lower blood glucose, cholesterol, and triglyceride levels. You are to provide education regarding pharmacotherapy and exercise.

  1. How can you incorporate Y.W.'s cultural preferences as you develop her education plan?

ANSWERS/2023.Qualified.DOWNLOAD TO SCORE A+

Teach her the signs and symptoms of hypoglycemia such as a headache, nervousness, fast heart beat, sweating, and tremors. Also what to do if these things should occur. Suggest to her that maybe she should wear some type of medical alert bracelet in case an emergency were to happen. Also teach her when and how to take her medications.

  1. What benefits should Y.L. receive from encouragement to exercise? Exercise can actually make your insulin more effective, and your cells can use the glucose more effectively. It can also be beneficial in preventing future heart problems. Exercise can also aid in weight loss to help keep her healthy.