Question

ll Sprint 12:34 AM Preusser DM 1.pdf Done Endocrine Disorders Case Study 77 chapter Case Study 77 Date Name Group Members INSTRUCTIONS All questions apply to this case study Your responses should be brief and to the poine When asked to provide several answers, Bist them in onder of prierity or significance. Do not asume information that is not provided Please print or wribe clearly your response is not legible, it will be marked as ? and you will need to wte it Class/Group. Scenario YL. makes an appointment to come to the dinic where you are employed. She has been complaining of (C/O) 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 (OTC) medication. She admits to starting smoking since going back to work full time as a clerk in a loan company. She also complains of having difficulty reading numbers and reports 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 reports that, after her delivery, she went back to her traditional eating pattern, which is high in carbohydrates (CHO In reviewing Y.L's chart, you notice she has not been seen since the delivery of her child 6 years ago. She has gained considerable weight; her current weight is 173 pounds. Today, her blood pressure (BP) is 152/97 mm Hg, and her plasma glucose is 291 mg/dl. Her primary care provider (PCP) arders the following labs: urinalysis (UA), hemoglobin Ale 0Hb A fasting complete metabolic panel (CMP) CBC, fasting lipid profile, and glomerular filtration rate (GFR). The lab values are as follows: fasting glucose 184 mg/dl, Hb A, 10.4, UA +glucose, -ketones, cholesterol 256 mg/dl, triglycerides 346 mg/dl, LDL 155 mg/dl, HDL 32 mg/dl, ratio 8.0. A subsequent fasting glucose is also elevated, and Y.L. is diagnosed with type 2 diabetes mellitus (DM) After meeting with Y.L. and discussing management theraples, the PCP decides to start multiple- dose injection (MDI) insulin therapy and have the patient count CHO. Y.L is scheduled for education dlasses and is to work with the diabetes team to get her blood glucose under control. 1. Identify the three methods used to diagnose DM.

Answer 1

1. Three methods used to diagnose DM:

• Random blood sugar level: The blood was collected randomly at any time. The blood sugar level of higher than 200mg/dL indicates diabetes.
• Glycated hemoglobin (A1C) test: It is used to find the average sugar level in the blood over the past three months.
• Fasting blood sugar: The blood sample was collected in the early morning after overnight fasting. The blood sugar level of greater than 110mg/dL indicates diabetes.

2. Three functions of insulin:

• Insulin controls the blood glucose level.
• it makes the liver and fat cells to utilize the glucose and stored as triglycerides.
• It converts glucose into energy and transforms throughout the body.

3. Hormones that inhibit the effects of insulin

• Glucagon produced by alpha cells of the pancreas stimulates the liver to release more glucose on the blood.
• epinephrine stimulates the liver and kidney to produce more glucose by inhibiting insulin secretion.
• Cortisol impaired the activity of insulin during stress.

4. The points that should be included in teaching of patient with glargine:

• Glargine removes the excess glucose from the blood and gives energy.
• It starts working on 1-2 hrs after administration and reaches a peak level after 6 hours.
• Rotate the insulin pen before administering it.
• Educate about the side effects of hypoglycemia that may experience using glargine.
• Avoid use of medications if it is cloudy.