1) option b. Prednisone therapy , this therapy induces elevated glucose levels by stimulating glucose secretion by the liver as well as reducing secretion by the liver as well as reducing glucose transport into adipose tissue and muscle cells. 2) option c, the patient should be aware of glucoae control is likely to deterorate and that they need increased treatment . 3) option c. 4)option d.
Case study 10 Application to Practice Scenario A 68-year-old woman with an 8-year history of diabetes...
A 68-year-old woman with an 8-year history of diabetes mellitus presents to the clinic for worsening dyspnea and cough. She has had chronic obstructive pulmonary disease (COPD; see the Respiratory Function chapter) since age 55. She now has dyspnea from walking one-third of a block, as well as a persistent cough. She has managed her type 2 DM with diet and exercise. Her last glycosylated hemoglobin (HgbA1c), which was measured 1 month ago, was 6.8% (normal range is 4–6%). Physical...
A 68-year-old woman with an 8-year history of diabetes mellitus presents to the clinic for worsening dyspnea and cough. She has had chronic obstructive pulmonary disease since age 55. She now has dyspnea from walking one-third of a block, as well as a persistent cough. She has managed her type 2 DM with diet and exercise. Her last glycosylated hemoglobin (HgbA1c), which was measured 1 month ago, was 6.8% (normal range is 4– 6%). Physical examination reveals an anxious woman...
CASE STUDY 17.8 A 23-year-old woman with a history of brought to the emergency department by aa extremely short of breath. Her level ofcon questions with nods or one-word responses. She had a of asthma was ambulance. She yma hwas diminished greatly, and she was only able to ou a cough, with nearly inaudible breath sounds. After dra respond t blood gases, she was placed on supplemental oxygen. V signs: heart rate, 160 bpm; blood pressure, 120/84 mm H d...
Case Study #4 Application to Practice Scenario History Application to Practice Scenario A 13-year-old boy presented to the clinic complaining of a sore throat that persisted for 2 days. After those 2 days, he developed fever, nausea, and malaise. A throat culture revealed the presence of Group A beta hemolytic streptococci, and the child was started on antibiotic therapy. The child’s symptoms gradually improved, but approximately 2 weeks later, he returned to the clinic because the fever, nausea, and malaise...
Scenario #2: M.A., a 55-year-old woman, was recently diagnosed with bronchial asthma. In the past week, M.A. has had three asthmatic attacks and had to use her abuterol inhaler. M.A takes an inhaled combination glucocorticoid (fluticasone propionate 100mcg/salmeterol 50 mcg) on a daily basis. 1. Explain the purpose for inhaled glucocorticoid therapy? What are the advantages to this drug classification? 2. What patient teaching is included with glucocorticoid therapy? Can they be used to treat an asthmatic attack? Explain. 3....
Mary McGee is a 21-year-old woman with a history of type 1 diabetes, diagnosed 3 years ago. She isa college senior at the local university where she also plays softball. She started using an insulin pump approximately 6 months ago. She noticed she was usually tired and short of breath at the beginning of her practice and then began feeling weak and nauseated. She was also very thirsty during practice . Her softball coach said she seemed "a little confused."...
An 80-year-old woman was admitted with a diagno-sis of hypertension, congestive heart failure, anemia, possible diabetes, and chronic renal failu She was treated with diuretics and IV fluids and released 4 days later. Her laboratory results are shown in Case Study Table below.Five months la she was readmitted for treat-ment of repeated bouts of dyspnea. She was placed on a special diet and medication to control her hypertension and was discharged. Medical staff believed that she had not been taking...
of COPD is admitted to the emergency department with A 66-year-old male with a history of COPD is admitted to the emers shortness of breath. He is not currently taking any medication for his breathing. Th states that he usually gets short of breath only upon exertion, but he developed several days ago that made his breathing worse. He has been placed on Oxygen The n placed on oxygen. The doctor wants him to have breathing treatments. a) What medication,...
Case Study #2 A 9-year-old boy presents with a complaint of chest tightness, cough, and shortness of breath. This usually occurs during periods of exertion, but he has also woken up several times during the night with similar symptoms. His general health has been good and his physical exam including breath sounds, is normal at this time. a) What possible diagnosis should be explored? b) What medication, dose, and route of administration would you suggest? c) How should he monitor...
COPD Case Study Day 1, 1330. Jim Lawson is a 64-year-old Caucasian male admitted to the hospital medical floor for a respiratory infection. Jim, a 2 pack-a-day smoker, has a history of chronic obstructive pulmonary disease (COPD). He awakened in the morning with increased shortness of breath and coughing with the production of green-brown sputum. Vital signs are BP 144/88. P94, R 30, temperature 100.2 orally. Physicians orders include: ABG’s stat, sputum for C & S then begin Ampicillin 500...