Patient with Newly Diagnosed Diabetes Mellitus (DM)
Natalie Smith is a 42-year-old female patient who presented to the emergency department at 9pm with vomiting and abdominal pain. She states that she had a 2-week history of excessive urination and thirst, accompanied by blurred vision and a 10-pound weight loss despite excessive eating. The patient indicated that she started treatment for newly diagnosed hypertension about 3 months ago.
PAST MEDICAL HISTORY: CURRENT MEDICATIONS:
- Hypertension - hydrochlorothiazide [Hydrodiuril]
- Depression - fluoxetine [Prozac]
LAB VALUES AND VITAL SIGNS: The following table includes the patient’s lab values and vital signs upon admission:
- Smoker
DIAGNOSIS AND TREATMENT:
The patient was diagnosed with DM and an acute complication of DM based on her symptoms and lab values upon admission. The patient was successfully treated for her acute complication of DM, and subsequently discharged 3 days later. Upon discharge the patient was prescribed the following outpatient drug regimen:
The patient was instructed to conduct self-monitoring blood glucose checks 4 times a day. She was scheduled to be seen in the outpatient clinic 1 week after hospital discharge.
Patient has type 2 diabetes as patient has classic signs of polyphagia, polyuria and polydipsia
no patient must have dm quite a long time as patient has developed chronic complications related to dm like blurred vision
patient has blurred vision as high blood sugar for long time has negative effect on retina as micro aneurysms form in retinal arteries that can burst easily .and can cause macular edema. Also it leads to swelling of eye lens.
patient has developed diabetic ketoacidosis as evidenced from sign symptoms and arterial blood gas analysis.die to lack of insulin in DM and corresponding elevation of glucagon, there is more production of glucose by glycolysis and gluconeogenesis. Also there is release of fatty acids from adipose tissue in liver which are again converted to ketone bodies by beta oxidation . These ketone bodies turn blood ph acidic and as a compensatory mechanism, patient hyperventilates. Cerebral edema may result of dka.
Patient with Newly Diagnosed Diabetes Mellitus (DM) Natalie Smith is a 42-year-old female patient who presented...
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