Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Further history reveals a family history of diabetes. Answer the following questions about Ms. Rodrigues and diabetes.
1. In addition to questions about her chest discomfort, what other assessment questions should you ask Ms. Rodrigues? Why?
2. Ms. Rodrigues has polyuria, paresthesias in her feet, an itching rash in her groin, and blurry vision. Why is it important to measure her blood pressure and the pain and vibration sensation in her hands and feet?
3. Her nurse practitioner ordered blood tests for glucose and HbA1C. What do you expect these values to be if Ms. Rodrigues has type 2 diabetes?
4. What information does HbA1C provide that the blood glucose level does not?
5. Ms. Rodrigues’s evaluation reveals Candida infection and mild coronary artery disease. Why does diabetes increase the risk of infection?
6. Why physiological mechanisms contribute to peripheral neuropathy in type 2 diabetes?
7. Why did her nurse practitioner refer Ms. Rodrigues to an ophthalmologist?
8. Why is it important to teach Ms. Rodrigues about diet, weight loss, and appropriate exercise, home glucose monitoring, and other ways (possibly including medications) to manage her blood sugar?
Answer:
1. As patient is suffering from dyspnea, chest discomfort, fatigue may related to cardiac issues. So ask the patient for any history of cardiac disease or family history of cardiovascular disease.
2. Patient with diabetes eventually has hypertension along with cardiac symptoms. To avoid complications and to assess the circulatory status, blood pressure monitoring is important. Peripheral neuropathy is a complication of diabetes which leads to numbness, loss of sensation, or pain in the extremities. It is a nerve damage caused by chronic diabetes mellitus.
3. If the patient has type 2 diabetes mellitus, the blood glucose will be high ( above 120mg/dl and HbA1c also will more than 6.5 %
4. Hba1c helps to monitor long term glycemic control and provide the information of cumilative glycemic history of two to three months. It also used to correlate with the risk of long term diabetes complications.
Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion,...
Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Further history reveals a family history of diabetes. Answer the following questions about Ms. Rodrigues and diabetes. 1. In addition to questions about her chest discomfort, what other assessment questions should you ask Ms. Rodrigues? Why? 2. Ms. Rodrigues has polyuria, paresthesias in her feet, an itching rash in her groin,...
Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Further history reveals a family history of diabetes. Answer the following questions about Ms. Rodrigues and diabetes. 1. In addition to questions about her chest discomfort, what other assessment questions should you ask Ms. Rodrigues? Why? 2. Ms. Rodrigues has polyuria, paresthesias in her feet, an itching rash in her groin,...
Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Further history reveals a family history of diabetes. Answer the following questions about Ms. Rodrigues and diabetes. 1. In addition to questions about her chest discomfort, what other assessment questions should you ask Ms. Rodrigues? Why?
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