ESSAY: Discussion 11

In the United States, 25.6 million adults age 20 years or older have diabetes (American Diabetes Association, 2011). If not properly treated and managed, these millions of diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. Proper treatment and management is the key for diabetic patients, and as the advanced practice nurse providing care for these patients, it is your responsibility to facilitate this process. Patient education is critical, as is working with patients to establish a regular pattern for daily activities such as eating and taking medications. When developing care plans for patients, you must keep the projected outcomes of treatment in mind, as well as patient preferences and other factors that might impact adherence to treatment and management plans. In this Discussion, you draw from your Practicum Experience and consider factors that impact the education and treatment of patients with diabetes.

To prepare:

• Review Chapter 206 in Part 17 of the Buttaro et al. text.
• Reflect on the clinical presentation of diabetes, as well as your Practicum Experiences and observations. Select a case from these experiences that involve a diabetic patient. When referring to the patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.
• Recall the medical details of the patient in the case that you selected including patient history, clinical presentation, physical exams, diagnostics, and the recommended treatment plan.
• Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the treatment plan and patient education strategies.

By Day 3

Post a description of the case that you selected including the diabetic patient’s medical details. Then, explain how the factor that you selected might impact the treatment plan and patient education strategies.

Please review an example of what I need.

Need  at least one reference from

Buttaro, Terry Mahan; Trybulski, JoAnn; Polgar-Bailey, Patricia; Sandberg-Cook, Joanne. Primary Care – E-Book: A Collaborative Practice (Kindle Location 48623). Elsevier Health Sciences. Kindle Edition..

NURS-6531N-16,Adv. Practice Care of Adults.2018 Spring Qtr 02/26-05/20-PT27: WEEK 7 Evaluation and Management of Genitourinary Disorders

Hermien Creger – hermien.creger@waldenu.edu <do-not-reply@email.laureate.net>

Sat 4/7, 5:10 PM

Review the case study and reflect on the information provided about the patient.

• Post a description of the history that you need to obtain from the patient in the case study. Include a list of questions that you might ask the patient. 
• Describe types of physical exams and screening tools
• Describe types of diagnostics (tests, labs, screening tools) that might be appropriate for evaluation of the patient.
• Make a diagnosis and explain your diagnosis. 
• Write a treatment plan for this patient 

Prescriptions(s)

Interventions/ lifestyle changes

Referrals

Follow up 

Education( Minimum of 2 references)

ily Physician, 79(3), 203-214.

ANSWER

Education and Treatment of Patients with Diabetes

Description of the Case

Patient History

Mr. X was a retired 58-year-old male. He lived with his wife and son. Besides farming, he also managed a small drugs and alcohol rehabilitation center.

Clinical Presentation

Mr. X enjoyed relatively good health until about a month ago when he started feeling week and exhausted. He reported waking up several times at night to take a glass of water and urinate. Throughout his service as a police officer, he maintained a healthy weight. Since his early retirement, five years ago, Mr. X had gained more weight. However, despite his appetite being constant, he has been losing weight over the last two months. Additionally, the pain in his feet worsened at night and at times his toes felt numb. His vision was blurred particularly in the afternoon.

Physical Exam

• Weight: 215 Ibs, height: 5’11 (Body Mass Index: 28), BP, 140/80, Overweight
• Pulses strong and equal
• Mild bleeding of gums after tooth brushing
• Chest, abdomen and genital exam normal

Diagnosis

Clinical presentations and laboratory tests guided the diagnostic process. Increased urination, dehydration, weight loss, fatigue, feet pain and numbness in toes as well as general body weakness pointed to Diabetes Mellitus Type 2. Additionally, Fasting Plasma Glucose test indicated 128 mg/dl. This test helped to confirm the condition (Tamrakar, Maurya & Rai, 2014).

Recommended Treatment Plan

Insulin glargine was prescribed. Mr. X was also advised to consider lifestyle changes to control the condition. This entailed fat and calories’ control. Increase in the physical exercise was also recommended as a way of improving insulin sensitivity of the muscles (Schernthaner et al., 2015).

Selected Factor: Behavior

Diabetes is a self-managed condition which requires the patient to make critical decisions relating to their own health and well-being. As such, the behavior of the patient largely affects the treatment plan adopted as well as the patient education strategies. The effectiveness of the medications depends on how well the patient adheres to the doctor’s prescription in terms of proper timing, dosage as well as consistency (Lind et al., 2014). Additionally, the success in the control of calories and body fats is greatly linked to the patient’s behavior including the willingness to avoid unhealthy diet, alcohol, and sedentary lifestyle. Positive patient behavior is a crucial element of the patient education program (American Diabetes Association, 2014).

References

American Diabetes Association. (2014). Standards of medical care in diabetes—2014. Diabetes care, 37(Supplement 1), S14-S80.

Tamrakar, A. K., Maurya, C. K., & Rai, A. K. (2014). PTP1B inhibitors for type 2 diabetes treatment: a patent review (2011–2014). Expert opinion on therapeutic patents, 24(10), 1101-1115.

Lind, L., Zethelius, B., Salihovic, S., van Bavel, B., & Lind, P. M. (2014). Circulating levels of perfluoroalkyl substances and prevalent diabetes in the elderly. Diabetologia, 57(3), 473-479.

Schernthaner, G., Durán‐Garcia, S., Hanefeld, M., Langslet, G., Niskanen, L., Östgren, C. J., … & Hardy, E. (2015). Efficacy and tolerability of saxagliptin compared with glimepiride in elderly patients with type 2 diabetes: a randomized, controlled study (GENERATION). Diabetes, Obesity and Metabolism, 17(7), 630-638.