...Case study 76 Endocrine Disorders 1. Interpret Y.L.'s laboratory results • HbA1C is elevated at 8.8% and the goal for diabetics is to keep that value below 7% Hemoglobin A1c. Her number is concerning because it indicates that her blood sugar has been way too high over the past few months. The A1c is an indication of glycosylation in the body which is damaging to the blood vessels and peripheral nerves. It causes thickening of the basement membrane which will impair oxygen transport to the tissues and carbon dioxide removal. • High BP • Total Cholesterol is elevated at 256mg/dL, normal value is below 200mg/dL • Fasting glucose is high at 184mg/dL, normal value is below 126mg/dL • Triglycerides are elevated at 346 mg/dL, normal levels are below 150mg/dL. Y.L. indicates levels that are high. • LDL levels are elevated at 155mg/dL and ideal values are below 100mg/dL; LDL is the value you want to be the lowest. • HDL levels are low and the HDL levels need to be high, 40-60mg/dL is desired. • Urine Analysis indicates that Y.L. is spilling glucose into her urine. 2. Identify the three methods used to diagnose DM. - Fasting blood glucose of > 126 mg/dl - Random Glucose Level >200 mg/dl (plus presence of other symptoms) - A1C > 6.5% 3. Identify three functions of insulin. • regulates glucose metabolism • stimulates lipogenesis • stimulates growth 4. Describe the major pathophysiologic difference between type 1 and type 2 DM. • Type 1 diabetes,...
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...Case Study NSG/340 March 3, 2015 Sandra Gilderson, MSN/Ed, RN Case Study Y.L. laboratory result The fasting glucose is over the limits, fasting should be no more 126. HgbA1c is over limits and should be less than 6.5 or 7 the most. Her cholesterol demonstrates hyperlipidemia with low HDL. UA demonstrates glycosuria which represents a degree of damage in the kidneys. The lab result presented is not within normal range and patient is also at risk for heart disease. Methods for diagnosis First one can do a spot test using a fasting plasma glucose test and is found to be positive if it is greater than 126. Secondly, an order of two-hour glucose test known as oral glucose tolerance test greater than 200 is positive for diabetes. Lastly if the random glucose plasma level is tested and found to be greater than 200, with demonstrated symptoms such as polyuria, polydipsia, or polyphagia diabetes can be diagnosed. Functions of insulin Insulin is responsible for assisting the body in the storage of fat by taking lipids from blood into the cells. Additionally, it is responsible for the regulation of glucose by transporting glucose from the blood into the muscles, and liver. Insulin also aids in gluconeogenesis Type1 vs Type 2 DM Type 1 is known to be caused by the autoimmune destruction of the beta cells within the pancreas leading to diabetes. Type 2 is a progressive destruction of the beta cells due to increased glucose levels, leading to a decreased production of insulin...
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...PHILIPPINES) In the Philippines, diabetes ranked 8th in the leading causes of mortality (Department of Health, 2005). As many as 1.4 million Filipino adults (aged 20 and above) acquired diabetes in the last five years mainly because of unhealthy diets and sedentary lifestyles, according to data compiled by anti-diabetes advocates. It has been proven that the prevalence of diabetes is constantly on the rise (Takrouri, 2009). According to a study made by Wild et al, the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030 worldwide(Diabetes Care, 2004). Diabetes mellitus is a chronic disease that requires long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. It is a disproportionately expensive disease; in 2002, the per-capita cost of health care was $13,243 for people with diabetes,...
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...Diabetes in the United States is at epidemic proportions. The Center for Disease Control and Prevention (2012), reports that diabetes is the seventh leading cause of death. Twenty nine million people are diagnosed with diabetes and a projected 79 million Americans are estimated to have pre diabetes. If trends continue, the incidence of diagnosed diabetes is expected to increase to one in three persons in the U.S. by the year 2050. The impacts of diabetes extend to all body systems, sometimes with devastating results. Diabetes is the leading cause of kidney failure, non-traumatic lower limb amputation and new cases of blindness in the U.S. Diabetes complications can be postponed or prevented with proper medical treatment, education, follow...
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...Diabetes [Name of Author] [Name of Institution] Question 1 The key area which must be considered for conducting initial assessments for Jazminder is the identification of hyperglycemia. It is recommended that her glucose concentrations for plasma must be measured. A two-hour post load glucose test or an FPG test is recommended by the International Diabetes Federation (IDF) and WHO for patient susceptible of developing diabetes. Assessment of diabetes is also done through HbA1c in which the hemoglobin HbA1c is measured. This area of assessment has particularly been deemed important by the International Expert Committee (2009). Measurement of HbA1c enables the healthcare providers to assess the blood glucose concentration. The WHO and ADA (2010) has also associated the HbA1c as the major test for diagnosing diabetes. Jazminder is doubtful that she might develop diabetes because her sister has developed recently. However, apparently there is no symptom for the presence of diabetes in diabetes. According to Saudek et al (2008), asymptomatic people may be at the higher risk of developing diabetes. In particular, for people ≥45 years of age, the screening is necessary. Jazminder must be evaluated for HbA1c, 2-h OGTT, and FPG to get appropriate results. It has been recommended by the IDF that it relies over the healthcare provider to decide which screening must essentially be done for respective patient cases. However, the FPG remains the test suggested in almost every...
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...Diabetes [Name of Author] [Name of Institution] Introduction The examination profile of Mr Ward is not satisfactory and predicts he is confronted with several risk factors. Triglyceride level of Mr. Ward is 1.8mmol/l which is considered to be borderline high. Likewise, the cholesterol is 5.2mmol/l which again is very high. He also has a blood pressure higher than a safe range and a BMI below satisfactory level. This paper aims to highlight the facts and interventions which can be used for disease management for Mr Ward. Discussion The major challenge for maintaining a suitable glycemic control for diabetic patients is to restrict the progression of disease or development of the risk factors which turn pertinent over the course of time. The progression of disease can be restricted through considering the factors leading to weight gain, the pharmaceutical considerations, incurrence of glycemic conditions, and by taking into account the inherent restraints for administering exogenous insulin (Nichols et al, 2000). According to Davies (2004), there are number of factors which influences the consultation for diabetes patients amongst which the prominent ones include age, span of diabetes, the BMI, and measure of physical exercise. The glycaemic control remains the first and foremost target for every healthcare provider to enable insulin uptake in patients suffering from type 2 diabetes. Janes et al (2013) have highlighted the significance of daily routine and activities...
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...have been changed. This work has not been submitted for any previous award. Date …17/5/2015……. Managing the Needs of Patients with Diabetes Mellitus LO1 Type 2 diabetes is a serious chronic condition affecting the body’s ability to regulate blood glucose levels. According to Diabetes UK (2012), there were 2.9 million people in the UK diagnosed with diabetes in 2012, and this is estimated to increase to 5 million by 2025. Up to 90% of people with diabetes are thought to be type 2. According to Diabetes UK (2006), many are unaware they have the condition and it can lead to long-term complications including eye problems, kidney disease, foot ulcers and cardiovascular disease. Gregg et al (2005), states advances in preventative medicine have seen an effective reduction in the burden of risk from hypertension and hyperlipidaemia but the incidence of diabetes has continued to rise, driving cardiovascular rates. There has been much done in recent years to identify people who are at high risk of developing diabetes. This assignment will discuss the link between diabetes, obesity and cardiovascular disease. It will also identify lifestyle and behaviour changes involving the multi-disciplinary team and structured patient education of diabetics. The case study for this assignment is Mrs Smith, newly diagnosed with type 2 diabetes and a family history of heart disease and diabetes. She leads a sedentary lifestyle...
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...1. What is the importance of closely monitoring blood sugar levels? The importance of closely monitoring blood sugar levels is because of the risks of hyperglycemia or hypoglycemia. The normal blood sugar is between 70-110 mg/dl. Hyperglycemia occurs when the body’s blood sugar is higher than the normal range. When the body is not using insulin properly, hyperglycemia occurs. Severe complication of hyperglycemia may cause ketoacidosis which is a diabetic coma. Ketoacidosis occurs when the body breaks down fats since the body cannot use glucose for energy. When the blood sugar is below the normal range hypoglycemia occurs. Confusion is a sign of hypoglycemia. Hypoglycemia may cause a loss of consciousness in a person if untreated. 2. What...
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...How to control complication of type 2 Diabetes Palakkumar Patel Monroe College Abstract This paper is presenting about how to control complication of type 2 diabetes. In the USA 90% of diabetes patients suffering from type 2 diabetes. In every year lots of patients going to die due to type 2 diabetes complication. In previous studies review is presenting about due to type 2 diabetes so many complications are occurring in different part of the body and some study is presenting about due to health education we can reduce the problem in community. By doing heath education, continues health check up and doing some personal health counseling about diet and personal lifestyles.in school health education also effect on child on diet personal life styles. How to control complication of type 2 Diabetes Chapter 1: Introduction Diabetes is a leading cause of adult-onset blindness, kidney failure, and non traumatic limb amputations; significantly higher risk for coronary heart disease, peripheral vascular disease, and stroke, and they have a hypertension, dyslipidemia, and obesity; Diabetes is a the seventh leading cause of death in the United States (1). USA is expending $245 billion annually for health care expenditures and productivity losses and is a leading driver of growing Medicare expenditures for controlling glucose levels, blood pressure (BP), and lipid levels and avoiding tobacco, singularly or in combination, reduce the incidence of costly and disabling micro- and...
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...PATHO Exam 3 Study Guide * Define KEY WORDS (terminology) listed in the syllabus * Answer the OUTCOMES in the syllabus as if they are questions * Review all Activities, Games, extra videos, journal articles, etc. posted in course contents * Review the handouts from class: case studies, matching, charts, etc. Normal Values | Intracranial pressure | 5-10 mm Hg | Blood glucose | 70-130 | Hgb A1c | <5.7% | Thyroid levels | | Parathyroid levels | | Types of bone cells | Osteoblasts | Bone forming cellsThey are responsible for bone growth and repair | Osteocytes | Osteoblasts that have become trapped, imprisoned within mineralized bone matrix (MATURE BONE CELLS) | Osteoclasts | Reabsorb or remove bone during growth and repair (also assist in the release of calcium and phosphate)**bone reabsorption; bone destroying cells | *So, if one is immobilized then the osteoclastic activity is greater than the osteoblastic activity in bone marrow decreases. This is why we have debone mineralization during immobilization. Maintenance of bone integrity | This occurs through remodeling and it is a 3 phase process where existing bone is resorbed and new bone is laid down [repairs bone, does not heal bones] | Phase 1 | Activation phaseThis is where a stimulus occurs, such as a weight baring exercise, causing the formation of osteoclasts | Phase 2 | Resorption This is where osteoclasts form a cutting zone and resorb or remove bone | Phase 3 | Formation...
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