1
Primary Care of the Maturing and Aged Family
Diabetes Case Study
Chamberlain College of Nursing NR 601
DATE:
NAME:
, 2
Primary Care of the Maturing and Aged Family Case Study
Introduction
The purpose of this assignment is to examine the provided subjective and objective data to
diagnose and apply national diabetes standard guidelines to develop a plan of care for the
selected case study. This assignment will display competence in determining risk factors,
developing a SOAP note, health promotion and disease prevention strategies. The mastery of
this assignment will help prepare me as an FNP for upcoming cases in clinical practice.
Assessment
Primary Diagnosis: Type 2 diabetes mellitus (ICD 10 E11)
Pathophysiology: Type 2 Diabetes Mellitus (T2DM) occurs because of progressive insulin
insufficiency due to failure of B- cells ability to secrete insulin, resulting in insulin resistance
(Introduction: Standards of medical care in diabetes, 2020). To keep up with the demand, the
pancreas will try to overcompensate by making more insulin in efforts to get glucose into cells
(Introduction: Standards of medical care in diabetes, 2020). The resistance of insulin leads to
too much sugar in the blood (Introduction: Standards of medical care in diabetes, 2020).
A diagnosis of diabetes is contingent on a plasma glucose criterion, which requires two
abnormal test results from the same sample or two separate test- day samples of either the
fasting plasma glucose > / = 126mg/dl or Hgb A1C > / = 6.5% or by a random plasma glucose &
Oral Glucose Tolerance Test (OGTT) result >/= 200 & symptomatic or 2-hour plasma glucose
200/= on OGTT with 75-gm glucose load (Introduction: Standards of medical care in diabetes,
2020). The two abnormal lab findings that confirmed the diagnosis in this case are #1 fasting
blood sugar (FBS)= 180 and #2 A1C 11.7%. Other abnormal labs Ms. that contributes to
diabetes include #3 HDL-C 50, #4 LDL-C 188, #5 Total Chol 248, #6 Triglycerides 188, and #7 UA
Glucose 1+.
The risks of developing T2DM increases with age, obesity (particularly the abdominal region),
women with prior gestational diabetes mellitus (GDM), in those with hypertension or
dyslipidemia, and in certain racial/ethnic subgroups (African American, American Indian,
Hispanic/Latino, and Asian American) (Introduction: Standards of medical care in diabetes,
2020). Mrs. TC has all the previously mentioned risk factors.
My reason for choosing T2DM for this case study are due to other risk factors identified in the
pertinent positive findings which includes a history of obesity (Wt. 190lbs, Ht. 5’0’’) (BMI 37.1),
report of increased weight gain to abdominal area, age 87, history of hypertension, poor diet,
drinks a a glass of cranberry juice 3-4 times per week, polyuria (urinating > 8-10x per day),
elevated blood glucose levels, + polydipsia, elevated A1C, +1 glucose UA, history of gestational
diabetes, ethnic background (Asian). Pertinent negatives include - fatigue, - polyphagia, -
blurred vison, -proteinuria, - blurred vision, - sedentary lifestyle, and no report of family history
T2DM.
Primary Care of the Maturing and Aged Family
Diabetes Case Study
Chamberlain College of Nursing NR 601
DATE:
NAME:
, 2
Primary Care of the Maturing and Aged Family Case Study
Introduction
The purpose of this assignment is to examine the provided subjective and objective data to
diagnose and apply national diabetes standard guidelines to develop a plan of care for the
selected case study. This assignment will display competence in determining risk factors,
developing a SOAP note, health promotion and disease prevention strategies. The mastery of
this assignment will help prepare me as an FNP for upcoming cases in clinical practice.
Assessment
Primary Diagnosis: Type 2 diabetes mellitus (ICD 10 E11)
Pathophysiology: Type 2 Diabetes Mellitus (T2DM) occurs because of progressive insulin
insufficiency due to failure of B- cells ability to secrete insulin, resulting in insulin resistance
(Introduction: Standards of medical care in diabetes, 2020). To keep up with the demand, the
pancreas will try to overcompensate by making more insulin in efforts to get glucose into cells
(Introduction: Standards of medical care in diabetes, 2020). The resistance of insulin leads to
too much sugar in the blood (Introduction: Standards of medical care in diabetes, 2020).
A diagnosis of diabetes is contingent on a plasma glucose criterion, which requires two
abnormal test results from the same sample or two separate test- day samples of either the
fasting plasma glucose > / = 126mg/dl or Hgb A1C > / = 6.5% or by a random plasma glucose &
Oral Glucose Tolerance Test (OGTT) result >/= 200 & symptomatic or 2-hour plasma glucose
200/= on OGTT with 75-gm glucose load (Introduction: Standards of medical care in diabetes,
2020). The two abnormal lab findings that confirmed the diagnosis in this case are #1 fasting
blood sugar (FBS)= 180 and #2 A1C 11.7%. Other abnormal labs Ms. that contributes to
diabetes include #3 HDL-C 50, #4 LDL-C 188, #5 Total Chol 248, #6 Triglycerides 188, and #7 UA
Glucose 1+.
The risks of developing T2DM increases with age, obesity (particularly the abdominal region),
women with prior gestational diabetes mellitus (GDM), in those with hypertension or
dyslipidemia, and in certain racial/ethnic subgroups (African American, American Indian,
Hispanic/Latino, and Asian American) (Introduction: Standards of medical care in diabetes,
2020). Mrs. TC has all the previously mentioned risk factors.
My reason for choosing T2DM for this case study are due to other risk factors identified in the
pertinent positive findings which includes a history of obesity (Wt. 190lbs, Ht. 5’0’’) (BMI 37.1),
report of increased weight gain to abdominal area, age 87, history of hypertension, poor diet,
drinks a a glass of cranberry juice 3-4 times per week, polyuria (urinating > 8-10x per day),
elevated blood glucose levels, + polydipsia, elevated A1C, +1 glucose UA, history of gestational
diabetes, ethnic background (Asian). Pertinent negatives include - fatigue, - polyphagia, -
blurred vison, -proteinuria, - blurred vision, - sedentary lifestyle, and no report of family history
T2DM.
