NR 507 Week 6 Assignment; Case Study - Diabetic Mellitus

Case Study Scenario Chief Complaint J.T. is a 48-year old male who presents to the primary care clinic with fatigue, weight loss, and extreme thirst and increased appetite. History of Present Illness J.T. has been in his usual state of health until three weeks ago when he began experiencing symptoms of fatigue, weight loss, and extreme thirst. He reports that he would like to begin a walking program, but he feels too fatigued to walk at any point during the day. Now he is very concerned about gaining more weight since he is eating more. He reports insomnia due to having to get up and urinate greater than 4 times per night. Past Medical History • Hypertension • Hyperlipidemia • Obesity Family History • Both parentsdeceased • Brother: Type 2diabetes Social History • Deniessmoking • Denies alcohol or recreational druguse • Landscaper Allergies • No Known DrugAllergies Medications • Lisinopril 20 mg once daily bymouth • Atorvastatin 20 mg once daily bymouth • Aspirin 81 mg once daily bymouth • Multivitamin once daily bymouth Review of Systems • Constitutional: - fever, - chills, - weightloss. • Neurological: denies dizziness ordisorientation • HEENT: Denies nasal congestion, rhinorrhea or sorethroat. • Chest: + Tachypnea. Deniescough. • Heart: Denies chest pain, chest pressure orpalpitations. • Lymph: Denies lymph nodeswelling. General Physical Exam • Constitutional: Alert and oriented male in no acutedistress • Vital Signs: BP-136/80, T-98.6 F, P-78, RR-20 • Wt. 240 lbs., Ht. 5'8", BMI 36.5 HEENT • Eyes: Pupils equal, round and reactive to light and accommodation, normalconjunctiva. • Ears: Tympanic membranesintact. • Nose: Bilateral nasal turbinates without redness or swelling. Narespatent. • Mouth: Oropharynx clear. No mouth lesions. Teeth present and intact; Oral mucous membranes and lipsdry. Neck/Lymph Nodes • Neck supple withoutJVD. • No lymphadenopathy, masses or carotidbruits. Lungs • Bilateral breath sounds clear throughout lung fields. Breathing quality deep with fruity breathodor Heart • S1 and S2 regular rate and rhythm; tachycardia; no rubs ormurmurs. Integumentary System • Skin warm, dry; Nail beds pink withoutclubbing. Labs J.T. is diagnosed with diabetes. Review all information provided in the case to answer the following questions. Case Study Questions Pathophysiology & Clinical Findings of the Disease 1. Review the lab findings and decide if the diagnosis is Type 2 or Type 1 DiabetesMellitus. 2. Explain the pathophysiology associated with your chosendiagnosis 3. Identify at least three subjective findings from the case which support the chosendiagnosis. 4. Identify at least three objective findings from the case which support the chosendiagnosis. Management of the Disease *Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations. 1. Identifytwo(2)"EvidenceA"recommendedmedicationclassesforthetreatmentofthisconditionandprovidean example (drug name) foreach. 2. Describe the mechanism of action for each of the medication classes identifiedabove. 3. Identify two (2) "Evidence A" recommended non-pharmacological treatment options for thispatient. 4. Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatmentrecommendations