FNP NR507 - Week 6 CS - Diabetes

Case Study, Cardiovascular Disorders  Gloria Gonzales is a 56-year-old Hispanic female with a history of type 2 diabetes mellitus, obesity, and hypertension. She was admitted to the medical unit 2 days ago with chest pain that was unrelieved with three nitroglycerin sublingual. She has had the following lab work: CK, LDH, AST, troponin, lipid levels, and an ECG stress test. She is scheduled to have a cardiac catheterization in the morning 3. According to Mrs. Gonzales’ medical history, what has contributed to her myocardial infarction?   4. What should the nurse anticipate doing to prepare Mrs. Gonzales to be discharged?

Case study 9 Miss Owusuaa was diagnosed with acromegaly, excess production of growth hormones. There are two ways to investigate it. Insulin growth factor -1 (IGF-1) test. a. State the other and how is it done. b. Classify the following (I) patient - 1 glucose from 0-2 hrs level : 134mg/dl (II) patient - 2 glucose from 0-2 hrs level :185mg/dl (III) patient -2 glucose from 0-2 hrs Level : 201mg/dl

Case Study, Cardiovascular Disorders  Gloria Gonzales is a 56-year-old Hispanic female with a history of type 2 diabetes mellitus, obesity, and hypertension. She was admitted to the medical unit 2 days ago with chest pain that was unrelieved with three nitroglycerin sublingual. She has had the following lab work: CK, LDH, AST, troponin, lipid levels, and an ECG stress test. She is scheduled to have a cardiac catheterization in the morning 1.Explain the rationales for the laboratory tests and ECG stress test.   2. What should the nurse do to prepare for the cardiac catheterization that is scheduled?

Presentation on type 2 diabetes 1 introduction and cause 2. Causes and diagnosis 3. Nursing intervention and conclusions

CASE STUDY: PRIMARY HYPOTHYROIDISM Connie, age 28, has been hospitalized for 2 days for symptoms leading to the diagnosis of primary hypothyroidism. 1. What tests does the nurse know will assist with the confirmation of diagnosis of primary hypothyroidism for Connie? 2. What clinical manifestations that are consistent with Connie’s diagnosis should be monitored? 3. What comfort measures can the nurse include in Connie’s care?

PLEASE ANSWER   write diagnostic statement for each ques   1. A hypertensive client states that she hasn't been taking her medication because it doesn't make her feel any better . Also, she says she has difficulty remembering to take it.   2. An elderly patient with left side paralysis has a red, broken area in the skin over his coccyx. The patient cannot turn himself in bed.   3. The client is 45 pounds overweight . He states that he is in a high stress job and doesn't have time to cook regular meals - he tends to eat fast food and snacks a lot . His job is sedentary , and he does not engage in any type of physical exercise or sport . Fo fun, he likes to " eat at a nice restaurant "

Case Study 3 – Congestive Heart Failure Dottie is a 78-year old CHF patient. She has been exercising with your facility for several years now. She had a CABGx3 in 2020. She came in today with a 5 lb. weight gain since yesterday when she weighed on her home scale this morning. Her meds include- Lipitor, Procardia, and Lasix. (Cholesterol, Calcium channel blocker Hypertension, and Diuretic, respectively) Her blood pressure is 132/88 and her HR = 102; Her weight is 196, up from 191 when last measured. She is a pleasant, overweight individual who enjoys walking on the treadmill and visiting with other members of your facility. 1. What are specific considerations for someone with CHF and exercise? How is the exercise prescription any different from the apparently healthy adult prescription? 2. What is your biggest concern with Dottie today and how would you handle this concern(s)?

Patient C., 32 y/o, complains of excessive weight, shortness of breath, defective memory, performance decrement, feeling cold, emotional retardation. It is known from the case history that the patient is suffering from primary hypothyroidism. Objectively: the skin is dry, waxlike, swollen, periosteal reflexes are lowered, body mass index: 33.5 kg/cubic meter, TSH (thyroid-stimulating hormone) – 25 µU/dL (norm 0.5 -5.0). Obesity is homogenous. Arterial pressure: 150/100 mm column ob mercury. What type of obesity can be suspected?A. Endocrine hypothyroidB. Endocrine accompanying dysfunctions of hypothalamopituitary systemC. Alimentary constitutionalD. HypothalamicE. Androidal with the developed symptoms of metabolic syndrome

PLEASE ANSWER asap   write diagnostic statement    3. The client is 45 pounds overweight . He states that he is in a high stress job and doesn't have time to cook regular meals - he tends to eat fast food and snacks a lot . His job is sedentary , and he does not engage in any type of physical exercise or sport . Fo fun, he likes to " eat at a nice restaurant "

John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID.  Question: Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome? Identify 2 IntraOp nursing diagnoses for Mr. Doe teaching does Mr. Doe require in order to prevent complications? Give 3-4 examples)

MAKE SHORT TERM GOAL AND 5 OBJECTIVES FOR THIS DX. Main Dx:  Imbalanced nutrition less than body requirements related to Lacto-Ovo vegetarian diet as evidenced by lack of essential minerals & nutrients (Iron, Zinc & Omega Fatty-acids) SHORT TERM GOAL: OBJECTIVES: 1.  2.  3.  4. 5. SCENARIO:  Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and B complex, and every year she gets flu vaccine from their family doctor. During the interview with the nurse,…

Questions for the Case Study:1. Make a table of the medications prescribed to the patient. Include the indication, mechanism of action, standard dose, and frequency. 2. Analyze the case and identify the adverse reaction/s that occurred. What type of ADR happened? 3. What should be done to avoid the type of adverse reaction that happened to the patient?

12:23 ll LTE cdn.fbsbx.com Done 6 of 24 Summary Post test 1: Multiple Choice Direction: Read the questions comprehensively and write the letter of your choice in your answer sheet. 1. It refers to any activities which involves movement of the muscles of our body and requires exertion of energy. a. Physical change b. Physical Body c. Physical Activities d. Physical appearance 2. The following are examples of physical activities EXCEPT? a. Eating and Drinking b. Running c. Pilates d. Aerobics 3. These are Physical activities that were planned and more structured it also gives us the opportunity to embrace healthy and active lifestyle by doing so. a. Physical fitness b. Exercise c. Yoga d. Physical education 4. These type of Physical Activities are also known as "cardio exercise" it increases our heart and breathing rate. They cause us to sweat profusely and breathe harder our heart pumps blood more vigorously, causing oxygen to circulate throughout our body.? a. Aeronautic activities b.…

UNIT 7 CRITICAL THINKING QUESTIONS Critical Thinking Questions 1. Imagine that there has been an emergency and you are calling 911. Write a brief paragraph describing the situation and giving what necessary information you would give on the phone call. 2. Under what circumstances would a health care professional not begin an exarsination by checking the vital signs? 3. If a woman is in an accident and her blood pressure is high immediately afterwards, is this an indication of a health problem? 4. The unit discusses the importance of hand washing in health care. Think of three other industries that would need to be especially careful about hand washing and explain its important in these fields. 5. Think about the kinds of common errors in health care described in Unit 6. How could root cause analysis be used to help health care facilities avoid errors?

Patient M., 36 y/o, was found in the street unconscious. The patient has a medical history of diabetes. There is a smell of alcohol from the mouth. The skin is moist, warm, arterial pressure -145/90 mm column of mercury, convulsive twitching of muscles. Breathing is shallow, eye ball tone is retained, pupils are dilated, hyperflexion. How would you treat this patients?A. Intravenous introduction of 40-80-100 ml 40% glucose solution B. Injecting 20 units of insulin subcutaneouslyC. Injecting 20 units of insulin intravenouslyD. Injecting 500 ml 5% glucose solution intravenouslyE. Injecting 500 ml 0.9% sodium chloride intravenously

Formulate a Discharge Plan for a 3-year-old male child newly diagnosed with Diabetes Mellitus Type 1. Use the acronym METHODS (medication, exercise(activity /environment, treatment, health education, out-patient follow-up, diets, social/spiritual). His home medication is Regular Insulin 3 units SC TID 30 minutes before meals. The doctor also ordered monitoring of blood glucose TID before an insulin injection. The doctor advised them to return for a follow-up checkup after 2 weeks with the CBG monitoring log, and as needed. The parents are anxious about their child's condition and worried that they might not be able to take care of him. The mother asks for instruction on how to administer the insulin as this is the first time that they will do this. The mother verbalized concern that his child might need diet and activity restrictions. They have heard the word "hyperglycemia and hypoglycemia" from an adult neighbor and asks you if their child would also experience those episodes. The…

Study questions: Betty Cooper, 25-y/o-female, is admitted to the emergency department with decreasing level of consciousness. She is 98lbs and stands at 5ft. She has a history of diabetes mellitus since she was 9 years of age. A physical assessment and laboratory data reveal the following: > Dry skin, poor turgor > RR = 40cpm, rapid and deep & labored > Serum Na = 130 mEq/L > HR = 118bpm, weak pulse > Temp = 98°F > BP = 110/70 mmHg > ABG: pH = 7.15; HCO3; 13mEq/L; PCO2 = 35 mEq/L 1. Calculate Betty's serum osmolality. > Serum glucose = 504mg/dl > Serum K = 5 mEq/L > Serum CI = 108 mEq/L > BUN = 74.68 mg/dL 2. What type of diabetes mellitus does Betty possibly have? Why? 3. Which complication of diabetes mellitus does Xia possibly have, diabetic ketoacidosis or hyperglycemic hyperosmolar state? Why? 4. What is the 1st priority nursing management and medical management? Why?

MAKE AN ANALYSIS OF THE SAID DX. dx: Imbalanced nutrition related to lack of knowledge about diet SCENARIO:  Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and B complex, and every year she gets flu vaccine from their family doctor. During the interview with the nurse, Aubrey mentioned that she has no known allergies. She said “I don’t think I have any problems with my health. I am lacto-ovo vegetarian. Most of the time I hang out with my friends for a tea or…

QUESTIONS. 1. What nursing assessment findings support the diagnosis of Liver Cirrhosis? 2. Correlate the patient’s presenting clinical manifestations of esophageal varices in livercirrhosis? 3. In what order should the nurse institute the physician orders that are listed above? Perform dosage calculations and state how to administer the medications. 4. The nurse observes the nasogastric secretions and, upon admission to the ICU, there was200 mL of dark red-colored drainage. The nurse continues to monitor the drainage and, asthe nurse hangs the first unit of PRBCs, 200 mL of bright red bloody drainage is dumpedinto the collection canister. What should the nurse do? 5. The gastroenterologist orders for the nurse to increase the octreotide to 50 mcg/hr and the endoscopy nurse and the physician will be up shortly to perform a vertical band ligation (VBL). What does the nurse need to do in preparation for this procedure? 6. What nursing diagnoses should the nurse formulate for the patient?…

Answer the ff. questions briefly  1. Describe the baroreceptor reflex when the blood pressure increases and decreases. 2. How is the mean arterial pressure related to heart rate, stroke volume and peripheral resistance? 3. For each of the following hormones, describe their effect/s on the circulatory system: Epinephrine, Renin, Angiotensin II, Aldosterone, ADH, and ANP

Written Assignments 1. Prepare child and parent teaching sheets on Lyme disease and mononucleosis, including preventive measures. 2. Create a poster that depicts nutritional recommendations for a school-age child with type 1 diabetes.

Name: Patient XOXO Age: 54 y/o Patient XOXO, a teacher at public school in Caloocan City. She currently weighs 57kg and stands 5'4'' tall with medium body frame size. She was recently diagnosed with Dysphagia secondary to Neurologic Disorder. Her doctor prescribed a Level 1 Dysphagia diet  based on her tolerance after the swallowing assessment and recommendations of OT and PT. Create a one-day meal plan for Patient XOXO requiring such diet.

Case Study 1   Morphine Suspension (1 mg/mL)   One of your long-term patients who you have known for many years has progressed to end-stage prostate cancer and been placed on a palliative care program. The currently commercially available morphine liquids he has been using contain a flavouring agent that makes him nauseous. His Physician has requested you compound a morphine liquid for him without flavour as his pain is well controlled on this medication and he does not want to change to another pain reliever. Your pharmacy team and the Physician would like to make his end-of-life process as comfortable as possible. A formulation for a suspension appears to be a good option to try.   RX: Morphine liquid 1 mg/mL Sig: Take 1-2 mL q1h prn Mitte: 100 mL   Formulation: Morphine HCl 10 mg Glycerol 1 mL Compound Hydroxybenzoate Solution 0.1 mL Purified water to 10 mL Use within 1 month Questions:   Calculate the quantities you will require for each ingredient and create a worksheet. (You may…

Case Study 1   Morphine Suspension (1 mg/mL)   One of your long-term patients who you have known for many years has progressed to end-stage prostate cancer and been placed on a palliative care program. The currently commercially available morphine liquids he has been using contain a flavouring agent that makes him nauseous. His Physician has requested you compound a morphine liquid for him without flavour as his pain is well controlled on this medication and he does not want to change to another pain reliever. Your pharmacy team and the Physician would like to make his end-of-life process as comfortable as possible. A formulation for a suspension appears to be a good option to try.   RX: Morphine liquid 1 mg/mL Sig: Take 1-2 mL q1h prn Mitte: 100 mL   Formulation: Morphine HCl 10 mg Glycerol 1 mL Compound Hydroxybenzoate Solution 0.1 mL Purified water to 10 mL Use within 1 month Questions:   What are the purposes of each excipient in this mixture?   What counselling instructions should…

CASE STUDY - SHOCKYou and your partner are dispatched for a report of an unresponsive 77-year-old male in asenior’s apartment complex. The time of the call is 08:36 am.Upon arrival, a home health aide greets you at the apartment door and informs you thepatient is in the bedroom. As she leads you towards the bedroom, the aide begins to tellyou she arrived for work about an hour ago and found the patient in his bed. “He normallyis awake when I get here, but today I found him still in his bed. I thought he was onlywanting to sleep in so I decided I would give him a little time, but he didn’t respond when Itried to wake him a few minutes ago.”She tells you she routinely visits Mr. Oliveira twice a week to help with cleaning andcooking. She says, “The last time I saw him was 3 days ago and he was sick at the time. Ithought he might have come down with a bad cold because he was coughing a lot and Itried to encourage him to see his physician.”As you approach the patient’s bedside, you observe…

Case Study 1   Morphine Suspension (1 mg/mL)   One of your long-term patients who you have known for many years has progressed to end-stage prostate cancer and been placed on a palliative care program. The currently commercially available morphine liquids he has been using contain a flavouring agent that makes him nauseous. His Physician has requested you compound a morphine liquid for him without flavour as his pain is well controlled on this medication and he does not want to change to another pain reliever. Your pharmacy team and the Physician would like to make his end-of-life process as comfortable as possible. A formulation for a suspension appears to be a good option to try.   RX: Morphine liquid 1 mg/mL Sig: Take 1-2 mL q1h prn Mitte: 100 mL   Formulation: Morphine HCl 10 mg Glycerol 1 mL Compound Hydroxybenzoate Solution 0.1 mL Purified water to 10 mL Use within 1 month. What special prescription requirements will you need from the doctor? Can he prescribe refills over the…

16-The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? 1. Administer the iron at mealtimes. 2.Administer the iron through a straw. 3. Mix the iron with cereal to administer. 4. Add the iron to formula for easy administration 17- Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1.Elevated hemoglobin level 2.Decreased reticulocyte count 3.Elevated red blood cell count 4. Red blood cells that are microcytic and hypochromic

Questions. 1. Formulate or create a structured plan of Daniel’s day-to-day activities based on his condition. 2. Can you help me create an illustration of an ideal room for Daniel? Thank you!

Fluid and Electrolytes Case Study Patient Profile: Frances, a 78 years old that lives alone, is admitted to the hospital because of weakness and confusion. She has a history atrial fibrillation and chronic heart failure (HF). On admission it is noted that her at home medications include Digoxin (Lanoxin), Furosemide (Lasix), Metoprolol, Diltiazem and Levothyroxine. Objective Data: Neurologic: Confused; slow to questioning; generalized weakness; states she has trouble focusing his vision- people look green with halo's Cardiovascular: BP 100/59; HR 55 irregular; peripheral pulses weak; ECG indicates Atrial fibrillation with controlled ventricular response Pulmonary: Respirations at 12/min; shallow Skin: decreased turgor; dry mucous membranes Laboratory Results: Digoxin level Electrolytes ● • Mag+ CI- BUN CBC Na+ K+ ABG ● RBC ● WBC ● Creatinine Glucose CO2 Hemoglobin Hematocrit Platelets pH PaO2 PaCO2 HCO3- 1.0 ng/ml 134 mEq/L 2.5 mEq/L 1.2 mEq/L 88 mEq/L 42 mg/dL 0.9 mg/dL 122 mg/dL…

NURSING CORRECT ANSWERS  .  Mr. Jackson was hospitalized today for heart failure. The physician orders a loading dose of digoxin 0.75 mg to be given intravenously. The digoxin is available in a solution of 0.5 mg/mL. (Learning Objectives 2, 4, 6) 1. How many milliliters should the nurse prepare? 2. What should the nurse do before administering the IV dose? 3. If digoxin toxicity develops, what signs or symptoms might Mr. Jackson have? 4. How often should Mr. Jackson be monitored for signs of digoxin toxicity? 5. What conditions might increase Mr. Jackson’s likelihood of exhibiting digoxin toxicity?.

Patient C., 32 y/o, was delivered unconscious to the intensive care department. The patient has a medical history of diabetes. Insulin was not found. The breathing is noisy, of Kussmaul’s type; acetone breath, the skin is dry, turgor is lowered, the facial features are sharp, periosteal reflexes are absent, eye ball tone is lowered. Blood contains 1.2 mmol/l of lactic acid (norm - 0.62-1.3 mmol/l), glycemia - 29 mmol/l. What kind of coma can be suspected?A. KetoacidoticB. Brain comaC. HyperosmolarD. HypochloremicE. Lactacidemic

CASE STUDY: Nelson Amoah, 54-year-old male presents to the emergency department with abdominal pain, nausea, vomiting, abdominal distension and constipation which started 3 days prior to presentation. He denied fever, chills and headache. Except for peptic ulcer disease, he is otherwise healthy with no previous surgeries. He is a smoker, smoking a little less than a pack a day for twenty-two years. On examination he was afebrile, with a heart rate of 120 beats/min, blood pressure 130/80 mmHg and respiratory rate of 22 cycles/min. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness in the epigastrium. There were no palpable masses and bowel sounds were absent. Erect and supine abdominal and chest radiographs were normal. However, abdominal ultrasonography revealed free fluid throughout the abdomen and pelvis. a.       State at least FIVE questions that you would ask in analyzing Mr. Amoah’s pain b.      Identify all;…

Edema Case Study Questions The following four patients all have severe edema for different reasons. Your challenge is to explain the cause of the edema. In each case, try to explain the edema in terms of either an increase or a decrease in one of the four pressures that cause bulk flow at capillaries. A picture may be useful. Patient 1: Mr. Taylor Mr. Taylor is a 66 year old alcoholic who has been drinking for years. During the past month he has gained over 25 pounds due to water retention. He exhibits swelling in all areas of the body. He has recently been admitted to the hospital and diagnosed with end stage liver failure. What is the connection between the liver failure and his edema? Which capillary pressure is altered and how does it cause edema? Hint: consider the functions of the liver, particularly the ones that affect blood composition.  Patient 2: Mrs. So   Mrs. So is a 28 year old visiting her OB in the 26th week of her pregnancy. She is experiencing varicose veins and…

Assignment 33-5: Insulin Shock and Diabetic Coma Activity mto a dlabetic coma (C) or for someone who is more likely to slip into insulin shock (S). 1. Confused and disoriented 2. Headache 3. Gradual onset 4. Skin is pale, cool, and clammy 5. Drowsiness 6. Thirst is intense 7. Fruity odor from the mouth 8. Pulse is full and pounding 9. Low blood sugar 10. High blood sugar

QUESTIONS: 1. Explain the role of dietary fat in atherosclerosis. 2. Define essential fatty acids and give examples.