Laboratory Test Results:
Fasting glucose: 193 mg/dL
Hemoglobin: 8.1%
Total cholesterol: 256 mg/dL
Triglycerides: 348 mg/dL
Low density lipoprotein (LDL): 155 mg/dL
High density lipoprotein (HDL): 32 mg/dL
Urinalysis: + glucose, – ketones
1. Interpret Y.I.’s lab results. What is abnormal? What do those abnormal findings suggest?
2. Identify 3 methods used to diagnose diabetes mellitus type 2.
3. Describe the major pathophysiologic difference between types 1 and type 2 DM?
4. Name 6 risk factors for type 2 DM. Underline or highlight those that Y.I has.
Case Study Progress:
Y.I. is diagnosed with type 2 DM. The provider starts her on metformin 500mg, glipizide 5mg, orally each day at breakfast, and atorvastatin 20mg orally at bedtime. She is referred to the dietician for instructions on starting a 1200 calorie diet using an exchange system to facilitate weight loss and lower blood glucose, cholesterol, and triglyceride levels.
5. During the discharge teaching Y.I. says she is confused on the reasoning of the medication she is starting. Explain to Y.I. what each medication is for and how it will treat her condition.
6. What will you educate to Y.I. on how to treat low blood sugars should she have a low blood sugar at home? What should she eat? When should she recheck her blood sugar? When should she inform her primary doctor?
7. You determine she understands your teaching about treating hypoglycemia if she states, “if my blood sugar is low, I should first have:
A. Apple slices with fat free milk.
B. Beef stick.
C. Diet soda.
D. Potato chips with cheese.
8. Besides a dietician what other referrals and community resources may be appropriate for Y.I.?
Case Study Progress:
Y.I. comments “I have heard many people with diabetes low their toes and even their feet”. You take this opportunity to teach her about neuropathy and foot care.
9. Which symptoms that Y.I. reported led you to believe she has some forms of neuropathy?
10. What will you teach Y.I regarding neuropathy and foot care for a diabetic?
11. What monitoring will Y.I. need for nephropathy and retinopathy?
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