Adolescent with diabetes mellitus (dm) case studies,

by | Aug 30, 2023 | Uncategorized | 0 comments

 

APA format

1) Minimum 12 pages  (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page

You must strictly comply with the number of paragraphs requested per page.

           Part 1: minimum  2 pages

           Part 2: minimum  2 pages

           Part 3: minimum  4 pages

           Part 4: minimum   3 pages (40 hours) 

           Part 5: minimum   3 pages (40 hours) 

 

           

Submit 1 document per part

2)¨******APA norms

         All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

         Don’t copy and paste the questions.

         Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Rreferences (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 1:  Minimum 4 references (APA format) per part not older than 5 years  (Journals, books) (No websites) 

Part 2:  Minimum 4 references (APA format) per part not older than 5 years  (Journals, books) (No websites) 

Part 2:  Minimum 6 references (APA format) per part not older than 5 years  (Journals, books) (No websites) 

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Part 1: Adolescent With Diabetes Mellitus (DM) Case Studies

  

According to the case 1 (Check File 1)

1. Why was this patient in metabolic acidosis? (One paragraph)

2. Do you think the patient will eventually be switched to an oral hypoglycemic agent? give a rationale (One paragraph- Write in the first person) 

3. How would you anticipate this life-changing diagnosis is going to affect your patient according to his age and sex?  give a rationale (Two paragraphs- Write in the first person) 

4. The parents of your patient seem to be confused and do not knowing what to do with this diagnoses. What would you recommend to them?   Give a rationale (Two paragraphs- Write in the first person)  

Part 2: Esophageal_Reflux

  

According to the case 2 (Check File 2)

1. Why would the patient be instructed to avoid tobacco and caffeine?   give a rationale  (One paragraph) 

2. Why did the physician recommend 6 weeks of medical management?  (One paragraph) 

3. How do antacid medication work in patients with gastroesophageal reflux?  (Two paragraphs) 

4. What would you approach the situation, if your patient decided not to take the medication and asked you for an alternative medicine approach?   give a rationale (Two paragraphs- Write in the first person)  

Part 3: Literature Review Assignment

 

Healthcare legislature:  Children’s Health Insurance Program (CHIP) 

1. Introduction (One paragraph)

2. Describe the purpose for the creation of healthcare legislature (One paragraph)

For example, health insurance is a problem within the USA. The ACA bill was created and passed into law

3. Discuss the historical background of the legislation including 

a. Person(s) who presented the bill. (One paragraph)

b. The committees the bill went through (One paragraph)

c. Revision of the bill until it was passed into law (One paragraph)

4. Select three articles that address the healthcare legislature development and explain

a. How and why these articles were selected (One paragraph)

b. Compare and contrast the selected articles selected (One paragraph)

5. Discuss the implication of the healthcare legislation to nursing practice according to the selected articles (Two paragraph)

6. Discuss what you have drawn from reviewing the literature so far (One paragraph)

7. Where might the discussion proceed? (One paragraph)

8. Conclusion (One paragraph)

 

Part 4: Nursing Role and Scope- Course reflection (Write in the first person)

Purpose: The purpose of this assignm3nt is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the Nursing Role and Scope course.  

1.  Introduction (One paragraph) includes:

a. BSN role with the course focus

2. Reflect on your acknowledgment about

a. Use standardized terminology in a care environment that reflects nursing’s unique contribution to patient outcomes (Two paragraphs)

b. Participate in evaluation of information systems in practice settings through policy and procedure development (Two paragraphs)

c. Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network (Two paragraphs)

3. Conclusion (Two paragraphs)

 

Part 5: Physical health assessment Course reflection (Write in the first person)

Purpose: The purpose of this assignm3nt is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the Physical assessment in health care course.  

1.  Introduction (One paragraph) includes:

a. BSN role with the course focus

2. Reflect on your acknowledgment about

a. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of patient care  (One paragraph) 

b. Create a safe care environment that results in high-quality patient outcomes (Two paragraphs) 

c. Revise the plan of care based on an ongoing evaluation of patient outcomes (Two paragraphs) 

d.. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the healthcare team (Two paragraphs) 

3. Conclusion (One paragraph)

Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition

Adolescent With Diabetes Mellitus (DM) Case Studies

The patient, a 16-year-old high-school football player, was brought to the emergency room in a coma. His mother said that during the past month he had lost 12 pounds and experienced excessive thirst associated with voluminous urination that often required voiding several times during the night. There was a strong family history of diabetes mellitus (DM). The results of physical examination were essentially negative except for sinus tachycardia and Kussmaul respirations.

Studies

Results

Serum glucose test (on admission), p. 227

1100 mg/dL (normal: 60–120 mg/dL)

Arterial blood gases (ABGs) test (on admission),

p. 98

pH

7.23 (normal: 7.35–7.45)

PCO2

30 mm Hg (normal: 35–45 mm Hg)

HCO2

12 mEq/L (normal: 22–26 mEq/L)

Serum osmolality test, p. 339

440 mOsm/kg (normal: 275–300

mOsm/kg)

Serum glucose test, p. 227

250 mg/dL (normal: 70–115 mg/dL)

2-hour postprandial glucose test (2-hour PPG), p.

230

500 mg/dL (normal: <140 mg/dL)

Glucose tolerance test (GTT), p. 234

Fasting blood glucose

150 mg/dL (normal: 70–115 mg/dL)

30 minutes

300 mg/dL (normal: <200 mg/dL)

1 hour

325 mg/dL (normal: <200 mg/dL)

2 hours

390 mg/dL (normal: <140 mg/dL)

3 hours

300 mg/dL (normal: 70–115 mg/dL)

4 hours

260 mg/dL (normal: 70–115 mg/dL)

Glycosylated hemoglobin, p. 238

9% (normal: <7%)

Diabetes mellitus autoantibody panel, p. 186

insulin autoantibody

Positive titer >1/80

islet cell antibody

Positive titer >1/120

glutamic acid decarboxylase antibody

Positive titer >1/60

Microalbumin, p. 872

<20 mg/L

Diagnostic Analysis

The patient’s symptoms and diagnostic studies were classic for hyperglycemic ketoacidosis associated with DM. The glycosylated hemo

Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition

Esophageal Reflux Case Studies

A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her physical examination were negative.

Studies

Results

Routine laboratory studies

Negative

Barium swallow (BS), p. 941

Hiatal hernia

Esophageal function studies (EFS), p. 624

Lower esophageal sphincter (LES)

pressure

4 mm Hg (normal: 10–20 mm Hg)

Acid reflux

Positive in all positions (normal: negative)

Acid clearing

Cleared to pH 5 after 20 swallows (normal:

<10 swallows)

Swallowing waves

Normal amplitude and normal progression

Bernstein test

Positive for pain (normal: negative)

Esophagogastroduodenoscopy (EGD), p. 547

Reddened, hyperemic, esophageal mucosa

Gastric scan, p. 743

Reflux of gastric contents to the lungs

Swallowing function, p. 1014

No aspiration during swallowing

Diagnostic Analysis

The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and shortness of breath at night were caused by aspiration of gastric contents while sleeping. This was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had only minimal relief of her symptoms after 6 weeks of medical management, she underwent a laparoscopic surgical antireflux procedure. She had no further symptoms.

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