05 Oct Discussion: Examining Endocrine, Metabolic, and He
Discussion: Examining Endocrine, Metabolic, and Hematologic Disorders In the United States, 25.6 million adults age 20 years or older have diabetes (American Diabetes Association, 2011). If not properly treated and managed, these millions of diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. Proper treatment and management is the key for diabetic patients, and as the advanced practice nurse providing care for these patients, it is your responsibility to facilitate this process. Patient education is critical, as is working with patients to establish a regular pattern for daily activities such as eating and taking medications. When developing care plans for patients, you must keep the projected outcomes of treatment in mind, as well as patient preferences and other factors that might impact adherence to treatment and management plans. In this Discussion, you draw from your Practicum Experience and consider factors that impact the education and treatment of patients with diabetes. For this Discussion, consider the following three case studies of patients presenting with endocrine, metabolic, and hematological disorders. Case Study 1 An 82-year-old female presents to the office complaining of fatigue, dizziness, weakness, and increasing dyspnea on exertion. She has a past medical history of atrial fibrillation, hypertension, and hyperlipidemia. Medications include warfarin 2 milligrams po daily, lisinopril 10 milligrams po daily, and simvastatin 10 milligrams po daily. There are no known drug allergies. The physical exam reveals a 5’2” older female. Her weight is 128 pounds, blood pressure is 144/80, heart rate is 98, temperature is 98 degrees Fahrenheit, and O2 saturation is 98%. Further examination reveals the following: Eyes: + pallor conjunctiva Cardiac: irregular rhythm. No S3 S4 or M. NO JVD Lungs: CTA w/o rales, wheezes, or rhonchi Abdomen: soft, BS +, + epigastric tenderness. No organomegaly, rebound, or guarding Rectal: no stool in rectal vault
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