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NR 601 Week 5 Case Study / NR601 Week 5 Case Study_Primary Care of the Maturing and Aged Family (V5)(NEWEST, 2021) : Chamberlain College of Nursing(Download to score A) $12.49   Add to cart

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NR 601 Week 5 Case Study / NR601 Week 5 Case Study_Primary Care of the Maturing and Aged Family (V5)(NEWEST, 2021) : Chamberlain College of Nursing(Download to score A)

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NR 601 Week 5 Case Study / NR601 Week 5 Case Study_Primary Care of the Maturing and Aged Family (V5)(NEWEST, 2021) : Chamberlain College of Nursing(Download to score A)

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  • July 29, 2021
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Running head: WEEK 5 CASE STUDY 1




NR 601 Week 5 Case Study Assignment

Chamberlain University

Primary Care of the Maturing and Aged Family

,WEEK 5 CASE STUDY 2


The intent of this paper is to examine subjective and objective findings of a case study

patient to appropriately diagnose and formulate an individualized management plan that utilizes

evidence-based practice guidelines. The case study patient is a 55-year-old Hispanic female who

presents to the office for her annual exam complaining of fatigue, weight gain, polyuria,

polydipsia, and polyphagia for the past 3 months. This paper will identify applicable primary,

secondary, and differential diagnoses; and apply national guidelines from the American Diabetes

Association’s (ADA) 2019 Standards of Medical Care in Diabetes to develop a management

plan that will include the appropriate diagnostics, affordable medications, education, referrals,

and follow-up.

Assessment

Primary Diagnosis

Type 2 diabetes mellitus without complications (E11.9).

Pathophysiology. Type 2 diabetes mellitus (T2DM) is characterized by high levels of

plasma glucose due to a decreased function of pancreatic beta cells, which causes insulin

resistance and impaired insulin secretion (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

The most common manifestations of T2DM include the following: fatigue, polyuria (increased

urination), polydipsia (increased thirst), polyphagia (increased appetite) with weight loss

(Dunphy et al., 2015).

Pertinent positive findings. Very fatigued and low energy, increased hunger and thirst

with exercise, increased urination at night and more frequently during the day; which all have

been occurring for the past 3 months and a weight gain of 3 pounds (subjective). Mrs. G is 55

years old, Hispanic, and obese according to the calculated BMI of 33.3 kg/m2; elevated

, WEEK 5 CASE STUDY 3


hemoglobin A1C of 6.9%, urinalysis showed 1+ glucose and small protein, and dyslipidemia

according to lipid panel (objective) (Dunphy et al., 2015).

Pertinent negative findings. No family history of diabetes and exercising twice a week

for at least 30 minutes (subjective). Glucose 95 and urinalysis negative for ketones (objective)

(Dunphy et al., 2015).

Rationale for the diagnosis. T2DM was selected as the primary diagnosis based on the

aforementioned pertinent positive findings, which include the following: fatigue, polyuria,

polyphagia, and polydipsia; along with several risk factors for T2DM, such as age, Hispanic

ethnicity, obesity (BMI ≥25), and lack of physical activity (ADA, 2019). Additionally, the

laboratory results showed conflicting results, a normal FPG of 95 and an elevated A1C of 6.9%.

Therefore, according to the criteria for diagnosing diabetes, an A1C ≥6.5% with obvious signs

and symptoms of hyperglycemia can confirm the diagnosis of T2DM without repeat testing

(ADA, 2019). Lastly, the urinalysis showed 1+ glucose and small protein (albumin), which is an

indication of diabetes and/or early sign of kidney disease; as well as, an indication for

dyslipidemia, a common condition associated with T2DM (Dunphy et al., 2015; ADA, 2019).

Secondary Diagnosis.

Hyperlipidemia, unspecified (E78.5).

Pathophysiology. Hyperlipidemia is an acquired or genetic metabolic condition

comprising of various lipids and lipoproteins that increase the risk of atherosclerosis, or plaque

sticking to the inner walls of arteries (Dunphy et al., 2015). Lipoproteins are molecules that carry

cholesterol in the bloodstream and are separated by the following groups: VLDL, LDL, and

HDL; and triglycerides are large lipid molecules from dietary fats (Dunphy et al., 2015).

Characteristically, patients do not exhibit manifestations of hyperlipidemia, but often this

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