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NURS 5334 DIABETES MELLITUS CASE STUDY 2
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NURS 5334 DIABETES MELLITUS CASE STUDY 2NURS 5334 DIABETES MELLITUS CASE STUDY 2
Diabetic Case Study
The University of Texas Arlington
College of Nursing and Health Innovation
In partial fulfillment of the requirements
of
N5334 Advanced Pharmacology for
APNs
Mary Davis, DNP, APRN, ANP-BC, BC-ADM
, NURS 5334 DIABETES MELLITUS CASE STUDY 2
Case Study Format
Assessment: Marion is a 55-year old white female that was previously treated for a
UTI at an urgent care clinic. Her UA shows protein in the urine and high glucose level.
Her random plasma glucose level is 220 mg/dL. Blood pressure reads 150/90. Her BMI
is 30.0. She has a family history of Diabetes type 2. Laboratory findings:
Fasting plasma glucose 180 mg/dL
Total cholesterol 250
Triglycerides 350 mg/dL
HDL 35 mg/dL
LDL 164 mg/dL
HbA1c 7.5 %
Serum Creatinine 1.2
GFR >60
Thyroid studies within normal limits.
Marion meets the criteria for diagnosis of diabetes mellitus type 2, hypertension,
hyperlipidemia and obesity.
Plan: Lifestyle changes include healthy eating and increased physical activity. Patient
will be instructed on reducing saturated fat, reducing sodium intake, eliminating trans-fat
and increasing dietary fiber. Increase activity to 150 minutes/week of moderate intensity.
Patient to start taking Metformin PO 850 mg PO once a day with meals for 14 days.
After 14 days, Metformin will increase to 850 mg PO BID with meals. Patient to begin
taking OTC ASA 81 mg PO once a day. Patient to begin taking Atorvastatin 40 mg PO
once a day for high cholesterol and Lisinopril 10 mg once a day for hypertension.
Patient will monitor blood glucose levels and blood pressure to ensure that they are
within normal limits while taking new medications. Patient to receive diabetes education.
Will provide patient with diabetes education resources as well. Follow up to be
scheduled 4 weeks from now.
Pharmacologic:
1. Metformin 850 mg PO once a day for fourteen days, then increase to 850 mg PO BID
(Epocrates, Inc., 2020).
2. ASA 81 mg PO once a day (Epocrates, Inc., 2020).
3. Atorvastatin 40 mg PO once a day (Epocrates, Inc., 2020).
4. Lisinopril 10 mg PO once a day (Epocrates, Inc., 2020).
Provide rationale:
Healthy eating varies depending on caloric requirements and personal or cultural food
preferences. Overall recommendations include reducing the intake of saturated fat,
eliminating trans-fat, lowering sodium intake and increasing dietary fiber (Wang, Hess,
Hiatt & Goldfine, 2016). Aerobic or resistance exercise helps to improve glucose control.
Moderate-intensity physical activity for 150 minutes/week is beneficial for decreasing
blood glucose levels. This amount of physical activity is associated with weight loss
(GC, Cadet, Hirani & Thomas, 2018). The initial drug of choice for type 2 DM is
Metformin. There is evidence of beneficial effects on A1C, decrease or maintenance of
weight and decreased cardiovascular mortality (Maruther et al., 2016). The ADA
recommends aspirin for primary prevention of CVD for diabetic patients over the age of
50 with one major risk factor (Clinical Resource, 2018). Hypertension is listed as a risk
factor. Marion meets the criteria for ASA for primary prevention of cardiovascular
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