NR 565 ENDOCRINE CASE STUDY 2023/2024 LATEST UPDATE/ NR 565 ENDOCRINE CASE STUDY WEEK 5 QUESTIONS AND ANSWERS
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Course
NR 565
Institution
NR 565
NR 565 ENDOCRINE CASE STUDY 2023/2024
LATEST UPDATE/ NR 565 ENDOCRINE CASE
STUDY WEEK 5 QUESTIONS AND ANSWERS
NR 565 ENDOCRINE CASE STUDY 2023/2024
LATEST UPDATE/ NR 565 ENDOCRINE CASE
STUDY WEEK 5 QUESTIONS AND ANSWERS
Using diagnostic criteria for diabetes, what is John’s diabetic status? What treatment plan should
be introduced at this time?
According to the Diagnostic Criteria presented by Rosenthal & Burchum (2021, p.398),
John is a diabetic and needs to begin initiating lifestyle modifications and pharmacological
therapy immediately. The DM Diagnostic Criteria by Rosenthal & Burchum (2021) states that
there are four criteria to diagnose Diabetes Mellitus. They include:
Fasting plasma glucose ≥126 mg/dL or
Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes or Oral glucose
tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dL or Hemoglobin A1c 6.5% or
higher.
John’s HgbA1C level is 8.1% which surpasses prediabetes and puts him in a disease diagnostic
state. Additionally, his plasma glucose level is 200md/dL and he is exhibiting signs and symptoms
of diabetes, such as frequent urination during the night. He also endorses weight gain of 3 pounds
in the past year.
, Metformin is the preferred initial pharmacologic agent for the treatment of type 2 diabetes as
identified by (American Diabetes Association, 2020). John should be started on Metformin as
tolerated. His treatment plan can also include diet, physical activity, and behavioral therapy
designed to achieve and maintain weight loss especially with his past medical history of obesity
and hyperlipidemia.
John should be referred to a dietitian or nutritionist to help assess his nutritional status and create
a personalized plan that coordinates with his treatment plan. He should also be encouraged to
begin engaging in physical activity weekly. The American Diabetes Association, (2020)
recommends in their guidelines that adults with type 2 diabetes should “engage in 150 min or
more of moderate- to vigorous-intensity aerobic activity per week, spread over at least 3
days/week, with no more than 2 consecutive days without activity” (p. 16).
3. Which of John’s behaviors should be addressed to encourage lifestyle changes and decrease
A1C levels?
- John’s diet consists of mostly fast-food meals. This is a big contributor to his hyperlipidemia
and obesity. His cholesterol and A1C levels will be greatly improved if he is able to decrease his
fast-food consumption. Fast foods are typically unhealthy and high in fats, sodium, and calories
all detrimental to our health and maintaining a healthy weight. John also drinks sweet tea with
every meal which is high in sugar and drinks about 3-4 cups of coffee a day. Depending on how
he takes his coffee, his coffee drinks are probably also high in sugar and need to be addressed as
well. Drinking beers on the weekends is also another behavior that will be addressed. Instead of
drinking beers every weekend, he can drink once a month until his A1C is at goal. John’s
sedentary lifestyle is also a contributor to his diabetes. The American Diabetes Association
(2020) advises that every adult especially those affected by type 2 diabetes, should reduce their
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