...prevalence, diabetic ketoacidosis, insulin pump complication, and insulin pump therapy today. At the end of literature review, chapter’s author will discuss the critical of patient safety and team in management for diabetes mellitus. The methodology will be in the following chapter number...
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...Diabetic Ketoacidosis Quinnton M Rees Brigham Young University-Idaho Diabetic Ketoacidosis The American diabetes association (2011) defines diabetic ketoacidosis (DKA) as a medical emergency that can progress to a diabetic coma and death if not rapidly diagnosed and treated (American diabetes association (ADA), 2011). DKA is a complication associated with diabetes mellitus (DM) and is characterized by hyperglycemia due to a deficiency in insulin (Urden, Stacey, & Lough, 2010). Rapid diagnosis and aggressive treatment of DKA is crucial because it is potentially life threatening (Kitabchi, Rose, 2011). Nurses in the critical care setting are responsible for understanding the disease process of DKA as well as identifying its signs and symptoms so that patients can receive prompt treatment early before it progresses. This paper will discuss DKA and explore its epidemiology, etiology, pathophysiology, assessment, diagnosis, treatment, and nursing and interventions associated with it. Epidemiology and Etiology DKA is a complication of type-one and type-two DM and is typically seen more in type-one diabetics because of they are deficient and lack the ability to produce insulin (Urden et al., 2010). Type-two diabetics can develop DKA but it is very rare and is usually precipitated in a patient who is severely ill (Diabetic ketoacidosis, 2011). Those most likely to develop DKA associated with type-two DM include Hispanics and African Americans (Diabetic ketoacidosis...
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...Abdelhamid Hadjahmed Drug: Metformin 1. Introduction of the medication (Case Study) A 54 year old male with obesity, and 6 year history poorly controlled type 2 diabetes. Complains of polyuria, polydipsia, fatigue, blurred vision, and headaches. Recently admitted to the hospital for diabetic ketoacidosis. He would like to get control over his diabetes so this doesn't happen again. 2. Demonstrates knowledge of the content through a teaching presentation? Actions of the medication- Metformin decreases the production of glucose or sugar in the liver, it decreases the absorption of glucose in the intestines, and it also helps increase the sensitivity of the insulin your body produces by increasing uptake and utilisation. Why is the patient taking...
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...Diabetes Case Study Diana Gallardo, Karen Joy, Brianna Herrera, Svetlana Knyazeva NUR/427 5/6/2013 Sara Gerrie RN, MSN, CPNP Diabetes Mellitus is a chronic illness affecting the metabolic and endocrine function of the body. Type 1 diabetes affects 5% to 10% of people with the disease, whereas type 2 diabetes affects nearly 90% to 95% of people with the disease (Centers for Disease Control and Prevention [CDC], 2008). An overview of the incidence of diabetes in the United States, signs and symptoms, and effects of diabetes as a chronic disease will be provided. The case study of Angelo Reyes, a 40-year-old White male living with type 1 diabetes will be used to implement teaching requirements with measurable learning objectives from Bloom’s taxonomy of learning domains. The psychosocial challenges that Angelo Reyes encounters will also be discussed. According to Smeltzer, Bare, Hinkle, and Cheever (2010), the number of people with diabetes in the United States is 23 million with increasing rates of 1 million new diagnosed cases per year. This number is expected to exceed 30 million by 2030 (CDC, 2008). People older than 65 years old seem to have more intolerance to glucose and 40% of them account for the population with diabetes. Minority groups such as African Americans, Native Americans, Hispanics, Asian Americans, and Pacific Islanders are at higher risk for diabetes, complications associated with the disease, and high rates of disease related death (CDC, 2008)...
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...Insulin resistance is characterized by a state where the body can produce insulin but it can’t use it properly. It occurs when a needed substance is present in the body, but it is unable to be utilized by the cells of the body. In this case of type 2 diabetes insulin resistance, the muscles and cells of the body do not respond or recognize the presence of insulin, resulting in decreased amounts of glucose being delivered to the cells. The body reacts to this decrease in glucose in the cells by sending signals demanding more glucose for energy, As long as the pancreas can produce enough insulin, meeting the demand for increased amounts of glucose, the body appears to function normally and glucose levels remain at healthy levels. If the demand for glucose exceeds the ability to produce insulin, blood glucose levels still increase. The pancreas then over-secretes insulin to compensate for insulin resistance; this process usually leads to -cell dysfunction, another characteristic dysfunction of type 2 diabetes. Insulin resistance leads to elevated fatty acids in the plasma, causing decreased glucose transport into the muscle cells, as well as increased fat breakdown, subsequently leading to elevated hepatic glucose production....
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...Diabetics Case Study Diabetes is of high incidence in the United States affecting children and adults of different ethnics groups and levels of education. Today we will discuss Diabetes, management, factors that interfere with its Control and the complication. The challenges of Mr. Reyes diabetes control and how this affects the family. Education to the public on prevention of diabetes by weight management and exercise is Imperative at an early age. Diabetes is a manageable disease which we can learn to live with it in order to control it. According to the ADA, nearly 26 million children and adults are living with diabetes, and another 79 million are at high risk for developing type 2 diabetes; even more alarming data suggests that by 2050, as many as one in three American adults will develop diabetes (“Cabot Creamery Cooperative Offers 5-Day Menu Planner for American Diabetes Month,” 2011, Para 1.). According to the CDC, the United States incurred an estimated $174 billion in direct and indirect medical costs related to diabetes in 2007(“Diabetes: Affects 25.8 million,” 2011, P. 26). "These statistics paint a disturbing picture for Americans in the near future," said Cabot Registered Dietitian Regan Jones, "but fortunately, there is still time to act. (“Cabot Creamery Cooperative Offers 5-Day Menu Planner for American Diabetes Month,” 2011, Para 2.). Education and a responsible diet may prevent some instances of type 2 diabetes from ever occurring, and for those already...
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...Approximately 17 million Americans have diabetes.(Lamb) As many as one-half are unaware they have it. This chronic disease causes serious health complications including renal failure, heart disease, stroke, and blindness. It is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced. Then glucose in the blood is not able to be absorbed into the cells of the body.(Kishore) The cells in the human body need energy in order to function. Glucose is the body's primary energy source. It is a simple sugar resulting from the digestion of foods containing carbohydrates. It circulates in the blood from the foods that are digested as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas, it is located behind the stomach. It bonds to a receptor site on the outside of cell and goes into the cell through which glucose can enter. Glucose can be saved for later use by converting to concentrated energy sources like glycogen or fatty acids. When there is not enough insulin produced , glucose stays in the blood rather entering the cells. The body will attempt to dilute the high level of glucose in the blood, which called hyperglycemia. Hyperglycemia acts by drawing water out of the cells and into the bloodstream, to dilute the sugar and excrete it in the urine. People with undiagnosed diabetes to be constantly thirsty, drink large quantities of water, and urinate...
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...Case Studies Weeks 1-4 Advanced Anatomy and Physiology Name: Robert Mixon Student ID#: 4321101 Case Studies – Instructions: Type your answers IN RED and use your textbook and other resources such as the ones listed below to help you answer the questions. Merck Manual of Diagnosis and Therapy: http://www.merck.com/mmpe/index.html MedlinePlus: Medical Dictionary: http://www.nlm.nih.gov/medlineplus/mplusdictionary.html E-medicine from WebMD: http://emedicine.medscape.com/________________________________________ Case #1: Jim and Jane Magnolia have tried for years to conceive a child, with no success. So instead, they have decided to adopt a child. They have found a beautiful little girl named Emma who has been given up by her mother....
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...Unit 2 Case Study Eillin Zamudio 09/23/2014 Case: D.K. is an 18-year-old high school student who began to experience weight loss despite a ravenous appetite and resulting increased dietary intake. She has to make frequent trips to the bathroom to urinate and has difficulty concentrating on her work because of fatigue. She drinks large volumes of coffee to help with a constant dry mouth and to combat her fatigue. At a clinic appointment, it was noted that D.K.’s weight has dropped from 140 to 128 pounds. She is 5 feet 7 inches tall. Her urine specimen shows glycosuria and ketonuria. A chemstick blood glucose level is 412 mg/dl. D.K. had eaten breakfast 3 hours before the chemstick blood test. Question-1: Indicate what form of diabetes mellitus is the patient suffering from and explain why you chose that form. From D.K.’s patient history and examination, many signs leading to the assumption of an insulin-related diabetes are present. We can note that D.K. has been experiencing increased levels of hunger, thirst and of course, urination. Additionally, she has had a rapid weight loss (from 140 lbs. to 128 lbs.) and continues to have fatigue and dry mouth, which she treats with coffee. D.K. has symptoms that correlate with diabetes mellitus type 1, which is known as an insulinopenia. Because D.K.’s glucose levels were above 412 mg/dl., it was appropriate to test for ketonuria, which ended up showing up positive. Additionally, D.K.’s glycosuria symptoms can arise from a hyperglycemia...
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...student will be able to: 1. Describe the negative feedback system for hormone control. 2. Differentiate type 1 and type 2 diabetes mellitus. 3. Identify etiologic risk factors for diabetes mellitus and early manifestations. 4. Compare and contrast hypoglycemia with hyperglycemia. 5. Describe the chronic complications associated with diabetes mellitus. 6. Differentiate diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar non-ketosis (HHNK). 7. Explain the effects of excess and deficit of thyroid hormone. Learning activities: 1. Read Chapter 31-33 in Porth. 2. Access the power point presentation in course documents. 3. Answer the following study questions: a. Why would a teenager with diabetes mellitus be more likely to have acute complications than an older adult? b. Compare the manifestations of DKA and HHNK. c. Describe two chronic complications of diabetes mellitus and discuss preventive measures for each. d. Identify the effects of hyperthyroidism and hypothyroidism in an adult. Complete the following case analysis: A 45-year-old female develops Graves’ disease (hyperthyroidism). She is married with two children ages 8 and 10. She works full-time as a grocery store clerk and goes to school part-time two evenings each week. During the past month, her mother died in an automobile accident and her father was diagnosed with prostate cancer. She has noticed that she has lost weight over the past...
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...different routes in becoming a Registered Nurse. There is the 2-3 year Associate degree level (ADN), which can be obtained at a community college, and there is the four year baccalaureate degree (BSN), which can be obtained at a university. In both routes after finishing the program the candidate needs to take the licensing examination test called NCLEX-RN. When making a decision of what route to take the difference in competencies need to be taken into consideration. Differences include level of knowledge, skill preparation, and clinical judgment. A BSN degree nurse has a more comprehensive knowledge base than those who have an ADN. The bachelor nursing program includes everything taught to an associate degree nurse plus more detailed studies on physical and social sciences, public and community health, humanities, nursing research, and nursing management. Nurses that obtain a baccalaureate degree in nursing have a broader knowledge of disease prevention, health promotion, and risk reduction (Ellis, 2007). Having a BSN degree prepares a nurse to deal with illness and disease management in a more efficient way than an ADN nurse. In addition, those who obtain a BSN degree must be able to make critical decisions about patient care and learn to understand more in depth about the patho-physiology of disease processes (Forster, 2008). The ADN education is more task orientated, putting less emphasis on applying critical thinking when making clinical decisions, sometimes resulting in...
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...body When someone has diabetes their body either doesn’t make any/enough or can’t use its own insulin as it should Glucose begins to build up in the blood Prevalence: WHO estimate in: 2000 = 177 million diabetic people 2025 = 300 million diabetic people = 9% global population IDF (international diabetes federation): 2 million diabetic people in UK with over 750,000 undiagnosed NICE: 650,000 women give birth in England & Wale each year and 2-5% (13,000-32,500) involves women with diabetes, of these: * 87.5% are Gestational Diabetes (GD) * 7.5% are Type 1 * 5% are Type 2 From 1997-2003 there was 74% rise in new cases in the UK with the West Midlands being one of the highest areas (News, 2009) Treatment: Aim: to maintain glycaemic control – regular monitoring is required Lifestyle: diet, exercise Medication – tablet or injection e.g. Insulin, rapid acting insulin analogues (Aspart, Lispro) and/or hypoglycaemic agents (Metformin and Glibenclamide) Diabetes health complications: Hypoglycaemia: Too much insulin; which can cause low blood sugar Symptoms: Paleness, shaking, hunger, sweating Specialist will advise what to do e.g. consume sugary soft drink Occasionally can cause loss of consciousness – an injection will be needed Diabetic Ketoacidosis (DKA)/Hyperglycaemia: A life-threatening complication. Near complete deficiency...
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...The risk factors B.Z. may have for contracting NIDDM are genetics and obesity. The case study had stated that his father and paternal grandmother had developed diabetes. The other risk factor is obesity because B.Z. is 5’8” and 210lbs, which is very much over weight for his height. The pathophysiology of NIDDM, which is a non-insulin dependent diabetes mellitus and the body stops producing enough insulin for the body. The body does not have any ketones and occurs more frequently in people over the age of 30. The signs and symptoms of NIDDM are a delay in the secretion of insulin, it gets worse with age, Muscle and adipose tissue are most resistant, you will have high blood sugar levels, and the liver will initiate gluconeogenesis. The basic defect in this type of diabetes is genetics and obesity. 2. The significance of B.Z.’s report of Polydipsia and Polyuria are that the signs and symptoms are very similar to the signs and symptoms of diabetes. The 3 P’s in diabetes are polyuria, polydipsia and polyphagia. Polyuria is increased urine output. Polydipsia is increased thirst. Polyphagia is increased eating or hunger. The water is pulled intracellular causing dehydration. - The recent weight loss of B.Z. is due to the fluid in the osmolarity levels and the loss of body tissue. - Orthostatic Hypotention is an abnormal decrease in blood pressure when a person stands up. B.Z. has orthostatic hypotension because he is not getting enough blood flow to the brain. 3...
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...Case Study of DKA Patient Anonymous Student Name College or University Name Your Nursing Class # Instructor’s Name November 18, 2011 R.C. is a 42 year old Native-American male that presents to the ER today generally looking ill and, appears to be 10 years older than his stated age. He is dehydrated, and has had Type 1 diabetes, which was diagnosed ten years ago. He has been sick for the last 2 days; as stated by his wife, “I brought him in today (ER) because he is just not getting any better.” Mrs. C. also said that her husband has vomited, over the last 2 days. R.’s chief complaint (c/c) is abdominal pain, voiding frequently, and hasn’t been taking insulin due to nausea. Vital signs (RR) 32, and oxygen saturation (SAO2) 95%. He is alert & orientated (A&O) A&O x 1 (oriented only to person), and his mouth and mucous membranes are very dry. Doctor’s Orders: After seeing Mr. C. the doctor orders: CBC, Chem Panel, Electrolytes, UA with ketones, ABG, 12 lead EKG, and sliding scale insulin to be given IVP, oxygen at 2L/min per nasal cannula, and IV bolus of 500 cc/NS. After initiating a peripheral IV catheter, blood samples are drawn for labs and the nurse administers the 500 cc/NS and rechecked VS: Temperature (T) 100.3, P-106, BP-92/56, and RR-28. Labs The labs return with blood glucose of 625, K+5.3, bicarb (HCO3) 8 mEq/l, large amounts of ketones in urine and serum. ABG of pH-7.19, PO2-89, CO2-25, and HCO3-15. EKG The EKG is noted for...
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...Running head: THE CONTRIBUTION OF HIGHER EDUCATION IN NURSING 1 The Contribution of Higher Education In Nursing Grand Canyon University: NRS- 430 V Professional Dynamics THE CONTRIBUTION OF HIGHER EDUCATION IN NURSING 2 Nursing in today’s day and age is a profession that is both rewarding and demanding. With increased pressure on hospitals to provide clinically sound medical care while functioning as a business, nurses are at the forefront of providing patient safety in a business environment. America depends on both two and four year institutions of higher education to prepare nurses, who will be working side by side in the healthcare environment. As a result of nursing job growth and projected retirement rates, it is estimated that America will need one million additional Registered Nurses by 2018 (Fulcher, Mullin, 2011). With strong evidence that a Baccalaureate degree in nursing improves patient outcomes, the IOM recommends 80% of nurses have a BSN by the year 2020. Evidence clearly suggests a relationship between a baccalaureate education and improved patient outcomes (Sarver, Cichra & Cline, 2015). One difference that may contribute to competency differences between ADN and BSN programs is number of credit hours obtained while in school. BSN programs require 120 credit hours whereas ADN programs require 71.5 (Fulcher, Mullin, 2011). Thus, the amount of hours spent learning is greatly reduced in an ADN program. One can infer that more school...
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