Homework
Case Study Diabetes02/07/2021Patient A.B. a 69-year-old White mail visited his local clinic for a checkup as lately he was feeling lethargic and has gained 22 lbs in the past year. He also has episodes of nocturia. He has being diagnosed with Type 2 diabetes for 5 years. However, he was diagnosed with Borderline diabetes since 1997, but never took it seriously and made no lifestyle changes. He has symptoms of hyperglycemia for the past 2 years. He does not check his glucose daily. He has never had a foot examination.AB carbohydrate intake daily most times consists of eating at least three slices of bread with each meal and eating pasta meals at least 3 times a week. He likes his wife to cook Italian meals no less than 3-4 times a week. He drinks a glass of red wine with dinner every day. He stopped smoking 10 years ago. He exercises on occasion, maybe once or twice a month.A.B. takes Atorvastatin 10mg daily. Glyburide 2.5mg daily. However, he reports he stopped taking the Glyburide about 6 months ago as it was making him feel dizzy whenever he took it. He has not notified his PCP about not taking the Glyburide.Physical ExaminationConstitutional: Alert and oriented to person, place, time and situation. He is well groomed. He is 5 feet 2 inches and weighs 178 pounds.Eyes: Pupils round, reactive to light. EOM intact. Fundi clear.Hearing: No deficit notedMouth: Mucosa moist. Upper and lower dentures.Heart: Rate and rhythm regular. No murmur.Lungs: Clear to auscultationNeurological assessment: Diminished vibrating sense to the forefoot, absent ankle reflexes. Monofilament felt only above the ankle.Vascular: No carotid bruits. Femoral, popliteal and dorsalis pedalis pulses 2+ bilaterally.His Immunization is updated. He has erectile dysfunction and takes Sildenafil.Vital signs: BP= 150/87, P= 88, RR= 20, T= 97.8, Oxygen Sat= 98%Laboratory Results:Glucose (fasting) = 178mg/dlCreatinine = 1.0mg/dlBlood Urea Nitrogen = 18mg/dlSodium = 141 mg/dlPotassium = 4.3 mg/dlTotal Cholesterol = 162 mg/dlHDL Chol = 43mg/dlLDL Chol = 84 mg/dlTriglycerides = 177 mg/dlAST = 14 IU/LALT = 19 IU/LAlkaline Phosphatase = 56 IU/LA1C = 8.1%a) Nursing Plan for A.B.b) No less than three nursing diagnosesc) Fully developed care pland) What is the priority nursing education this patient needs with rationale?e) Nursing interventionsRemember no less than 2 references.
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