Fundamentals Lab

Case Study Diabetes02/07/2021Patient A.B. a 69-year-old White male visited his local clinic for a check-up 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. Gluburide 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 is 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%Please these are the characteristics that the Professor wants the Care Plan to haveNursing Plan for A.B.No less than three nursing diagnosesFully developed care planWhat is the priority nursing education this patient needs with rationale?Nursing interventionsRemember no less than 2 references

 

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