Review the lab findings and decide if the diagnosis is

Week 6 Case Study Template

Pathophysiology & Clinical Findings of the Disease

1. Based on the review of the history, physical and lab findings what is the most likely diabetes diagnosis for this patient?

2. Explain the pathophysiology associated with the chosen diabetes diagnosis.

3. Identify at least three subjective findings from the case which support the chosen diagnosis.

4. Identify at least three objective findings from the case which support the chosen diagnosis

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

1. Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.

2. Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.

3. Describe the mechanism of action for each of the medication classes identified above.

4. Identify two (2) “ Evidence A” recommended non-pharmacological treatment options for this patient.

References

[Must be on a separate page and in APA format]

,

Preparing the Assignment

Requirements

Content Criteria

1. Read the case study listed below.

2. Refer to the rubric for grading requirements.

3. Utilizing the  Week 6 Case Study TemplateLinks to an external site. , provide your responses to the case study questions listed below.

4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.

5. You must use the current Clinical Practice Guideline (CPG) for the Standards of Medical Care in Diabetes -Abridged for Primary Care Providers provided by the American Diabetes Association to determine the patient's type of diabetes and answer the treatment recommendation questions. The most current guideline can be found at the following web address:  https://professional.diabetes.org/content-page/practice-guidelines-resourcesLinks to an external site.  At the website, locate the current year’s CPG for use. 

6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.

Case Study Scenario

Chief Complaint

J.T. is a 48-year old male who presents to the primary care clinic with fatigue, weight loss, and extreme thirst and increased appetite.

History of Present Illness

J.T. has been in his usual state of health until three weeks ago when he began experiencing symptoms of fatigue, weight loss, and extreme thirst. He reports that he would like to begin a walking program, but he feels too fatigued to walk at any point during the day. Now he is very concerned about gaining more weight since he is eating more. He reports insomnia due to having to get up and urinate greater than 4 times per night.

Past Medical History 

· Hypertension

· Hyperlipidemia

· Obesity

Family History

· Both parents deceased

· Brother: Type 2 diabetes 

Social History

· Denies smoking

· Denies alcohol or recreational drug use

· Landscaper  

Allergies

· No Known Drug Allergies 

Medications

· Lisinopril 20 mg once daily by mouth

· Atorvastatin 20 mg once daily by mouth

· Aspirin 81 mg once daily by mouth

· Multivitamin once daily by mouth

Review of Systems

· Constitutional: – fever, – chills, – weight loss.

· Neurological: denies dizziness or disorientation

· HEENT: Denies nasal congestion, rhinorrhea or sore throat.  

· Chest: (-)Tachypnea. Denies cough.

· Heart: Denies chest pain, chest pressure or palpitations.

· Lymph: Denies lymph node swelling.

General Physical Exam  

· Constitutional: Alert and oriented male in no acute distress   

· Vital Signs: BP-136/80, T-98.6 F, P-78, RR-20

· Wt. 240 lbs., Ht. 5'8″, BMI 36.5

HEENT 

· Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva. 

· Ears: Tympanic membranes intact. 

· Nose: Bilateral nasal turbinates without redness or swelling. Nares patent. 

· Mouth: Oropharynx clear. No mouth lesions. Teeth present and intact; Oral mucous membranes and lips dry. 

Neck/Lymph Nodes 

· Neck supple without JVD. 

· No lymphadenopathy, masses or carotid bruits. 

Lungs 

· Bilateral breath sounds clear throughout lung fields. Breathing quality deep with fruity breath odor

Heart 

· S1 and S2 regular rate and rhythm; – tachycardia; no rubs or murmurs. 

Integumentary System 

· Skin warm, dry; Nail beds pink without clubbing.  

Labs

Test	Patient's Result	Reference
Glucose (fasting)	132	60-120 mg/dL
BUN	20	7-24 mg/dL
Creatinine	0.8	0.7-1.4 mg/dL
Sodium	141	135-145 mEq/L
Sodium	141	135-145 mEq/L
Chloride	97	95-105 mEq/L
HCO3	24	22-28 mEq/L
A1C	7.2
Urinalysis Protein Glucose Ketones	Negative Positive Negative
Oral glucose tolerance test (OGTT)	220 mg/dL

J.T. is diagnosed with diabetes. Review all information provided in the case to answer the following questions.

Case Study Questions

Pathophysiology & Clinical Findings of the Disease

1. Review the lab findings and decide if the diagnosis is Type 2 or Type 1 Diabetes Mellitus.

2. Explain the pathophysiology associated with your chosen diagnosis

3. Identify at least three subjective findings from the case which support the chosen diagnosis.

4. Identify at least three objective findings from the case which support the chosen diagnosis.

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

1. Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.

2. Describe the mechanism of action for each of the medication classes identified above.

3. Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.

4. Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations

ASSIGNMENT CONTENT
Category	Points	%	Description
Pathophysiology & Clinical Findings of the Disease	45	45%	The student: · Identifies the likely diagnosis based on exam and lab findings.  · Explains the pathophysiology associated with the chosen disorder. · Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only). · Identifies at least three subjective findings from the case. · Identifies at least three objective findings from the case. (5 Required Elements)
Management of the Disease	45	45%	The student: · Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations. · Identifies two (2)“Evidence A” recommendedmedicationclassesfor the treatment of the condition and provides an example (drug name) for each. · Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition. · Describes the mechanism of action for each of the medication classes identified above. (4 Required Elements)
	90	90%	Total CONTENT Points = 90 pts

NR507 Week 6 Diabetes Case Study

NR507 Week 6 Diabetes Case Study
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomePathophysiology & Clinical Findings of the Disease The student:  – Identifies the correct type of diabetes  – Explains the pathophysiology associated with the chosen disorder.  – Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).  – Identifies at least three subjective findings from the case.  – Identifies at least three objective findings from the case.  (5 Required Elements)	45 pts All 5 required elements are present. 41 pts 1 required element is missing. 37 pts 2 required elements are missing 23 pts 3-4 required elements are missing. 0 pts All 5 required elements are missing.	45 pts
This criterion is linked to a Learning OutcomeManagement of the Disease The student:  – Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.  – Identifies two (2) “Evidence A” recommended medication classes for the treatment of the condition and provides an example (drug name) for each.  – Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition.  – Describes the mechanism of action for each of the medication classes identified above  (4 Required Elements)	45 pts All 4 elements are present 41 pts 1 required element is missing 37 pts 2 required elements are missing 23 pts 3 required elements are missing 0 pts All 4 required elements are missing	45 pts
This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA format The student:  – Uses the week 6 case study template for case study responses.  – Provides correct in-text citations for responses which match the reference page.  – Has minimal spelling, grammar & APA format errors.	10 pts Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format. 9 pts Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format. 8 pts Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format. 5 pts Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format. 0 pts Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.	10 pts
This criterion is linked to a Learning OutcomeLate penalty deductions Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.	0 pts Manual Deductions 0 pts Manual Deductions	0 pts

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