NR 507 Week 6 Assignment: Case Study

NR 507 Week 6 Assignment: Case Study

NR 507 Week 6 Assignment: Case Study

Week 6Case Study

Assignments

Purpose

The purpose of this assignment is to apply endocrine pathophysiological concepts to explain assessment findings of a patient with Diabetes. Students will examine all aspects of the patient’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.

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Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

Examine the case scenario and analyze the exam and lab findings results to determine the patient’s type of diabetes. (CO1)

Explain the pathophysiology of the type of diabetes. (CO1)

Differentiate between subjective and objective findings which support the chosen diagnosis. (CO4)

Apply evidence-based practice guidelines to develop an appropriate treatment plan. (CO1, CO5)

Total Points Possible

This assignment is worth 100 points.

Preparing the Assignment

Requirements

Content Criteria

Read the case study listed below.

Refer to the rubric for grading requirements.

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

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.

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.

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

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

Explain the pathophysiology associated with your chosen diagnosis

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

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.

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

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

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

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

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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
ASSIGNMENT FORMAT
Category Points % Description
Organization, spelling, grammar & APA format 10 10% 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 10% Total FORMAT Points = 10 pts
100 100% ASSIGNMENT TOTAL= 100 points

Rubric

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 DiseaseThe 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 ptsAll 5 required elements are present. 41 pts1 required element is missing. 37 pts2 required elements are missing 23 pts3-4 required elements are missing. 0 ptsAll 5 required elements are missing.
45 pts
This criterion is linked to a Learning OutcomeManagement of the DiseaseThe 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 ptsAll 4 elements are present 41 pts1 required element is missing 37 pts2 required elements are missing 23 pts3 required elements are missing 0 ptsAll 4 required elements are missing
45 pts
This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA formatThe 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 ptsCase 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 ptsCase 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 ptsCase 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 ptsCase 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 ptsCase 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 deductionsStudents 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 ptsManual Deductions 0 ptsManual Deductions
0 pts
Total Points: 100

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