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COLBY_NR601_Week_5_Case_Study1./ Score A Guide

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Week 5 Case Study: Mrs. R. Chamberlain University NR 601: Primary Care of the Maturing and Aged Family July 2018 Week 5 Case Study: Mrs. R. The case study scenario introduced the class to Mrs. R., a 5 6-year old Hispanic female who reported to the office clinic with complaints of extreme fatigue and experiencing a gradual weight gain. The onset of her symptoms started three months ago. She exercises twice a week by walking on the treadmill for 30 minutes in an attempt to lose weight but has been unsuccessful. The intention of this paper is to examine the analysis of the subjective and objective findings that was collected to diagnose and create a management plan for Mrs. R. In addition, the application of national diabetes guidelines will be included into the patient’s management plan. This paper will also discuss the assessment of the primary, the secondary, and the differential diagnoses for Mrs. R., as well as the management plan for treatment of the primary, the secondary, and the differential diagnoses, which consists of diagnostics, medications, education, referrals, and follow-up care. This paper also includes a discussion on medication costs of all prescribed and over-the-counter (OTC) medications. Assessment According to the information provided by Mrs. R., she has symptoms of major concerns, which includes extreme fatigue, the inability to lose weight regardless of her attempts to exercise, her increase in thirst, hunger, and urination. Per the Center for Disease Control and Prevention BMI calculator (CDC) (2015), her calculated BMI of 29.7 showed that she is overweight for her given height. The result from her urine analysis showed glucose and small concentration of protein. Her HgbA1C is 6.9% and her fasting glucose is 126 mg/dL, which according to the American Diabetes Association (ADA) (2018), she meets the conditions for the diagnosis of diabetes. Mrs. R’s CBC values, TSH and Free T4 levels were unremarkable, which ruled out hypothyroidism and anemia. Her lipid panel results revealed she has hyperlipidemia. Her elevated cholesterol places her at risk for a stroke and cardiovascular disease (AACE, 2017). Primary diagnosis Diabetes Mellitus Type 2 (DM2) (E11.9). Type 2 diabetes or DM2 is referred to as adult-onset diabetes and is indicated by hyperglycemia, insulin deficiency, insulin resistance that can lead to the development of vascular and neurologic complications (American Diabetes Association [ADA], 2018)

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