METABOLIC CASE STUDY Primary Care of the Maturing and Aged Family Practicum (NR601)

Mrs. G. It is paramount to accurately and safely diagnose and treat all patients, especially those who fit within the maturing population. The following pages demonstrate the diagnosing and creation of an appropriate treatment plan for Mrs. G. by utilizing evidence-based literature and 2 METABOLIC CASE STUDY clinical practice guidelines. A primary diagnosis with a secondary diagnosis and associated pertinent findings, tests and treatment plans will be included. Assessment Primary Diagnosis: Diabetes Mellitus II (E11.0) Pathophysiology: Type 2 diabetes is present when the pancreas recognizes the need for insulin production in due to increased level of glucose but over time has become insulinresistant as its ability to force glucose into the cell ceases causing hyperglycemia (Skyler et al., 2016). Thirst, fatigue, excessive hunger, and increase in frequency of urination are results of an increase in free glucose (ADA, 2019a). Pertinent Positive Findings: In addition to fatigue, Mrs. G. possesses the three trademark signs of type 2 diabetes: polyuria, polyphagia and polydipsia. Mrs. G. also has a HgBA1C of 6.9%, glucose 95, 1+ glucose in her urine, BMI of 32.8. Although Mrs. G. has a fasting glucose of 95 mg/dL, the ADA (2019a) states that a HgBA1c greater than 6.5 % is within diabetic range. Pertinent Negative Findings Negative findings include nocturia, weight gain, and a nonsedentary lifestyle (ADA, 2019a), as well as a negative family or past medical history of diabetes. Rationale for the Diagnosis: Mrs. G.’s weight gain regardless of participating in an exercise regimen, increased hunger, exhaustion and disproportionate thirst are subjective indications for having type 2 diabetes. Objectively Mrs. G. is an obese 55-year-old Hispanic female with a BMI of 32.8 (Calculate Your BMI - Standard BMI Calculator, 2019), with a 50% greater chance of becoming diabetic due to her ethnicity at a younger age than other ethnicities (CDC, 2019c).