Diabetes Type 2 ScenarioY.L., a 34-year-old Southern Asian woman, comes to the

Diabetes Type 2 ScenarioY.L., a 34-year-old Southern Asian woman, comes to the ER with chronic fatigue, increased thirst, constant hunger, and frequent urination. She denies any pain, burning, or low-back pain on urination. She tells you she has a vaginal yeast infection that she has treated many times with over-the-counter medication. She works full time as a clerk in a loan company and states she has difficulty reading numbers and reports, resulting in her making frequent mistakes. She says, “By the time I get home and make supper for my family, then put my child to bed, I am too tired to exercise.” She reports her feet hurt; they often “burn or feel like there are pins in them.” She has a history of gestational diabetes and reports following a traditional eating pattern, which is high in carbohydrates.In reviewing Y.L.’s chart, you note she last saw the provider 6 years ago after the delivery of her last child. She has gained considerable weight; her current weight is 173 pounds (78.5 kg). Today her BP is 152/97 mm Hg, and a random plasma glucose level is 291 mg/dL (16.2 mmol/L). The provider suspects she has developed type 2 diabetes mellitus (DM) and orders the laboratory studies shown in the chart.Laboratory Test ResultsFasting glucose184 mg/dL (10.2 mmol/L)Hemoglobin A1c (A1C)8.8%Total cholesterol256 mg/dL (6.6 mmol/L)Triglycer1ides346 mg/dL (3.91 mmol/L)Low-density lipoprotein (LDL)155 mg/dL (4.01 mmol/L)High-density lipoprotein (HDL)32 mg/dL (0.83 mmol/L)Urinalysis (UA)+ glucose, – ketonesACTIVITY:1. Interpret Y.L.’s laboratory results.2. Identify 3 methods used to diagnose DM.3. Name 6 risk factors for type 2 DM. Underline those that Y.L. has.4. Name 6 clinical manifestations of type 2 DM. CASE STUDY PROGRESSY.L. is diagnosed with type 2 DM and admitted the medical unit. You are to provide teaching about pharmacotherapy.Doctor’s Orders:1200-calorie dietMetformin 500 mg p.o. dailyGlipizide 5 mg p. o. dailyGlargine 20 unit subcutaneously each H.S.Atorvastatin 20 mg orally at bedtimeFingerstick glucose readings before each meal and H.S.urine culture and sensitivity 5. How can you incorporate Y.L.’s cultural preferences as you develop her teaching plan? 6. What is the reason for starting Y.L. on metformin and glipizide?7. Outline the teaching you need to provide to Y.L. about insulin administration. 8. You determine she understands your teaching about treating hypoglycemia if she states, “If my blood sugar is low, I should first have:an apple with milk.”peanut butter sandwich.”fruit juice or regular soda.”crackers with cheese slices.”9. What do you teach Y.L. to do if she becomes ill with the flu or viral illness? 10. Discuss the benefits Y.L. should receive from exercising. 11. What would you include in the teaching plan about exercise? CASE STUDY PROGRESSY.L. comments, “I’ve heard many people with diabetes lose their toes or even their feet.” You take this opportunity to teach her about neuropathy and foot care. 13. Highlight symptoms that Y.L. reported that led you to believe she has some form of neuropathy? 14. What other findings in Y.L.’s history increased her risk for developing neuropathy? 15. What would you teach Y.L. about neuropathy? 16. Because Y.L. has symptoms of neuropathy, placing her at risk for foot complications, you realize you need to instruct her on proper foot care. Outline what you will include when teaching her about proper diabetic foot care. 17. What monitoring will Y.L. need for nephropathy and retinopathy?       Health Science Science Nursing NURS 3250 Share EmailCopy link Comments (0)

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