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

· Deniessmoking

· 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. 240lbs.,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

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

95-105 mEq/L

HCO3

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

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.

Interested in getting help with this assignment?

Get a professional writing team to work on your assignment!

Order Now
Recent posts
For this final assignment, you will prepare a brief paper detailing the steps undertaken to complete a presentation that disseminates information you assemble
Please choose to answer only one of the 2 following questions. Option 1: In your opinion and based on scientific, peer-reviewed published evidence, does child
At the beginning of the previous academic year, the institution announced it would drop football at the conclusion of the season. The announcement created pub
you will review current research in Personality and provide a critical evaluation of that personality research through an annotated bibliography. An annotated
In Module 5, we considered the third in our three-part series on research design. Specifically, the focus was on the longitudinal studies, in which the resear

Need help with a similar or different Task?

We have the best writers to help you. Hire Writer Now