Case Study
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• Points 100
• Submitting a file upload
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.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
1. Examine the case scenario and analyze the exam and lab findings results to determine the patient’s type of diabetes. (CO1)
2. Explain the pathophysiology of the type of diabetes. (CO1)
3. Differentiate between subjective and objective findings which support the chosen diagnosis. (CO4)
4. Apply evidence-based practice guidelines to develop an appropriate treatment plan. (CO1, CO5)
Content Criteria:
1. Read the case study listed below.
2. Refer to the rubric for grading requirements.
3. Utilizing the Week 6 Case Study Template (Links to an external site.), provide your responses to the case study questions listed below.
4. 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.
5. 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-resources (Links to an external site.). At the website, locate the current year’s CPG for use.
6. 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
Potassium 3.7 3.5-5.0 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
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
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 6case 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.
100 100% Total FORMAT Points= 10 pts
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 Disease
The 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 pts
All 5 required elements are present. 41 pts
1 required element is missing. 37 pts
2 required elements are missing 23 pts
3-4 required elements are missing. 0 pts
All 5 required elements are missing.
45 pts
This criterion is linked to a Learning OutcomeManagement of the Disease
The 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 pts
All 4 elements are present 41 pts
1 required element is missing 37 pts
2 required elements are missing 23 pts
3 required elements are missing 0 pts
All 4 required elements are missing
45 pts
This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA format
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 pts
Case 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 pts
Case 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 pts
Case 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 pts
Case 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 pts
Case 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 deductions
Students 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 pts
Manual Deductions 0 pts
Manual Deductions
0 pts
Total Points: 100
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Study of a Case
Begin the Assignment
• 100 points
• Making a file upload
Purpose
The goal of this assignment is to explain assessment findings of a diabetic patient using endocrine pathophysiological ideas. Students will examine all aspects of the patient’s assessment, including the Chief Complaint (CC), the History of Present Illness (HPI), the Past Medical History (PMH), the Family History (FH), the Social History (SH), the Review of Systems (ROS), and the Medications, and then answer the questions that follow on the provided Comprehensive Case Study template.
Outcomes of Activity Learning
The student will exhibit the ability to: through this assignment, the student will demonstrate the ability to:
1.
Examine the case scenario and the physical and test results to determine the type of diabetes in the patient. (CO1)
2.
Explain the pathophysiology of the type of diabetes. (CO1)
3.
Differentiate
