BIOL205 – Module 6 – Type 2 Diabetes Pathophysiology Homework

This Assessment is part of the Homework category, worth 10% of your grade.

Deadline
See Tracking Calendar for due dates.

Completing this Assessment will help you to meet the following:

Course Outcomes
• Illustrate how changes in one body system affect functioning of other body systems.
• Examine diagnosis, treatment, and prevention options for disease states.

Directions
Read the following case study on type 2 diabetes. Please answer the following 10 questions, listed throughout the assignment, on a word document using complete sentences.
Chief Complaint
• “My left foot feels weak and numb.”
History of Present Illness
Charles is a significantly overweight, 48-year-old man who had high blood sugar and cholesterol levels three years ago. The patient had participated in the state’s annual health screening program and was told his fasting blood sugar was 141, and his cholesterol was 225. However, he felt “perfectly fine at the time” and could not afford any more medications. He has felt fine until recently.
Today he presents to his primary care provider complaining that his left foot has been weak and numb for nearly three weeks, and now the foot is difficult to move. He denies any other weakness or numbness currently. However, he does report that he has been very thirsty lately and gets up more frequently at night to urinate. He has attributed these symptoms to the extremely warm weather and drinking more to stay hydrated. He has gained 65 pounds in the last 14 years, 15 pounds in the last six months alone.
Past medical history
• Seasonal allergic rhinitis since early 20s
• Hypertension for 10 years
• Moderate to severe osteoarthritis in both hands and knees for four years
• Occasional constipation
Past surgical history
• None
Family history
Type 2 diabetes present in the younger sister and maternal grandmother; both were in their late 40s. Maternal grandmother died from kidney failure while waiting for a transplant. Father had emphysema. Two older siblings are alive and well. All four of his children are healthy.
Social history
Married for 29 years with four children. The family lives in a two-bedroom trailer. He works full-time in a small family-owned business. Smokes 2 packs per day since the age of 14, drinks two beers most evenings. Has never used illegal or illicit drugs. The patient rarely exercises and admits to trying various fad diets for weight loss with very little success. Has given up on trying to lose weight and now eats a diet rich in fats and processed sugars.
Review of systems
• General
o The patient admits to the recent onset of fatigue.
• HEENT
o Has awakened on several occasions with blurred vision and dizziness or Lightheadedness upon standing. Denies vertigo, head trauma, ear pain, ringing sensation in the ears, difficulty swallowing, and pain with swallowing.
• Cardiac
o Denies chest pain, palpitations, and difficulty breathing while laying down.
• Lungs
o The patient denies any cough or difficulty breathing
• GI
o The patient denies nausea, vomiting, diarrhea, abdominal bloating, or abdominal pain. Admits to occasional episodes of constipation.
• GU
o Has experienced increased frequency and volumes of urination. The patient denies pain during urination, blood in urine, or urinary incontinence.
• Extremities
o Denies leg cramps or swelling in the ankles and feet. The patient denies weakness, tingling, or numbness in the arms or legs prior to this episode.
• Neuro
o The patient denies any seizures or headaches
• Skin
o No history of rashes or excessive sweating.
• Endocrine
o Denies history of a goiter and has not experienced heat or cold intolerance.
Medications
• Lisinopril 20mg
• Acetaminophen 500mg with hydrocodone 5mg
• Naproxen 500mg
• Omeprazole 20mg
• Docusate sodium 100mg
• Loratadine 10mg
Question 1:
1. Propose a reason that the patient is taking the medications listed above and why?

Physical Exam
• General: The patient is a significantly overweight white male who appears slightly nervous. The patient is alert and oriented, using appropriate words. He does not appear to be in any acute distress and looks at his stated age.
Vital signs
• Blood pressure: 165/100
• Pulse: 88 and regular
• Respiratory rate: 15 and non-labored
• Temperature: 98.0F
• Height: 5 feet-10 inches
• Weight: 245 pounds
Question 2:  2. Elaborate on which two vitals above are of most concern and detail the reasons. Skin
Dry and cool skin with tenting and poor skin turgor. Significant xerosis on both feet with cracking. The patient has a scaling rash in the axilla bilaterally, normal capillary refill throughout.
Head, Ears, Eyes, Nose, and Throat
Pupils are equal, round, reactive to light with accommodation. Extraocular movements are intact. Conjunctiva is pink. Tympanic membranes are intact nares and oropharynx are clear. Mucous membranes are dry. BIOL205 – Module 6 – Type 2 Diabetes
Neck
The neck is supple. Negative for thyromegaly, adenopathy, jugular venous distention, or nodules. There is a bruit auscultated over the right carotid artery.
Chest and lungs
No chest deformity. Chest expansion is symmetric. Lungs are clear to auscultation and percussion throughout.
Heart
Regular rate and rhythm, S1-S2, no murmurs, rubs, or gallops.
Abdomen
The abdomen is soft and non-tender with prominent central obesity. Bowel sounds are auscultated in all four quadrants. The abdomen is without masses, distension, organomegaly. faint abdominal bruit is auscultated.
Question 3:
3. Identify the significance of the two bruits auscultated in the neck and abdomen and what a bruit indicates about the patient.
Musculoskeletal
Normal range of motion in the upper extremities. Reduced range of motion in the knees. Negative for edema and clubbing. Peripheral pulses are 1+ in both feet. Feet are cold to the touch and dry with cracking but no ulceration. Strength is 5/5 throughout except 2/5 in the left foot.
Question 4: BIOL205 – Module 6 – Type 2 Diabetes
4. Investigate the significance of the patient’s cold feet and diminished peripheral pulses in the lower extremities.
Neurologic
The patient is alert and oriented to person, place, time. Cranial nerves II-XII are intact, including good visual acuity. Sensory response to light touch, vibration, proprioception subnormal in both feet with abnormalities greater in the left foot. Deep tendon reflexes are 2+ throughout. Gait is normal except for left foot weakness.
Question 5:
5. List at least six (6) clinical signs and symptoms from above that support a diagnosis of type 2 diabetes in this patient and why.
Laboratory Blood Test Results (Fasting)
Na= 139 meq/L ALT= 15IU/L
K= 4.0meq/L Cholesterol= 246mg/dL
BUN= 14mg/dL HDL= 27mg/dL
Creatinine= 0.9mg/dL LDL= 168mg/dL
Glucose=174mg/dL Triglycerides= 468mg/dL
AST= 20IU/L HbA1c=8.2%
Urinalysis
Appearance= pale yellow and clear Ketones= negative
pH= 5.8 Protein= negative
Specific gravity=1.008 Glucose= positive
Bilirubin= negative Microscopy= negative for RBC and WBC
Electrocardiogram
Findings are consistent with early left ventricular hypertrophy.
Question 6 – 10:
6. List five (5) risk factors that predispose this patient to type 2 diabetes and why.
7. Identify five (5) symptoms that support that diagnosis of type 2 diabetes.
8. Interpret which single urinalysis test results is indicative of type 2 diabetes.
9. List two (2) blood test results that support a diagnosis of type 2 diabetes and explain how they support the diagnosis.
10. Create a counseling plan for this patient, including education and referrals.

Short Essay: On a word document, write a short essay with a minimum of 200 words, answer the following regarding the patient above:

1. Outline all treatments you feel appropriate to this patient. BIOL205 – Module 6 – Type 2 Diabetes
2. Explain some prevention options and/or recommendations for this patient.
3. Explain some of the potential complications this patient may experience in other body systems without treatment

Sample Short Essay: The diagnosis from this scenario would be type 2 diabetes. Some of the possible cause of this diagnosis are that the patient has a family history of type 2 diabetes. Besides, the patient having a family history of diabetes they are overweight, smokes two packs a day and he rarely exercises. The treatments that would be used for a patient with type 2 diabetes are promoting a healthy diet, weight loss and exercise to help control their blood sugar in the blood. A patient who are unable to keep their type 2 diabetes under control would be prescribed insulin. This is where monitoring their blood sugar level comes into play because that number would determine how much insulin the patient needed to administer. Preventing type 2 diabetes is pretty similar to the treatment plan for patients with diabetes. The person would want to keep their weight under control and eat a healthy diet. The patient would also want to increase the amount of exercise they take part of to help with their weight and manage their blood sugar level. Then finally they would want to refrain from smoking. People should refrain from smoking because nicotine can increase a blood sugar level in the body. If type 2 diabetes is left untreated it can affect other part of the body. Some of the issues a patient may face are they can have a stroke, develop heart of kidney disease, and develop eye and foot problems.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. BIOL205 – Module 6 – Type 2 Diabetes

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• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. BIOL205 – Module 6 – Type 2 Diabetes

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Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. BIOL205 – Module 6 – Type 2 Diabetes

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