SUBJECT IS :Endocrine, Metabolic, and Nutritional Disorders HPI:…

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Question Answered step-by-step SUBJECT IS :Endocrine, Metabolic, and Nutritional Disorders HPI:… SUBJECT IS :Endocrine, Metabolic, and Nutritional DisordersHPI: Ms. Lewis is a 63-year old female who comes into your office with concerns of low blood sugar in the morning, fasting. She reports seeing blood sugar as low as 50 fasting in the mornings for the last few weeks. She has a known history of Diabetes, Hypertension, Hyperlipidemia, and Chronic Osteoarthritis. She also reports elevated blood pressures. Her blood pressure at presentation is 165/90.Ms. Lewis is a 63 y/o female who is AAOX4. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She denies any falls, denies any pain. Vital Signs: BP 165/90, HR 89, RR 20, Temp 98.1PMH: Hypertension, Hyperlipidemia, Diabetes, Chronic OsteoarthritisAllergies: Penicillin, lisinoprilMedications:Women’s One A Day-Multivitamin dailyChlorthalidone 25mg dailyFish Oil 1 tablet dailyAmlodipine 5mg p.o. dailyAtorvastatin 40mg p.o. at bedtime dailyNovolog 10 units with meals TIDAspirin 81mg p.o. dailyLantus 25 units Subcutaneous nightlyErgocalciferol 50,000 units PO once a monthDiagnostics/Assessments done:CXR- Last cxr showed no cardiopulmonary findings. Within normal limits.Basic Metabolic Panel and CBC as shown belowVitamin D Level- as noted below in lab resultsTEST RESULT REFERENCE RANGEGLUCOSE 85 65-99SODIUM 134 135-146POTASSIUM 4.2 3.5-5.3CHLORIDE 104 98-110CARBON DIOXIDE 29 19-30CALCIUM 9.0 8.6- 10.3BUN 20 7-25CREATININE 1.01 0.70-1.25GLOMERULAR FILTRATION RATE(eGFR) 76 >or=60 mL/min/1.73m2Vitamin D 1,25 OH 58 36-144WBC 7.3 3.4- 10.8RBC 4.31 4.7 to 6.1 HEMOGLOBIN 14 13-17.2HEMATOCRIT 42% 36-50PLATELET 272 150-4001. Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.2. Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned;reference : copy the link to get to the book ( Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2019). Endocrine, metabolic, and nutritional disorders. In Advanced practice nursing in the care of older adults (2nd ed., pp. 361-406). F. A. Davis.)https://books.google.com/books?hl=en&lr=&id=nd11DwAAQBAJ&oi=fnd&pg=PR1&dq=Kennedy-Malone,+L.,+Martin-Plank,+L.,+%26+Duffy,+E.+(2019)&ots=I4XNiqJeKF&sig=oX7B6falkf3svwqdi-3sQybXgH4#v=onepage&q&f=falselinks :https://care.diabetesjournals.org/content/43/Supplement_1/S66https://www.uptodate.com/contents/treatment-of-type-2-diabetes-mellitus-in-the-older-patientTHIS IS A RANDOM CASE YOU CAN USE INTERNET TO SOLVE AND ANSWER THE QUESTIONS Health Science Science Nursing NRNP 6540 Share QuestionEmailCopy link Comments (0)

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