Read the case study listed below.

Refer to the rubric for grading requirements.

Utilizing the Week 6 Case Study Template Links to an external site., provide your responses to the case study questions listed below.

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.

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. 

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

Review the lab findings and decide if the diagnosis is Type 2 or Type 1 Diabetes Mellitus.

Explain the pathophysiology associated with your chosen diagnosis

Identify at least three subjective findings from the case which support the chosen diagnosis.

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.

Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.

Describe the mechanism of action for each of the medication classes identified above.

Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.

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

      ASSIGNMENT TOTAL=100 points

Rubric