This case scenario discusses the diagnosis, management, and treatment of UTI, diabetes, and lymphedema in a patient. It covers topics such as symptoms, causes, and prevention.
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Running head: CASE SCENARIO 21 Case Scenario 2 Name Institution
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CASE SCENARIO 22 Case Scenario 2 Question 1 The nurse should collect a urine sample from a patient and send it to the laboratory for analysis. The nurse might also check for history of sexually transmitted illnesses. Question 2 Patients with Urinary Tract Infection (UTI) have elevated nitrites and leucocytes in urine (Nitzan et al., 2015). Question 3 In the case study, urine inconsistence, offensive smell, fever and diabetes support a diagnosis of UTI. Question 4 Betty should maintain proper genital hygiene and drink plenty of fluids especially water and cranberry juice to prevent future occurrence. Question 5 The lymphedema in her right arm time was caused by mastectomy. Some lymph nodes might have been damaged or removed during the procedure. Question 6 The use of the right arm to check BP might cause swelling and exacerbate the existing lymphedema. Question 7 A normal blood sugar level is 3.9–6.0 mmol/L while fasting or levels of up to 7.8mmol/L after meals (Nussey & Whitehead, 2013).UTI increase these levels due to an upsurge of cortisol and adrenaline which block insulin.
CASE SCENARIO 23 Question 8 Signs of hypoglycemia include sweating, rapid heartbeat, dizziness and blurred vision (Nitzan et al., 2016). Question 9 In type 2 diabetes, the body cells are resistant to insulin or the pancreas produces inadequate amounts of the hormone(Nussey & Whitehead, 2013). As a result, the levels of glucose in the blood remain high and damage vessels. It is insulin-independent and mostly occurs in adults. Question 10 Unlike type 2 diabetes, type 1 diabetes occurs in children due to an autoimmune reaction. The body’s antibodies attack and destroy the beta cells of the pancreas, which eliminates the source of insulin in the body(Nussey & Whitehead, 2013). Consequently, the patient requires constant insulin injections. Question 11 Diabetes affects wound healing by predisposing the individual to infections. Betty’s wounds will take longer to heal due to her diabetic condition. Question 12 HBA1C or glycated hemoglobin is a test to assess how patients adhere to treatment. It indicates the amount of sugars that have bound to circulating hemoglobin. High circulating glucose levels result in high HBA1c levels (Nitzan et al., 2016). Since the average lifespan of red blood cells is three to four months, elevated HBA1c levels indicate high blood sugar levels for the past three months.
CASE SCENARIO 24 Question 13 Graves’ disease is an autoimmune disorder that results in hyperthyroidism. It mostly manifests as enlargement of the thyroid gland and bulging eyes(Nussey & Whitehead, 2013). Uncontrolled Graves’ disease might lead to psychosis, dermopathy or ophthalmopathies. Question 14 Betty has a problem with urinary inconsistency. To stop passing urine unconsciously will undergo bladder control training and do exercises that to strengthen the pelvic muscles. She will, therefore, gain the ability to control urine passage. Betty’s urine has an offensive odor. To get clear non-smelling urine, she should increase fluid intake and void urine after every 2 to 3 hours. These measures will prevent the accumulation and multiplication of bacteria which cause the bad smell. Betty has a fever. To lower her body temperature from 38.2°C to 37°C, her caregivers will treat infections that could be causing the fever. They will ensure she has appropriate clothing and takes adequate food and fluids. These interventions will reduce the temperature. Question 15 Betty should see a physiotherapist to help her with exercises to control urine incontinence. A dietician could advise her on the best diets to control her blood sugar (Early & Stanley, 2018).Also, a geriatrician would help her deal with social and rehabilitative issues that affect her health. A urogynaecologist could help her manage the UTI and keep the genital-urinary tract.
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CASE SCENARIO 25 References Early, K. B., & Stanley, K. (2018). Position of the Academy of Nutrition and Dietetics: The Role of Medical Nutrition Therapy and Registered Dietitian Nutritionists in the Prevention and Treatment of Prediabetes and Type 2 Diabetes.Journal of the Academy of Nutrition and Dietetics,118(2), 343-353. Nitzan, O., Elias, M., Chazan, B., & Saliba, W. (2015). Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management.Diabetes, metabolic syndrome and obesity: targets and therapy,8, 129. Nussey, S. S., & Whitehead, S. A. (2013).Endocrinology: an integrated approach. CRC Press.