Analyze and Respond to Client’s Health Information - Case Studies

This article presents case studies on analyzing and responding to client's health information. It covers topics such as diabetes type 2, foot ulcer, low BGL, wound red with exudate, urinalysis, risk factors of UTI, TIA and CVA, and more. Three health professionals are also discussed in each case study.

Running Head: CASE STUDIES
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Analyze and respond to client’s health information
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CASE STUDIES
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Table of Contents
Case study 1...............................................................................................................................3
Answer 1. Diabetes type 2......................................................................................................3
Answer 2. diabetes type 2 and foot ulcer...............................................................................3
Answer 3. Low BGL and related interventions......................................................................3
Answer 4. Wound red with exudate.......................................................................................3
Answer 5. Three health professionals....................................................................................4
Case study 2...............................................................................................................................4
Answer 6. Urinalysis..............................................................................................................5
Answer 7. Risk factors of UTI...............................................................................................5
Answer 8. The relation between temperature and infection...................................................5
Answer 9. TIA and CVA........................................................................................................5
Answer 10. Three health professionals..................................................................................6
Case Study 3...............................................................................................................................7
Answer 11. Genetics of cystic fibrosis..................................................................................7
Answer 12. Impacts of CF on respiratory system..................................................................7
Answer 13. Impact of CF on male fertility.............................................................................7
Answer 14. Impacts of pregnancy on respiratory system.......................................................7
Answer 15. Three health professionals..................................................................................7
References..................................................................................................................................9

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Case study 1
Answer 1. Diabetes type 2
Type 2 diabetes is a disorder that develops in the absence of a proper response to the
insulin by the human body (National Health Service, 2017). However the pancreas still
produces insulin but insulin does not work effectively (Diabetes Australia, 2018). Abnormal
secretion of insulin occurs due to the glucose responsiveness that can be examined before the
diagnosis of the disease. The impaired secretion rises with the time and the progression of
this condition includes lipo-toxicity and glucose toxicity. The untreated condition leads to
cause a reduced level of pancreatic beta cells mass. This progression of impaired beta cells
may affect the long-term blood-glucose level control. Farther it causes a permanent elevation
of blood glucose. The insulin abnormality majorly targets the organs such as like liver. It
commonly occurs in people who are more than 30 years old. This disorder can be caused by
the genetic factors and may become worse in case of overweight and lack of exercises (Kahn,
Cooper, & Del Prato 2014, pp. 1068-1083).
Answer 2. Diabetes type 2 and foot ulcer
Foot ulcers can occur in any person and appear on the lower leg or foot as the patches
of broken down skin. When the blood sugar level is increased or fluctuate at regular intervals,
the skin that heals normally may not repair properly itself due to nerve damage. As
mentioned in Percy’s case his blood glucose level was disturbed and fluctuates below the
normal range. The people with diabetes have the reduced nerve functioning because of
peripheral diabetic neuropathy. This means the sensation carrying nerves do not function
properly and the patient cannot feel the foot damage (Tesfaye, & Selvarajah 2012, 18-14).
The ulcers generally neglected due to it does not cause pain. The issues may occur in diabetes
by the diseased blood vessels and the increased susceptibility to infection. Various factors

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associated with the neurotropic foot ulcers are neuropathy, vascular supply, and
biomechanical pressure. People with the diabetic disorders have the high risk of developing
arterial ulcers. The arterial leg ulcers are caused by the poor blood pressure circulation
because of the narrowed arteries. In Percy's case, the systolic pressure was abnormal (140/80)
which indicated the abnormal blood circulation and risk of having hypertension. People with
diabetes have the higher risk of developing atherosclerosis.
Answer 3. Low BGL and related interventions
The blood glucose level of Percy (2.7 mmol/L) is below the normal range that is
4mmol/L which indicated that the patient has hypoglycemia. This health condition can occur
in people with diabetes type 2 where the person does not use insulin. The symptoms of
hypoglycemia include sweating, headache, dizziness, pins and mood change (Ktsilambros,
Kanaka- Gantenbein, Liatis, Makrilakis, & Tenrolouris 2011, pp. 28-32). In the given case
the patient suffers from severe low BGL and the immediate nursing care that can be provided
is administration basal and the prandial insulin. The patient can also be provided with glucose
and jelly beans to recover the low levels of glucose. The hypoglycaemic medication such as
glipizide and glimepiride should be given orally (Briscoe, Griffith, & Davis 2010, pp. 225-
235). After the analysing the decreased blood glucose level in the patient, the assigned
physician should be reported immediately and the levels related to the BGL should be
recorded in the patient’s datasheet
Answer 4. Wound red with exudate
In Percy's case, the red appearance is may be due to the chemical reaction caused by
long time dressing on foot. As discussed in the case study he visits the general practitioners to
have the dressing changed once in a week which is a long time. During this time the bacterial
infection may be occurring. The exudate plays a critical role to heal the wound and providing

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the most environment, nutrients and oxygen to the newly developing tissues and removing
the toxic material and waste products. The highly educating and non-healing wound exudate
may create problems. The red color is the sign of normal healing of the wound. Diabetes
occurs when the body is unable to produce or use insulin which is the hormone that allows
the body to turn glucose into energy. The peripheral neuropathy is caused by the altered
BGL levels, this leads to damaged nerves and vessels and cause poor or no sensation at the
affected areas. When the body has difficulty to metabolize the glucose it ultimately leads to
slow healing of wounds. There are various factors that may contribute to this situation such as
high blood sugar level, peripheral neuropathy which occurs due to the abnormal BGL levels,
poor blood circulation level in the diabetic patient, immune deficiency and microbial
infection. When the blood sugar level is imbalanced it prevents the nutrients and oxygen
distribution in cells and increases the inflammation in cells, these results in affected wound
healing (Brem & Tomic-Canic 2007, pp. 1219-1222).
Answer 5. Three health professionals
Wound Nurse
A wound Nurse is the one who is expert in managing and providing nursing care to the
patient with wound. The role and responsibilities the wound care nurse has been developed to
meet the requirements of expert wound care advice. The wound care nurse improves the
healing times and reduced the pressure injury prevalence (Dutton, Chiarella, & Curtis 2014,
pp. 39-47). Percy has been suffering with the exudate wound and a wound nurse might help
him to improve his wound.
Dietician
The dietician or nutritionist is the allied health professional who is an expert in
maintaining the nutrition intake for the patient. The registered nutritionist or dietician

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nutritionist change the diet and nutrition consumption according to the requirements and the
type of disease they have (Brown & Phillips 2010, pp.432-439). In the case of Percy, the
nutrition balance is very essential as his BGL level and systolic blood pressure are
unbalanced. Therefore the dietician can help to maintain the essential nutrients intake to
successfully achieve the health goals.
Endocrinologist
An endocrinologist is the one who specializes or expert in treating diabetes and
diseases related to the endocrine system. They also deal with diseases associated with bones,
thyroid gland, and pituitary gland. The pancreas is the part endocrine system where the
insulin produced (Diabetes Australai, 2017). Many people with diabetes may prefer
dialectologist as they have taken a special interest in diabetes management but diabetology is
not abroad field of medicine as endocrinology. As mentioned in the case study the patient is
suffering from diabetes type 2 and has a low BGL level. As menrioned in the case study
Percy has disturbed BGL levels and an endocrinologist can help to maintain the insulin levels
in the patient’s body.
Case study 2
Answer 6. Urinalysis
Urinalysis is the test that examines Urine for the diagnosis of diseases or infections,
kidney problems, and diabetes. It involves examining the urine for its color, appearance, and
odor. It also checks the urine for any substances that are not present in the urine normally
such as blood, high protein, glucose, bilirubin, and ketones (Medline Plus, 2016). Urinalysis
can diagnose the disease that is not noticed because they do not possess any symptoms for
example diabetes mellitus (Klatt, 2018)

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Post urinalysis results of Percy
Glucose – negative (Low levels of glucose
Protein ++ (patient have protein in urine, this can be a sign of kidney disorder)
Nitrates ++ (means presence of nitrate in urine)
Ketones –negative (means ketone level is less than 0.6 mmol/L)
Blood ++ (means presence of blood in urine)
Ph -5 (Acidic nature or urine)
Answer 7. Risk factors of UTI
Urinary tract infection is the infection occurs in any part of the urinary system such as
kidneys, bladder, and urethra. The risk factors of UTI are Age, gender, and genetic factor, the
medical condition like diabetes and paralysis, and sexual activity. In the case of Lee, there are
two major risk factors associated with urinary tract infection include age and paralysis. He
was suffering from hemiplegia and aphasia which increases the risk of UTI. The people with
paralysis have the high risk of developing urinary tract infections which can be caused by the
microbial activity. In paralysis case the patient is not able to empty their bladder completely;
the microbes are likely to be developing in the urine that left in the bladder. The symptoms
associated with this infection are smelly and cloudy urine, fever, chills, headache, and
autonomic dysreflexia (Christopher & Dana Reeve Foundation, 2018). People of this age
group and sex have a higher rate of UTI because the openings of the rectum and urethra are in
close proximity. Menopause is also the contributing factor of UTI that occurs after 40 or 45
years, as mentioned in given information the patient is of 45 years old women, therefore, she
has the risk of developing the problem (Mayo clinic, 2018)

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Answer 8. The relation between temperature and infection
The presence of elevated temperature is usually related to the body's immune system
response against the microbial attack in the body. The raising temperature supports the
immune system to kill the pathogenic agents that may cause infection. When the bacteria
enter the body, the immune system identifies the pathogen as the foreign invader and triggers
the chemical process to destroy that agent. Some of these events result in pyrogens. These
chemical agents travel to the brain. When the hypothalamus interacts with these pyrogens, it
reset the thermostat and indicates the body to generate more heat which results in elevated
temperature (Haugen & Galura 2010, pp. 150-170). In this given case scenario the patient is
suffering from the Urinary tract infection and elevated temperature (which is more than 38-
degree centigrade) is associated with it.
Answer 9. TIA and CVA
TIA (Transient ischemic attack)
The transient ischemic attack is the neurological event in which the blood supply to
the brain is blocked for some time. The signs of this blockage are similar to the stroke,
therefore, it is called mini-stroke. It typically lasts for two to thirty minutes. It occurs due to
the temporary lack of blood and oxygen supply to the brain. This is caused by the narrowing
of carotid arteries that supply blood to the brain. The people with diabetes have the high risk
of TIA. The symptoms associated with TIA include loss of vision, numbness, dizziness,
headache, and paralysis of the face, arm or legs (Pendlebury, Lau, & Rothwell 2018, pp. 243-
250).
CVA (Cerebrovascular accident)
The cerebrovascular accident is a medical condition of stroke in which the blood flow
is stopped in a part of the brain either by a blockage or the rupture of a blood vessel. The

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occurrence of symptoms depends on the area of the brain that affected by this stroke. The
types of CVA attack are ischemic stroke and hemorrhage stroke. The symptoms associated
with CVA are difficulty walking, dizziness, and loss of balance, difficulty in speaking,
numbness or paralysis on one side of the body, blurred or dark vision, and sudden headache
(Carpenito-Moyet, 2009).
Ischemic strokes also CVA embolic strokes that are caused by the formation of a
blood clot that developed elsewhere in the body (embolus) and passes through the blood
circulation to the brain. In some cases, the clots are formed in the largest artery of the heart
called the aorta and travels to the brain. These strokes can cause the symptoms of ischemic
attacks (Mena, 2016).
Answer 10. Three health professionals
Neurologist
The neurologists are the one who treat the problems related to the brain spinal cord,
and nervous systems such as transient ischemic attack, acute ischemic strokes, and
cerebrovascular disease. As mentioned in the case study the patient is diagnosed with a
transient ischemic attack in which a neurologist can play a vital role to achieve recovery.
Urologist
A urologist is a specialist doctor who deals with the problems associated with the
urinary tract. They trained in the medical and surgical treatment of the disease caused in
organs such as kidneys, urinary bladder, adrenal glands, and urethra. The urologist can help
to manage and treat the urinary tract infection and other related problems in Lee’s case.
Nutritionist or dietician

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A nutritionist or dietician is expertise in the field of nutrition and food they trained to
maintain the nutrition in the patient according to the disease. As nutrition and diet are the key
elements to recover in most of the health issues. The patient in the given case study having
low pH and glucose level and instructed to take thickens fluids. In this case, the nutritionist
might help to maintain the diet and to provide essential nutrition so that the problem can be
controlled. The dietician can also help the patient to maintain the water loss occurs due to the
frequent urination.
Case Study 3
Answer 11. Genetics of cystic fibrosis
Cystic fibrosis is the inherited disorder in which, thick and sticky mucus is build up
that can damage many organs of the body. The most common symptoms of this disease
include problems in the digestive system, and progressive damage occurs in the respiratory
system. To have cystic fibrosis a person must inherit two copies of the CFTR gene that
contains the mutation. There is a 25 % of probability for them having a child with CF
(Lommatzsch, & Aris 2009, pp. 531-538)
Answer 12. Impacts of CF on the respiratory system
Cystic fibrosis builds up a thick and clogs in certain parts of the body like lungs
caused by a mutation occurs in the gene called CFTR. The changes occurred, may cause the
mucus to become more thickened and sticky over the time (University of Rochester medical
center, 2018). Initially, it affects the small airways of lungs and then can affect all the
airways. In children's, the thickened mucus can also prevent the cilia to sweep the microbes
or germs and the other particles to pass out of the lungs. Because of this the bacteria is
trapped inside and may cause infections. To remove the bacteria immune system sends
WBCs t the lungs that kill bacteria as well as other surrounding healthy cells. other impacts

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of respiratory system includes chronic cough, collapsed lungs, heart enlargement, nasal
polyps, shortness of breath, and coughing up blood. (Healthwise, 2018)
Answer 13. Impact of CF on male fertility
In males vas deference is caused to atrophy in embryonic development by CF because
of the males with CF born without VD, this is called the congenital bilateral absence of the
vas deference (CBAVD). The vas deferens is the tube-like structure that carries the sperm
from testicles to the other parts of the male reproductive system. People with this disorder the
vas deferens is may be blocked or defective. Therefore the person might can experience a
normal erection or ejaculation but there is no sperm in the semen. Due to this it is not
possible to fertilize the egg.
Answer 14. Impacts of pregnancy on the respiratory system
There are marked changes occurs in respiratory physiology during the pregnancy. The
pulmonary blood flow is increased due to an increase in cardiac output. Hypermedia and
edema of upper respiratory mucosa occur due to the blood volume expansion and the
vasodilation in pregnancy. During pregnancy capillary engorgement and swelling in mucosa
lining occurs due to the hormonal changes. The oxygen consumption increases up to 60%. In
some cases the manipulation of airways leads to profuse bleeding form oropharynx or nose,
airway resistance is reduced because of bronchial musculature relaxation mediated by
progesterone hormone. Other possible changes that occur during pregnancy are running nose,
barrel-shaped chest, movement of the diaphragm upward, and reduced lung capacity. These
changes may cause shortness of breath in some women's (LoMauro & Ai]liverti 2015, pp.
297-302).
Answer 15. Three health professionals
Pulmonologist

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The pulmonologist is ta Cystic fibrosis doctor who is an expert in providing care to
the people with CF. he or she is trained to diagnose and treat the diseases related to lungs. CF
is a complex disorder, and the treatment requires a whole team of nurse, physiotherapist,
social-worker, general physician to provide goal-oriented interventions. A CF doctor
collaborates with other team members in order to achieve quality improvement. In the given
case study the patient diagnosed with respiratory issues and a pulmonologist can help in this
case.
Respiratory therapist
The respiratory therapist is the allied health professional who performs the pulmonary
function test or measures the flow and volume of air in the lungs. (The respiratory therapist
also helps in pulmonary therapies that are used to clear the mucus from the lungs and
controlling the bacterial infection of airways. The RF is responsible to teach the patients and
their family about how to take the inhaled medication. As mentioned in the case of
Madeleine Brown has respiratory problems, an RF can play an important role to treat the
respiratory system related issues such as breathless, increased RR, and reduced air entry.
CF dietician
The higher weight promotes a better lung function and this can be achieved by
consuming a good nutrition and a better diet. The registered dieticians are expert and trained
to maintain a daily food intake, growth, and the overall nutritional status. He or she can teach
the patient or the family members about how to improve the eating habits, vitamin, and
dietary supplement intake (European Cystic Fibrosis Society, 2018)

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References
American Diabetes Association (2017). Your healthcare team. Retrieved from:
http://www.diabetes.org/living-with-diabetes/treatment-and-care/whos-on-your-health-
care-team/your-health-care-team.html
Diabetes Australia (2015). Type 2 diabetes. Type 2. Retrieved from:
http://www.diabetes.org/diabetes-basics/type-2/
Brem, H., & Tomic-Canic, M. (2007). Cellular and Molecular Basis of wound healing in
diabetes. The Journal of clinical investigations, 117(5), 1219-22.
Briscoe, V. J., Griffith, M. L., & Davis, S. N. (2010). The role of glimepiride in the treatment
of type 2 diabetes mellitus. Expert opinion on drug metabolism & toxicology, 6(2), 225-
235.
Brown, K. L., & Phillips, T. J. (2010). Nutrition and wound healing. Clinics in
dermatology, 28(4), 432-439.
Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and
collaborative problems. (5th ed.).China: Lippincott Williams & Wilkins.
Christopher & Dana Reeve Foundation (2018). Bladder management. Retrieved from:
https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/
bladder-management
Cystic fibrosis Western Australia (2014). A guide to Cystic fibrosis for health professionals.
Retrieved from: https://www.cfwa.org.au/wp-content/uploads/2017/12/CF-Services-
for-Health-Professionals.pdf

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Dutton, M., Chiarella, M., & Curtis, K. (2014). The role of the wound care nurse: an
integrative review. British journal of community nursing, 19(Sup3), S39-S47.
European Cystic Fibrosis Society (2018). Allied health professionals. Retrieved from:
https://www.ecfs.eu/groups-projects/allied-health-professionals
Haugen, N., & Galura, S. J. (2010). Ulrich & Canale's Nursing Care Planning Guides-E-
Book. (7th ed.). Missouri: Elsevier Health Sciences.
Healthwise (2018). How cystic fibrosis affects breathing and the lungs?. Retrieved from:
https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=hw184872
Klatt, E. C. (2018). Urinalysis. Retrieved from:
https://library.med.utah.edu/WebPath/TUTORIAL/URINE/URINE.html
Ktsilambros, N., Kanaka- Gantenbein, C., Liatis, S., Makrilakis, K., & Tenrolouris, N.
(2011). Diabetic emergencies: diagnosis and clinical management. (2nd ed.). West
Sussex, UK: John Wiley & Sons.
Lommatzsch, S. T., & Aris, R. (2009). Genetics of cystic fibrosis. In Seminars in respiratory
and critical care medicine, 30(5), 531-538.
Mayo Clinic (2018). Urinary tract infection. Retrieved from:
https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-
causes/syc-20353447
Medline Plus (2016). Urinalysis. Retrieved from: https://medlineplus.gov/urinalysis.html
Medline Plus (2018). Diabetes- low blood sugar- self-care. Retrieved from:
https://medlineplus.gov/ency/patientinstructions/000085.htm

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Mena, K. (2016). Embolic stroke. Retrieved from:
https://www.healthline.com/health/stroke/embolic-stroke-symptoms
National Health Service (2017). What is type 2 diabetes?. Retrieved from:
https://www.nhs.uk/conditions/type-2-diabetes/
Pendlebury. S. T., Lau, G. K. K., & Rothwell, P. M. (2018). Transient ischemic attack and
stroke: diagnosis, investigation, and treatment. (2nd ed.). Port Melbourne, Australia:
Cambridge University Press.
Tesfaye, S., & Selvarajah, D. (2012). Advances in the epidemiology, pathogenesis, and
management of diabetic peripheral neuropathy. Diabetes/metabolism research and
reviews, 28, 8-14.
University of Rochester medical center, (2018). Cystic fibrosis and respiratory system.
Retrieved from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?
contenttypeid=90&contentid=P02936
Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2
diabetes: perspectives on the past, present, and future. The Lancet, 383(9922), 1068-
1083.
LoMauro, A., & Aliverti, A. (2015). Respiratory physiology of pregnancy. Breathe, 11(4),
297-301.