nursing project
CASE STUDY PRESENTATION:
POWERPOINT CREATION AND TRANSCRIPT FOR PRESENTATION
For this project, you will complete a clinical case study analysis, research review, and PowerPoint video presentation about the pathophysiology of a topic of your choice.
Your presentation should follow a case study SBAR format (situation, background, assessment, and recommendations).
You must include three (3) different medical-based evidence and/or research recommendations.
You must include at least three (3) scholarly sources in your overall presentation.
Your PowerPoint presentation should include the following slides:
Introduction to the case or situation
Background detail
Clinical assessment
Recommendations
Application to future practice
Reference slide: At least three (3) scholarly references supporting your ideas.
Your presentation should be 3-5 minutes in length. Upload your completed video presentation here for grading.
You will also post it to the Discussion Board for your Week 9 Discussion. Look ahead to the Week 9 Discussion Board for details.
Review the rubric for further information on how your assignment will be graded.
Points Possible: 70
Due: Sunday, 11:59 p.m. (Pacific time)
Requirements: see rubric
Due: Sunday, 11:59 p.m. (Pacific time)
Rubric
General Education Standardized Rubric: Research Project and Presentation Rubric (Individual)
Week 6: Signature Assignment: Type II Diabetes Mellitus
Ashley Facendola
West Coast University
Dr. Ken
Pathophysiology 370
March 5, 2023
Introduction
The subject of this case study, William Thomas Harrison, is a male, 60-year-old inhabitant of Florida who is of Caucasian ethnicity. Being a combat veteran, he has a history of military duty. The symptoms William Thomas Harrison displays are those of type 2 diabetes. He has been complaining of having to urinate a lot, being very thirsty and tired, having a hazy vision, having wounds or bruises taking longer to heal, and having neuropathy in his hands and feet. With type 2 diabetes, the body produces insufficient insulin or develops insulin resistance, which results in elevated blood glucose levels (Wondmkun, 2020). The condition will need careful management to avoid consequences, including nerve damage, renal disease, and cardiovascular disease. Given its severity, the appropriate actions will be implemented to ensure the patient’s symptoms don’t deteriorate and lead to further complications.
In the case of William Thomas Harrison, the nurse must concentrate on treating and mitigating issues related to type 2 diabetes. The patient must have his blood sugar levels closely monitored and his medications managed. Moreover, it will be imperative to initiate lifestyle changes, including eating a nutritious diet and exercising. William has to be informed of the significance of taking his medications as prescribed, checking his blood sugar levels, and identifying the symptoms and indications of hyperglycemia and hypoglycemia. In order to avoid the onset or advancement of problems like cardiovascular disease, it is also crucial to evaluate his risk for such conditions. As a nurse, I can assist William in achieving his best health outcomes and enhance his quality of life by giving him thorough, tailored care.
Pathophysiology
Type 2 diabetes is a metabolic condition often?characterized by hyperglycemia. This is due to insulin resistance or inadequate insulin production (Burgos-Morón et al., 2019). The metabolic disorder can be evidenced by Polyuria and polydipsia (Vieira et al., 2019). Other symptoms that may be witnessed are such as weariness, blurred vision, and slowly healing wounds. Furthermore, peripheral neuropathy is a typical sign of type 2 diabetes (Mayeda et al., 2020). Sometimes, a person’s appetite may grow when they lose or gain weight. The microvascular and macrovascular consequences of type 2 diabetes, such as neuropathy, nephropathy, retinopathy, and cardiovascular disease, can be brought on by persistent hyperglycemia. Hence, early identification and appropriate therapy of this illness are crucial to avoid or postpone the development of these symptoms and improve health outcomes.
As mentioned earlier, type 2 diabetes is characterized by decreased insulin production or insulin resistance that results in hyperglycemia. The onset of insulin intolerance and beta-cell dysfunction is caused by a complex interaction of hereditary and environmental variables that have a role in the pathogenesis of the metabolic disorder (Redondo et al., 2020). In peripheral tissues such as skeletal muscle, adipose tissue, and the liver, insulin resistance is defined by reduced glucose absorption and utilization (Mu, Cheng, Liu, Lv, Liu, Zhang & Li, 2019). This leads to reduced glucose metabolism and increased hepatic glucose synthesis. Insufficient insulin production is a hallmark of beta-cell dysfunction, defined by reduced insulin release in response to glucose stimulation.
History
William Thomas Harrison has a medical history of Mycobacterium TB infection and type 2 diabetic symptoms. Mycobacterium tuberculosis is an infectious illness that predominantly impacts the respiratory system but can also affect other body regions (Chai, Lu & Liu, 2020). The illness might result from many symptoms, including a cough, fever, weight loss, and weariness. While the patient’s TB infection has been treated, monitoring him in case there is a recurrence or any other problems from the original illness is crucial. The patient has never had surgery before. His type 2 diabetes and prior Mycobacterium TB infection are not being treated with medications. Therefore, his blood glucose levels and any potential repercussions from his problems must be closely monitored.
Nursing Physical Assessment
Upon conducting a physical assessment, it was found that the patient’s fasting blood glucose levels only slightly increased at 110 mg/dL. Moreover, his blood pressure is within the acceptable range at 120/80 mmHg. The patient’s hemoglobin A1c is 6.5%, indicating good glucose management and average blood glucose levels for the previous two to three months. William has an overweight but not obese body mass index (BMI) of 28 kg/m2. The patient’s peripheral pulses are +2 bilaterally, and bowel sounds are standard in the four quadrants. He can walk a short distance independently, but due to his slight neuropathy, he may feel some mild pain or numbness in his feet after standing or walking for an extended amount of time.
Related Treatments
William Thomas Harrison is not currently taking any type 2 diabetes medication. Instead, he has changed his lifestyle to include regular exercise, a healthy diet, and close attention to his blood sugar levels. In order to assist in controlling his blood sugar levels, medication may be suggested if his symptoms get worse. He had, however, previously taken duloxetine, an antidepressant that is occasionally recommended to treat neuropathic pain.
Nursing Diagnosis & Patient Goal
The nursing assessment for the patient is Risk for Uncontrolled Blood Glucose Levels associated with insufficient care and monitoring of Type 2 Diabetes. The diagnosis is based on the patient’s symptoms, medical history, and present state of health. The patient’s excessive blood glucose levels brought on by insufficient diabetes control are the main problem. The nurse’s main goal should be to inform the patient on how to manage their diabetes, including diet and exercise, blood glucose monitoring, and medication administration when required (Chai et al., 2018). The objective is to avoid side effects, including cardiovascular disease, renal disease, and nerve damage. To avoid additional difficulties, the nurse will monitor the patient’s blood glucose levels and ensure they follow their treatment plan.
Nursing Interventions
A multidisciplinary strategy will be used to manage William’s type 2 diabetes and avoid complications in accordance with the nursing goals. I will serve as the patient’s primary caregiver and collaborate with the patient’s physician, nutritionist, and diabetes educator to establish an efficient management strategy. Initially, the patient will be educated on the value of maintaining a nutritious diet, engaging in regular physical activity, and self-monitoring blood glucose levels. According to Du, Y., Dennis, B., Rhodes, S. L., Sia, M., Ko, J., Jiwani, R., & Wang, J. (2020), it is imperative to offer patients self-monitoring kits. This enables them to take the necessary precautions when their glucose levels are very high. I will instruct him on how to spot the symptoms of hypo and hyperglycemia and what to do when they occur.
Second, medication compliance will be carefully watched, particularly for drugs recommended for comorbid conditions like hypertension. Aminde, Tindong, Ngwasiri, Aminde, Njim, Fondong & Takah (2019) inform that medication compliance is one of the leading reasons for diabetes exacerbation. Therefore, this measure will be taken to ensure that the patient does not experience other adverse outcomes. Moreover, the patient has a history of depression, so I will consult with his physician to see if duloxetine is a suitable medicine for him to take given his diabetic condition. Finally, follow-up appointments will be regularly to check William’s blood pressure, blood sugar levels, and general wellness. Also, the right experts will be referred, such as an ophthalmologist or podiatrist. According to Wong et al. (2018), the ophthalmologist will be able to evaluate and treat retinopathy. However, the podiatrist will evaluate and treat the recurring neuropathy. Finally, I will encourage the patient to engage in self-care actively, enabling him to make wise decisions about his health. He will be urged to record his blood sugar readings, prescriptions, and food consumption so that we may utilize this data to make any necessary modifications.
Evaluation
The patient significantly improved once the nursing interventions were applied. He reported feeling less tired and thirsty when his blood sugar levels normalized. While ambulating for longer durations, he could control his neuropathy symptoms better and experienced less discomfort. His fasting blood glucose levels were within the normal range during his follow-up appointment, and his hemoglobin A1c had dropped to 6.0%. The frequency of his symptoms had also decreased, according to him, and his peripheral pulses were still bilaterally +2. He could walk for long periods without experiencing pain or numbness, and his bowel movements were regular in all four quadrants.
Recommendations
William Thomas Harrison should adhere to the advice given to maintain his recovery and enhance his health. This entails following his diabetic eating plan, regular exercise, and monitoring his blood sugar levels. He must also continue to keep his weight in check. Moreover, the patient must keep going to his scheduled follow-up meetings with his physician and have routine evaluations of his diabetes condition, such as HbA1c readings and eye, kidney, and foot tests, to look for early complications of the disease.
The patient and his family must continue to receive education about the long-term management of diabetes and the significance of following the prescribed course of action. The nurse should urge him to adopt healthy habits and should also offer any additional resources, such as diabetes support groups or dietary advice, as needed. It’s crucial to address any psychological disorders, such as depression or anxiety, and, if required, offer tools or referrals. In order to assist the patient in acquiring the knowledge and self-assurance needed to control his diabetes adequately, the nurse should highlight the value of self-management and offer support.
References
Aminde, L. N., Tindong, M., Ngwasiri, C. A., Aminde, J. A., Njim, T., Fondong, A. A., & Takah, N. F. (2019). Adherence to anti-diabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC endocrine disorders,?19(1), 1-9.
Burgos-Morón, E., Abad-Jiménez, Z., Martínez de Marañón, A., Iannantuoni, F., Escribano-López, I., López-Domènech, S., … & Víctor, V. M. (2019). Relationship between oxidative stress, ER stress, and inflammation in type 2 diabetes: the battle continues.?Journal of clinical medicine,?8(9), 1385.
Chai, Q., Lu, Z., & Liu, C. H. (2020). Host defense mechanisms against Mycobacterium tuberculosis.?Cellular and Molecular Life Sciences,?77, 1859-1878.
Chai, S., Yao, B., Xu, L., Wang, D., Sun, J., Yuan, N., … & Ji, L. (2018). The effect of diabetes self-management education on psychological status and blood glucose in newly diagnosed patients with diabetes type 2.?Patient education and counseling,?101(8), 1427-1432.
Du, Y., Dennis, B., Rhodes, S. L., Sia, M., Ko, J., Jiwani, R., & Wang, J. (2020). Technology-assisted self-monitoring of lifestyle behaviors and health indicators in diabetes: qualitative study.?JMIR diabetes,?5(3), e21183.
Mayeda, L., Katz, R., Ahmad, I., Bansal, N., Batacchi, Z., Hirsch, I. B., … & de Boer, I. H. (2020). Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease.?BMJ Open Diabetes Research and Care,?8(1), e000991.
Mu, W., Cheng, X. F., Liu, Y., Lv, Q. Z., Liu, G. L., Zhang, J. G., & Li, X. Y. (2019). Potential nexus of non-alcoholic fatty liver disease and type 2 diabetes mellitus: insulin resistance between hepatic and peripheral tissues.?Frontiers in pharmacology,?9, 1566.
Redondo, M. J., Hagopian, W. A., Oram, R., Steck, A. K., Vehik, K., Weedon, M., … & Dabelea, D. (2020). The clinical consequences of heterogeneity within and between different diabetes types.?Diabetologia,?63, 2040-2048.
Vieira, R., Souto, S. B., Sánchez-López, E., López Machado, A., Severino, P., Jose, S., … & Souto, E. B. (2019). Sugar-lowering drugs for type 2 diabetes mellitus and metabolic syndrome??strategies for in vivo administration: part-II.?Journal of clinical medicine,?8(9), 1332.
Wondmkun, Y. T. (2020). Obesity, insulin resistance, and type 2 diabetes: associations and therapeutic implications.?Diabetes, metabolic syndrome and obesity: targets and therapy,?13, 3611.
Wong, T. Y., Sun, J., Kawasaki, R., Ruamviboonsuk, P., Gupta, N., Lansingh, V. C., … & Taylor, H. R. (2018). Guidelines on diabetic eye care: the international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings.?Ophthalmology,?125(10), 1608-1622.
Week 8 Assignments
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Hello Everyone,
Welcome to week 8 and I hope you had a wonderful weekend. It is now?week 8?for us, which means we have only two more weeks to the end of the term. This week is special because we have the?Evidence-Based Medicine: Research Presentation due on Sunday. To save you time you may?use the topic you chose for your week 6 Signature Assignment. I am also including a Sample Presentation below to give you an idea what your presentation should look like. Please read the instructions for the Research Presentation assignment carefully. I hope you have a wonderful, happy, and safe week.
Research Presentation Hints:
Presentation?must have?Power Point background (each PPT should have an image)
Presentation?must have both audio and video?(including your profile (face))
Remember to choose?SHARE YOUR VIDEO?on PANOPTO.?If I cannot view your video, you will receive a zero.
Remember to include a REFERENCE PAGE (a zero will be given for PLAGIARISM)
What is Application to Future Practice? In 1981 a game changing movement called ??Evidence ?? Based Medicine?? began. Evidence ?? Base Medicine is the practice of medicine based on research. Medical professionals shared their most current best practices and most effective strategies to treat and manage a specific disease. Application to future practice explains how and why this strategy (your proposed strategies) is the most current, best, and most effective in managing and or treating your patient.?You must provide evidence (research articles)?to?prove your case.
Best wishes,
Dr. Ken
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