Discussion: Examining Endocrine, Metabolic, and Hematologic Disorders
Patient education is critical, as is working with patients to establish a regular pattern for daily activities such as eating and taking medications. When developing care plans for patients, you must keep the projected outcomes of treatment in mind, as well as patient preferences and other factors that might impact adherence to treatment and management plans. In this Discussion, you draw from your Practicum Experience and consider factors that impact the education and treatment of patients with diabetes.
For this Discussion, consider the following three case studies of patients presenting with endocrine, metabolic, and hematological disorders.
Case Study 1
An 82-year-old female presents to the office complaining of fatigue, dizziness, weakness, and increasing dyspnea on exertion. She has a past medical history of atrial fibrillation, hypertension, and hyperlipidemia. Medications include warfarin 2 milligrams po daily, lisinopril 10 milligrams po daily, and simvastatin 10 milligrams po daily. There are no known drug allergies. The physical exam reveals a 5’2” older female. Her weight is 128 pounds, blood pressure is 144/80, heart rate is 98, temperature is 98 degrees Fahrenheit, and O2 saturation is 98%. Further examination reveals the following: Eyes: + pallor conjunctiva Cardiac: irregular rhythm. No S3 S4 or M. NO JVD Lungs: CTA w/o rales, wheezes, or rhonchi Abdomen: soft, BS +, + epigastric tenderness. No organomegaly, rebound, or guarding Rectal: no stool in rectal vault
· Think about the personal, medical, and family history you need to obtain from the patient in the case study. Reflect on what questions you might ask during an evaluation.
· Consider types of physical exams and diagnostics that might be appropriate for evaluation of the patient in the study.
· Reflect on a possible diagnosis for the patient.
· Review the Marroquin article in this week’s Resources. If you suspect prostate cancer, consider whether or not you would recommend a biopsy.
· Think about potential treatment options for the patient.
Post an explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study that you selected or were assigned. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis.