| Time: | 323 minutes |
|---|---|
| Current Score: | 110 out of 110 |
| Kept Score: | 110 out of 110 |
Question 1
Your Answer:
When a student does his or her own work, he or she is more likely to be optimistic, motivated, learn faster and make fewer mistakes. The student will also comply with the university academic integrity policies and is less likely to be accused or found guilty of plagiarism. A student is also able to schedule his tasks according to priority. An independent student usually performs highly because he can tackle any assignment at any time. And most importantly, the student is able to gain genuine skills that are key to enhancing his career.
Question 2
Use the John Jones case study to answer the following question.
Using diagnostic criteria for diabetes, what is John’s diabetic status? What treatment plan should be introduced at this time?
Your Answer:
John has met one of the criteria for Type 2 diabetes mellitus diagnosis. According to Rani (2016), one of the WHO Diagnostic Criteria that a patient must meet to be diabetic is 2-hour PG ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT). John’s glucose level is 200 mg/dL (11.1 mmol/L), which indicates he is diabetic. The treatment plan for John should involve engaging in physical exercises at least 30 minutes per day, insulin injection, and diet improvement. He also needs emotional support because he seems to be depressed due to burnout at work.
Reference
Rani, P. R. (2016). Screening and diagnosis of gestational diabetes mellitus, where do we stand. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/jcdr/2016/17588.7689 (Links to an external site.)
Question 3
Use the John Jones case study to answer the following question.
Which of John’s behaviors should be addressed to encourage lifestyle changes and decrease A1C levels?
Your Answer:
John is reluctant to engage in physical exercises, yet his condition demands physical activities. It seems John’s job requires him to sit for 8 to 10 hours. He should be encouraged to engage in physical exercises once he returns home instead of sitting in front of the television. John should engage in moderate to intense physical activities for at least 30 minutes per day. Physical activity will help him control blood sugar levels and lower his risk of heart disease and nerve damage (Mayo Clinic, 2020). Physical activities will also increase the insulin sensitivity of his cells. Besides, John should cease taking beer and sweet tea. Beer and sweet tea contain carbohydrates and may raise blood sugar (Ambardekar, 2021).
References
Ambardekar, N. (2021, May 8). Diabetes and alcohol. WebMD. https://www.webmd.com/diabetes/guide/drinking-alcohol (Links to an external site.)
Mayo Clinic. (2020, January 21). Diabetes care: 10 ways to avoid complications. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20045803 (Links to an external site.)
The combination of moderate exercise and weight loss reduces the risk for the development of type 2 diabetes and improves outcomes for patients with type 2 diabetes (Rosenthal & Burchum, 2021). Your response should identify behaviors specific to John and the case presented that address factors that either contribute to high blood sugar or high blood pressure. Blood pressure is an important health factor to monitor and improve as necessary but with diabetes increasing cardiovascular risks, it is even more important in people with diabetes.
Question 4
Use the John Jones case study to answer the following question.
Which behavior in John’s social history poses a potential concern with first line pharmacological treatment for diabetes and why?
Your Answer:
Fast food poses a potential threat to first line pharmacological treatment. These foods contain processed meats, trans fats, additives such as monosodium glutamate (MSG), high in fat, sugar and salt, low fiber, nutritionally poor and highly calorific (Sami & Ansari, 2016). This can promote insulin resistance which can exacerbate the blood sugar levels and weight gain. This makes it difficult for medications to regulate the blood sugar. Beer and sweet tea contain carbohydrates and may raise blood sugar. This also interferes with the positive effects of oral diabetes medicines or insulin.
Reference
Sami, W., & Ansari, T. (2016). Type 2 diabetes mellitus: Link between diet, HbA1c and complications. Australasian Medical Journal, 9(9). https://doi.org/10.4066/amj.2016.2708 (Links to an external site.)
Metformin is contraindicated in alcoholics. John’s history indicates routine alcohol consumption so further assessment is needed. The reason alcohol is contraindicated with alcohol is related to exacerbation of a potential risk with metformin itself regardless of alcohol intake.
Question 5
Use the John Jones case study to answer the following question.
Name the specific names of labs you would order and the intervals at which you would order them to monitor the safety and efficacy of metformin.
Your Answer:
Question 6
Use the Alfonso Giuliani case study to answer the following question.
Atherosclerotic cardiovascular disease (ASCVD) risk factors include age, gender, race, blood pressure, cholesterol values, history of diabetes, tobacco use, treatment of hypertension, statin therapy, and aspirin therapy.
Look at Alfonson’s ASCVD risk factors. Should Alfonso be taking something for hyperlipidemia? If so, what would you recommend?
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., … & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 74(10), 1376-1414. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000677 (Links to an external site.)
Your Answer:
Question 7
Use the Alfonso Giuliani case study to answer the following question.
Which diabetic drug classes should be considered in addition to metformin to prescribe for Alfonso and why?
Your Answer:
Question 8
Use the Alfonso Giuliani case study to answer the following question.
There are two drug classes to consider for prescribing for Alfonso in addition to metformin. What baseline data will you need to obtain for each of those drug classes? Provide the name of the drug class and the baseline data needed for that drug class.
Your Answer:
Question 9
Use the Alfonso Giuliani case study to answer the following question.
You decide to prescribe liraglutide (Victoza) in addition to metformin for Alfonso. What patient teaching do you need to provide when prescribing medication from this drug class?
Your Answer:
Question 10
Use the Helen Smith case study to answer the following question.
Why is caution indicated if metformin was prescribed for Helen?
Your Answer:
Question 11
Use the Helen Smith case study to answer the following question.
If the standard starting dose of levothyroxine 1.6 mcg/kg/dose is prescribed for Helen, what is the correct dose? Would this be the correct starting dose for Helen? Why or why not?
Your Answer:
Question 12
Use the Helen Smith case study to answer the following question.
Which of the Helen’s lab values require consideration for possible treatment? Provide the lab name and Helen’s result. Use these sources for lab reference values:
Your Answer:
Question 13
Use the Helen Smith case study to answer the following question.
Which DM drug class is contraindicated in patients with heart failure and why?
The why portion of this question will require some independent web or article searching to understand why this contraindication exists. Be sure to cite your sources.
Your Answer:
DM Diagnostic Criteria on page 398 (Rosenthal & Burchum, 2021) reviews the four criteria to diagnose DM which is the precursor to pharmacological intervention. Treatment is dependent on diabetic status, HgbA1C, and other patient factors.