NU636 Unit 4: Discussion Diabetes Management

Initial Response

Scenario

You are seeing a 64-year-old Hispanic male for his diabetes management. He reports that his morning capillary blood sugar readings are ranging in the 150 to 190 range.

Last month his Hgb A1C was 7.4
He is on Metformin 1000mg twice a day and Glipizide 5mg daily.
He walks a couple miles three to five times a week.
A dietary review reveals that his daily total carbohydrate intake is in the range of 75 to 100 grams.
Last eye exam did not reveal any problems. He wears reading glasses when needed.
He does report some intermittent burning sensation in his feet.
Ht 6’2”, Wt 200 lbs, BP 118/72, P 72, R 17
Heart regular rhythm, without murmur or gallop
Lungs clear
Monifilament testing does not reveal any decreased sensation in the feet

Please develop a discussion that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.

Initial Post

Utilize the information provided in the scenario to create your discussion post.

Construct your response as an abbreviated SOAP note (Subjective Objective Assessment Plan).

Structure your ‘P’ in the following format: [NOTE: if any of the 3 categories is not applicable to your plan please use the ‘heading’ and after the ‘:’ input N/A]

Therapeutics: pharmacologic interventions, if any – new or revisions to existing; include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention]

Educational: health information clients need in order to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit

Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making

Support the interventions outlined in your ‘P’ with scholarly resources.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Solution: NU636 Unit 4: Discussion Diabetes Management

This 64-year-old Hispanic male presents for follow-up diabetes management. He reports self-monitoring his blood glucose levels in the morning has shown readings ranging from 150-190 mg/dL over the past month. His A1C was 7.4% at his last visit one month ago. For exercise, he walks approximately 2 miles 3-5 times per week. A review of his daily dietary intake reveals he consumes around 75-100 grams of total carbohydrates. His last eye exam did not reveal any issues and he only use reading glasses occasionally. Significantly, he now reports an intermittent burning sensation affecting both feet.

On physical exam, his vital signs are within normal limits with a blood pressure of 118/72, pulse of 72, and respiratory rate of 17. Cardiac and pulmonary exams are unremarkable without murmurs, gallops, or abnormal breath sounds auscultated. His height is 6’2″ and weight is 200 pounds, giving him a BMI of 27.5 kg/m², classified as overweight. A 10-gram monofilament test of both plantar foot surfaces does not reveal any areas of decreased protective sensation.

Based on the history and physical findings, this patient has a diagnosis of type 2 diabetes mellitus with suboptimal glycemic control as evidenced by his elevated A1C and post-prandial blood glucose readings (ADA, 2020). The new complaint of intermittent burning in both feet is…Please click purchase button below to get full answer for $5

(Solution) NU636 Unit 4: Discussion Diabetes Management