Epidemiological Analysis: Chronic Health Problem

Case Study

Assignment

 

Please fill the template provided 

 

Purpose

The purpose of this assignment is to apply endocrine pathophysiological concepts to explain assessment findings of a patient with Diabetes. Students will examine all aspects of the patient’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

  1. Examine the case scenario and analyze the exam and lab findings results to determine the patient’s type of diabetes. (CO1)
  2. Explain the pathophysiology of the type of diabetes. (CO1)
  3. Differentiate between subjective and objective findings which support the chosen diagnosis. (CO4)
  4. Apply evidence-based practice guidelines to develop an appropriate treatment plan. (CO1, CO5)

Due Date

Sunday by 11:59 PM MT of Week 6

Total Points Possible

This assignment is worth 100 points.

Preparing the Assignment

Requirements

Content Criteria

  1. Read the case study listed below.
  2. Refer to the rubric for grading requirements.
  3. Utilizing the Week 6 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
  4. You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
  5. You must use the current Clinical Practice Guideline (CPG) for the Standards of Medical Care in Diabetes -Abridged for Primary Care Providers provided by the American Diabetes Association to determine the patient’s type of diabetes and answer the treatment recommendation questions. The most current guideline can be found at the following web address: https://professional.diabetes.org/content-page/practice-guidelines-resourcesLinks to an external site. At the website, locate the current year’s CPG for use.
  6. Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.

Case Study Scenario

Chief Complaint

J.T. is a 48-year old male who presents to the primary care clinic with fatigue, weight loss, and extreme thirst and increased appetite.

History of Present Illness

J.T. has been in his usual state of health until three weeks ago when he began experiencing symptoms of fatigue, weight loss, and extreme thirst. He reports that he would like to begin a walking program, but he feels too fatigued to walk at any point during the day. Now he is very concerned about gaining more weight since he is eating more. He reports insomnia due to having to get up and urinate greater than 4 times per night.

Past Medical History 

  • Hypertension
  • Hyperlipidemia
  • Obesity

Family History

  • Both parents deceased
  • Brother: Type 2 diabetes

Social History

  • Denies smoking
  • Denies alcohol or recreational drug use
  • Landscaper

Allergies

  • No Known Drug Allergies

Medications

  • Lisinopril 20 mg once daily by mouth
  • Atorvastatin 20 mg once daily by mouth
  • Aspirin 81 mg once daily by mouth
  • Multivitamin once daily by mouth

Review of Systems

  • Constitutional: – fever, – chills, – weight loss.
  • Neurological: denies dizziness or disorientation
  • HEENT: Denies nasal congestion, rhinorrhea or sore throat.
  • Chest: (-)Tachypnea. Denies cough.
  • Heart: Denies chest pain, chest pressure or palpitations.
  • Lymph: Denies lymph node swelling.

General Physical Exam  

  • Constitutional: Alert and oriented male in no acute distress
  • Vital Signs: BP-136/80, T-98.6 F, P-78, RR-20
  • Wt. 240 lbs., Ht. 5’8″, BMI 36.5

HEENT 

  • Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
  • Ears: Tympanic membranes intact.
  • Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
  • Mouth: Oropharynx clear. No mouth lesions. Teeth present and intact; Oral mucous membranes and lips dry.

Neck/Lymph Nodes 

  • Neck supple without JVD.
  • No lymphadenopathy, masses or carotid bruits.

Lungs 

  • Bilateral breath sounds clear throughout lung fields. Breathing quality deep with fruity breath odor

Heart 

  • S1 and S2 regular rate and rhythm; – tachycardia; no rubs or murmurs.

Integumentary System 

  • Skin warm, dry; Nail beds pink without clubbing.

Labs

TestPatient’s ResultReference

Glucose (fasting)

132

60-120 mg/dL

BUN

20

7-24 mg/dL

Creatinine

0.8

0.7-1.4 mg/dL

Sodium

141

135-145 mEq/L

Sodium

141

135-145 mEq/L

Chloride

97

95-105 mEq/L

HCO3

24

22-28 mEq/L

A1C

7.2

Urinalysis

Protein

Glucose

Ketones

 

Negative

Positive

Negative

Oral glucose tolerance test (OGTT)

220 mg/dL

J.T. is diagnosed with diabetes. Review all information provided in the case to answer the following questions.

Case Study Questions

Pathophysiology & Clinical Findings of the Disease

  1. Review the lab findings and decide if the diagnosis is Type 2 or Type 1 Diabetes Mellitus.
  2. Explain the pathophysiology associated with your chosen diagnosis
  3. Identify at least three subjective findings from the case which support the chosen diagnosis.
  4. Identify at least three objective findings from the case which support the chosen diagnosis.

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

  1. Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
  2. Describe the mechanism of action for each of the medication classes identified above.
  3. Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.
  4. Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations

ASSIGNMENT CONTENTCategoryPoints%Description

Pathophysiology & Clinical Findings of the Disease

45

45%

The student:

  • Identifies the likely diagnosis based on exam and lab findings.
  • Explains the pathophysiology associated with the chosen disorder.
  • Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).
  • Identifies at least three subjective findings from the case.
  • Identifies at least three objective findings from the case.

(5 Required Elements)

Management of the Disease 

45

45%

The student:

  • Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.
  • Identifies two (2)“Evidence A” recommendedmedicationclassesfor the treatment of the condition and provides an example (drug name) for each.
  • Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition.
  • Describes the mechanism of action for each of the medication classes identified above.

(4 Required Elements)

90

90%

Total CONTENT Points = 90 pts

ASSIGNMENT FORMAT

CategoryPoints%DescriptionOrganization, spelling, grammar & APA format

10

10%

The student:

  • Uses the week 6 case study template for case study responses.
  • Provides correct in-text citations for responses which match the reference page.
  • Has minimal spelling, grammar & APA format errors.

1010%Total FORMAT Points = 10 pts100100%ASSIGNMENT TOTAL= 100 points

Rubric

NR507 Week 6 Diabetes Case Study

NR507 Week 6 Diabetes Case Study

CriteriaRatingsPts

This criterion is linked to a Learning OutcomePathophysiology & Clinical Findings of the Disease

The student:- Identifies the correct type of diabetes- Explains the pathophysiology associated with the chosen disorder.- Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).- Identifies at least three subjective findings from the case.- Identifies at least three objective findings from the case.(5 Required Elements)

45 pts

All 5 required elements are present.

41 pts

1 required element is missing.

37 pts

2 required elements are missing

23 pts

3-4 required elements are missing.

0 pts

All 5 required elements are missing.

45 pts

This criterion is linked to a Learning OutcomeManagement of the Disease

The student:- Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.- Identifies two (2) “Evidence A” recommended medication classes for the treatment of the condition and provides an example (drug name) for each.- Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition.- Describes the mechanism of action for each of the medication classes identified above(4 Required Elements)

45 pts

All 4 elements are present

41 pts

1 required element is missing

37 pts

2 required elements are missing

23 pts

3 required elements are missing

0 pts

All 4 required elements are missing

45 pts

This criterion is linked to a Learning OutcomeOrganization, spelling, grammar & APA format

The student:- Uses the week 6 case study template for case study responses.- Provides correct in-text citations for responses which match the reference page.- Has minimal spelling, grammar & APA format errors.

10 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format.

9 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format.

8 pts

Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format.

5 pts

Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format.

0 pts

Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.

10 pts

This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0 pts

Manual Deductions

0 pts

Manual Deductions

0 pts

Total Points: 100

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Epidemiological Analysis: Chronic Health Problem

The paper should be organized into the following sections:

 

 

This paper should clearly and comprehensively discuss a chronic health disease.  Select a topic: Interstitial Lung Disease

 

  1. 1-Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA currentedition. 
  2.  
  3. 2-Background and Significance of the disease, to include:  Definition, description, signs and symptoms.  Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease.  If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of ….  This indicates a gap in surveillance that will be included in the “Plan” section of this paper.  
  4.  
  5. 3-Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific. 
  6.  
  7. 4-Epidemiological Analysis:  Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s:  What, Who, Where, When, Why.  Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health.  Include costs (both financial and social) associated with the disease or problem.
  8.  
  9. 5-Screening and Guidelines:  Review how the disease is diagnosed and current national standards(guidelines).  Pick one screening test : “Low-dose computed tomography screening” and review its sensitivity, specificity, predictive value, and cost.
  10.  
  11. 6-Plan:  Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation.  Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?)  Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts.  All interventions should be based on evidence – connected to a resource such as a scholarly piece of research. 
  12.  
  13. 7-Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
  14. The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition. 
  15.  
  16. Adhere to all paper preparation guidelines (see below).

Preparing the Paper:

  1.  
  2. APA format current edition
  3.  
  4. Include scholarly in-text references throughout and a reference list. 
  5. Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details.  APA formatting required. 

 

References no later than 5 years

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