Discussion: Examining Endocrine, Metabolic, and Hematologic Disorders

In the United States, 25.6 million adults age 20 years or older have diabetes (American Diabetes
Association, 2011). If not properly treated and managed, these millions of diabetic patients are at
risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and
blindness. Proper treatment and management is the key for diabetic patients, and as the
advanced practice nurse providing care for these patients, it is your responsibility to facilitate this
process. 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 case study of patients presenting with endocrine,
metabolic, and hematological disorders.
Case Study 2
A 78-year-old female presents to the emergency room after a fall 3 days ago. She recently had a
right above-the-knee amputation and was leaning over to pick something up when she fell. She
did not want to come to the hospital, but she is having difficulty managing at home because of
the pain in her left leg where she fell. Her patient medical history reveals RAKA, peripheral
vascular disease, Type 2 diabetes, and stage 3 chronic kidney disease. Current medications
include quinapril 20 milligrams PO daily, Lantus 30 units at bedtime, and Humalog to scale
before meals. There are no known drug allergies. The physical exam is negative and x-rays
reveal no acute injuries. Laboratory studies reveal a normal white blood cell count: Hgb of 8 and
HCT 24. The MCV is normal.
To prepare:
• Review Part 17 and 21 of the Buttaro et al. text in this week’s Resources.
• You will either select or be assigned to a patient case study for this Discussion.

• Review the patient case study and reflect on the information provided about the patient.
• 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.
• Think about potential treatment options for the patient.
By Day 3
Post a 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, including medication, dosage and frequency
Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis
representative of knowledge gained from the course readings for the module and current credible
sources.–
Outstanding Performance 44 (44%) – 44 (44%)
Thoroughly responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the
course readings for the module and current credible sources.

supported by at least 3 current, credible sources
Main Posting:
Writing–
Outstanding Performance 6 (6%) – 6 (6%)
Written clearly and concisely
Contains no grammatical or spelling errors
Fully adheres to current APA manual writing rules and style