Prompt 1 explain in detail the pathogenesis of dm type 1 2...

Name: prompt 1 explain in detail the pathogenesis of dm type 1 2 and dka prompt 2 explain how ms fernandezs past medical history correlates to her current condition 31717
Uploaded: 2024-07-25T13:02:10-08:00
Duration: 2 min 48 s
Channel: Shu Naito
Description: prompt 1 explain in detail the pathogenesis of dm type 1 2 and dka prompt 2 explain how ms fernandezs past medical history correlates to her current condition 31717

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Discussion post Using the video from Episode 7 “time for change” on Ms. Fernandez, answer two of the following prompts. Prompt 1: Explain in detail the pathogenesis of DM Type 1 & 2 and DKA. Prompt 2: Explain how Ms. Fernandez’s past medical history correlates to her current condition. Prompt 3: Describe treatments that would be used for DM and DKA. Please correlate your responses to Ms. Fernandez’s case. Include in-text citations and references

Shu N.

A 21-year-old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she's been ill and unable to keep any food down. She's only tolerated sips of water and juices. Since she's also been unable to eat, she hasn't taken any insulin as directed. While helping A.M. from the lobby to the examining room, you note that she's unsteady, her skin is warm and flushed, and that she's drowsy. You also note that she's breathing rapidly and smell a slight sweet/fruity odor. A.M. has difficulty answering questions but keeps asking for water to drink. You get more information from A.M. and learn: - She had some readings on her glucometer which were reading 'high'. - She vomits almost every time she takes in fluid. - She hasn't voided for a day but voided a great deal the day before. - She's been sleeping long hours and finally woke up this morning and decided to seek care. Current labs and vital signs: What is the pathophysiology for the condition you believe A.M. has? Relate the etiology and clinical manifestations for the condition you identified for A.M. The practitioner at the urgent care facility makes the decision that A.M. needs to go to the hospital by ambulance. Once at the Emergency Department (ED), the ED physician orders these items: - 1000 ml Lactated Ringer's (LR) IV stat - 36 units NPH (Humulin N) and 20 units regular (Humulin R) insulin SQ now - CBC with differential; CMP: blood cultures X2 sites; clean-catch urine for UA and C&S; stool for ova and parasites; Clostridium difficile toxin, and C&S; serum lactate; ketone; osmolality; ABGs on room air - 1800 calorie, carbohydrate-controlled diet - Bed rest - Acetaminophen (Tylenol) 650 mg orally Q4 hrs PRN - Furosemide (Lasix) 60 mg IV push now - Urinary output every hour - VS every shift The orders above -- which are questionable related to her condition and which are appropriate? What are the expected treatments for this condition? Instructions: Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition. Use two evidence-based articles from peer-reviewed journals or scholarly sources to support your findings. Be sure to cite your sources in-text.

Madhur L.

A 21-year-old noncompliant female with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Her blood glucose was high, as well as her urine glucose, urine ketones, and serum ketones. Her serum bicarbonate was < 12 mEq/L (normal = 23-29 mEq/L). Her respiration was exaggerated, and her breath had an acetone odor. Her blood pressure was 90/60, and her pulse weak and rapid (120 bpm). What causes type I diabetes mellitus? What is the fundamental organ and cell type impacted? How is this different from type II diabetes? Differentiate ketoacidosis from insulin shock. Is this person experiencing ketoacidosis or insulin shock? Explain your answer. pH considerations What is the acid-base status of this individual? Explain why her serum bicarbonate is low. (2 points) What is the cause of the hyperpnea (rapid deep breathing)? (2 points) What would cause this female's hypotension as well as her tachycardia (HR > 100 bpm)? What type of treatment does this person need? 6. It is not uncommon for a person with extreme hyperglycemia to experience nausea. This can, in turn, elicit the fight-or-flight response. Considering how the endocrine system responds in a fight-or-flight situation, hypothesize why this response may worsen a diabetic's situation.

Alexander B.

Transcript

00:01 Okay, so we're going to do from prompt 1, pathogenesis of dm type 1, dm type 2, and dka.

00:08 So type 1 diabetes mellitus or dm1 involves the autoimmune destruction of pancreatic beta cells, which leads to insulin deficiency.

00:43 And as for type 2 diabetes, there is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response and inadequate compensatory insulin.

01:23 Okay, so as for dka, so dka typically occurs in dm1 when there is an absolute insulin deficiency leading to hyperglycemia and ketone production from fat metabolism, which causes acidosis...

Question

Prompt 1: Explain in detail the pathogenesis of DM Type 1 & 2 and DKA. Prompt 2: Explain how Ms. Fernandez’s past medical history correlates to her current condition.

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