Michelle Elevated Fasting Blood Glucose Case Study Nursing Assignment Help

Assignment Task

Michelle
Michelle is a 58 year old university lecturer. She had recently decided to do something about her weight after coming across an online body mass index calculator and finding that she fell well and truly into the obese category (BMI 39.5kg/m2). She made an appointment with the doctor to discuss how she should address her weight issue and have a general health check-up. The doctor referred her for some blood tests and provided her with information on how to embark on an exercise program and find out how she should modify her diet. Her vital sign values were as follows: blood pressure (140/90mmHg), heart rate (80bpm), and respiratory rate (22bpm). The blood tests revealed that she had prediabetes (elevated fasting blood glucose) and dyslipidaemia (abnormal amount of lipids in the blood). Around this time COVID arrived so she had to convert all of her teaching materials to be delivered online and found herself being even less physically active than she was previously. A year and a half later she went to the doctors again, this time to report that she had experienced an episode where she was unable to effectively use her left hand, had a “droopy” face (also on the left side) and slurred speech. This episode lasted only about 10 minutes but it was the second time that it had happened in the last two weeks and she was afraid that it might happen again while she was giving an online lecture. Her vital signs were the same as last time. The doctor referred her the ER department of the local hospital for an ECG and cranial MRI. Both revealed no abnormalities.

Systolic blood pressure (mmHg) 140mmHg 120mmHg
Diastolic blood pressure (mmHg) 90mmHg 80mmHg
Heart rate (beats per minute) 80bpm 60-80bpm
Respiratory rate (breaths per minute) 22bpm 12-20bpm
Biochemistry Michelle Reference
Fasting blood glucose 6.5mmol/l 3.9-5.6mmol/l
Triglycerides 200mg/dl <150mg> Total cholesterol 250mg/dl 125-200mg/dl
LDL cholesterol 160mg/dl <100mg> HDL cholesterol 35mg/dl >50mg/dl

Question 1 (Diagnosis) 30 WORDS
Based on the signs and symptoms what issue is Michelle experiencing? (1 mark)
TRANSIENT ISCHEMIC ATTACK
There are a number of follow ups that might be indicated here (other than the already mentioned ECG and cranial MRI or CT scans). Name an additional follow up. (1 mark)
Question 2 (Description of pathology) 300 WORDS
Describe the pathology of the disease.
In your answer provide an explanation for the symptoms Michelle is experiencing and indicate what is causing these symptoms (provide a description of anatomical or physiological dysfunction that might cause them to occur). Why do these symptoms appear to come and go? What could possibly happen if this is not treated?
Question 3 (Recommended treatment or management) 70 WORDS
Based on your diagnosis, what is the best course of action for treatment of Michelle’s disease? (provide a recommended treatment regimen). In this case, there are two different classes of drugs (with different modes of action) that are often used to treat this disease – usually they are used in combination.
Question 4 (Treatment rationale and mechanism of action) 300 WORDS
Justify your selection of treatment(s) by indicating what the prescribed drug(s) do(es) and how they treat the disease (is it a cure or a management?). Indicate the likely duration of treatment and explain why this is the case. Certain lifestyle changes might also help with management, what are these and how do they help? For Michelle, some form of surgical intervention might also be beneficial (depending on the outcome of additional tests). Describe the surgical process and how it might be of benefit.
 

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