Hi, I’m having trouble with the following

Hi, I’m having trouble with the following practice questions: Please let me know if you have any questions, hope you can help. A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 1997, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118-127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. A.B. also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to the daily schedule. During the past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a “pancreas elixir” in an attempt to improve his diabetes control. He stopped these supplements when he did not see any positive results. He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. “What would knowing the numbers do for me?,” he asks. “The doctor already knows the sugars are high.” A.B. states that he has “never been sick a day in my life.” He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of 48 years and has two married children. Although both his mother and father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies. Since selling his business, A.B. complained that him and his wife have been struggling to pay their mortgage and are seeking assistance from their older son. A.B. has finished grade 10 before dropping out of high school to help his immigrant parents pay bills and believes his son should help out just like he has. Questions: 1. Consider the above case study and summarize the report you would give the oncoming nurse about this patient. 2. Review the Social Determinants of Health and analyze what barriers might this client face—be specific to this case scenario. 3. As a nurse caring for this patient, establish 3 priority-nursing interventions that you might be considering for this patient. Consider the risk factors for this patient. 4. Before discharging this patient, whom from the interprofessional health team might you collaborate with? And Why? 5. What community resources might this patient need? SCIENCE HEALTH SCIENCE NURSING PNC 301

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