Topic: Glucose Regulation You are the nurse caring for the

Topic: Glucose Regulation You are the nurse caring for the following patients with Diabetes. Karen has Type 1 diabetes and Nancy Type 2 diabetes. Carefully read each case study and you will answer the questions provided below. Case Study 1: Katie Smith is a 20 year old college student with a history of diabetes mellitus type 1 for the past six years. Katie lives at home with her extended family. Katie’s father and grandmother have a history of diabetes mellitus type 1. Katie is a respiratory therapist major at a community college and is a member of the volleyball team. Katie is brought to the emergency department (ED) by emergency medical services after she collapsed during volleyball practice at the college. She is 5’7″ and weighs 160 pounds. On arrival at the hospital, she is responsive to verbal and tactile stimuli, very diaphoretic, mildly lethargic, and is complaining of abdominal pain and nausea. Her vital signs on admission are: BP 100/70, P88, R 22, T 98.1 F. She is hyperventilating and manifesting acetone breath. Stat labs reveal: Blood glucose: 450 mg/dL pH: 6.9 pCO2: 20mm Hg HCO3: 22 mEq/L Sodium: 128 mEq/L Potassium: 3.0 mEq/L Katie is seen by the ED physician and a diagnosis of diabetic ketoacidosis (DKA) is made. Case Study 2: Nancy is 45 year old female who presents to her primary care physician for a routine physical. Upon assessment of the client, the nurse discovers that Nancy has symptoms of increased thirst, increased urine output, and mild fatigue. The physician orders a series of laboratory diagnostics. Included in this is fasting plasma glucose reading. Nancy’s fasting plasma glucose level was 145 mg/dL. Nancy is diagnosed with type 2 diabetes. The primary care physician orders Nancy to begin glucophage (Metformin) 500 mg by mouth two times a day. The nurse completes an education session with Nancy on the importance of monitoring her blood glucose level and diet. The physician also orders an Hgb A1C to be drawn prior to her re-check visit in three months. Discuss the pathophysiology of type I & II diabetes. Compare and contrast the causes of type I & II diabetes. Based on the two case studies presented, create a list of individual risk factors and health conditions associated with impaired glucose regulation for Katie and Nancy? Why is ongoing control of blood glucose within a normal range such a priority? Create a patient education plan to ensure that Nancy does not develop foot and leg complications. Describe how the patient education plan would differ for Katie. Explain the rationale for the doctor ordering Hemoglobin A1C (Hgb A1C) for Nancy? What are the defining characteristics of DKA? Explain the cause of each. Create two priority nursing diagnosis and 3 related interventions for both Katie and Nancy. Discuss how the nursing diagnosis and interventions vary between Katie and Nancy. *One Reference (APA format) is needed Preferably a nursing journal article (>6years) with an attached PDF link to the article

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