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NURBN2016 Advanced Pathophysiology And Pharmacology

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Question:

Part 1 Questions

Melanie is distressed that her blood glucose level is elevated and asks you for help in understanding her diabetes. She tells you that she has a friend who is very overweight, eats lots of cake and hardly ever exercises, and he does not have diabetes.

1.Describe the pathophysiology of T2DM with links to Melanie’s case. Include in your answer risk factors for T2DM, the pathogenesis of T2DM, possible complications of T2DM and outline the 3 levels of treatment options for T2DM.

2.Differentiate between T2DM and T1DM (at least 6 differences).

3.Identify at least 2 reasons Melanie’s BGL is high on admission. Discuss how each reason you identify effects

BGLs.

Part 2 Questions

The surgery is successful and Melanie comes to see you in the outpatient clinic for cortisone injections (Kenacort-A 40). She has been commenced on metformin (APO-Metformin Tablets) and glipizide (Minidiab Tablets) to help control her diabetes. Her blood test on this visit were BGL 8.8 mmol/L; HbA1c: 8%.

1.Discuss the three medications Melanie is on. Include in your answer the action, complications/side effects and nursing considerations linked to Melanie’s situation.

2.Discuss the two blood results, one from prior to surgery and one from the clinic visit of Melanie’s BGL and HbA1c. What are they? What do they measure and why have they changed?

Part 3 Questions

While Melanie is waiting to see the doctor, she starts talking to you about her condition. She asks if she has insulin dependent diabetes or early onset diabetes. She is also unsure of how to use her BGL machine and BGL strips.

1.1  Discuss why the terms insulin dependent diabetes mellitus/ non insulin dependent diabetes mellitus and early onset/mature onset are misleading.

2.2  You need to teach Melanie how to use her BGL machine. Discuss the “teach back” method for patient education (include evidence from peer reviewed sources). Discuss how you would use this method to teach Melanie how to use her BGL machine.

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