WEEK 5 CASE STUDY ASSIGMENT 1
Week 5 Case Study Assignment
NR-601- Primary Care of the Maturing and Aged Family
Chamberlain College of Nursing
,WEEK 5 CASE STUDY 1
Week 5 Case Study Assignment
This paper will develop an accurateprimary and secondary diagnosis for Mr. Jones
utilizing the subjective and objective data provided and will also include a brief discussion of the
pathophysiology of the chosen diagnoses.It will include common signs and symptoms; pertinent
positives and negatives as they relate to the patient and the disease processes. Additionally, it
willinclude evidenced-based rationales to support the chosen diagnoses and a detailed
management plan that is individualized; consisting of diagnostics, medications, education,
referrals, as well as follow-up-care. This paper will include assessment and identification of one
comorbidity; with a discussion on the significance and impact that comorbidity has on health
outcomes. Anticipated monthly medication costs will be included for all prescription and over
the counter (OTC)medications, as well as,where the patient can obtainmedications for the best
price, and end with a discussion of how this future nurse practitioner will utilize medication
pricing resource in future practice.
Assessment
Mr. Jones is a 60-year-old African American male that presents to the clinic for a 6
month follow up for hyperlipidemia and weight loss. Although he reports that he has been going
to the gym 3 to 4 times a week, walking on the treadmill, and lifting weights as recommended,
and adhering to dietary modifications “as good as he could remember” he has not lost any weight
and has gained 7 pounds. He reports increased fatigue for approximately 10 weeks, with
increased hunger and thirst. Over the past 2 months he has been experiencing an increase of
urinary frequency during the day, as well as having to get up during the night.He is concerned
about his increase in fatigue and his inability to lose weight.
, WEEK 5 CASE STUDY 1
His vital signs are: BP: 119/77; P: 80 & regular; R: 16 & regular; Ht.: 5’9.5”, Wt.: 210
lbs., BMI: 30.6 (U.S. Department of Health & Human Services, n.d.). Pertinent laboratory
findings include urinalysis with 1+ glucose; fasting blood glucose (FBG) 135, HgA1C of 6.9%,
as well as total cholesterol of 202 mg/dl, LDL 134 mg/dl, HDL 32 mg/dl, and triglycerides of
225. He has a PMH significant for hyperlipidemia and osteoarthritis of the right knee. Based on
the HPI, ROS, and objective findings an appropriate primary and secondary diagnosis can be
determined.
Primary Diagnosis: new onset Type 2 Diabetes Mellitus (T2DM), ICD-10 (E11.9)
PathophysiologyT2DM is a chronic condition that impairs the way the body metabolizes
glucose. In T2DM the body either resists the effects of insulin or does not produce
enough insulin. Common signs and symptoms of T2DM include polydipsia, polyuria,
polyphagia, as well as fatigue (ADA, 2020b).
Pertinent positive findings: Polyuria, polydipsia, polyphagia, increased fatigue, a 7-
pound weight gain, as well as 1+ glucose in urine, FBG 135, and HgbA1C of 6.9%(ADA,
2020b). African American adults are 60% more likely to be diagnosed with T2DM than
non-Hispanic white adults (U.S. Department of Helath & Human Services Office of
Minority Health, 2019). Mr. Jones has a BMI of 30.6 and obesity is a known risk factor
for the development of T2DM (ADA, 2020b).
Pertinent negative findings: He exercises regularly and tries to adhere to dietary
restrictions; he does not have a sedentary lifestyle. Negative ketones on urinalysis and he
has no known family history (ADA, 2020b). Skin is warm dry and intact with no
evidence of yeast like rashes or acanthosis nigricans. Acanthosis nigricans typically
occurs in persons who are obese or are diabetic; it is characterized by dark, velvety, areas
Week 5 Case Study Assignment
NR-601- Primary Care of the Maturing and Aged Family
Chamberlain College of Nursing
,WEEK 5 CASE STUDY 1
Week 5 Case Study Assignment
This paper will develop an accurateprimary and secondary diagnosis for Mr. Jones
utilizing the subjective and objective data provided and will also include a brief discussion of the
pathophysiology of the chosen diagnoses.It will include common signs and symptoms; pertinent
positives and negatives as they relate to the patient and the disease processes. Additionally, it
willinclude evidenced-based rationales to support the chosen diagnoses and a detailed
management plan that is individualized; consisting of diagnostics, medications, education,
referrals, as well as follow-up-care. This paper will include assessment and identification of one
comorbidity; with a discussion on the significance and impact that comorbidity has on health
outcomes. Anticipated monthly medication costs will be included for all prescription and over
the counter (OTC)medications, as well as,where the patient can obtainmedications for the best
price, and end with a discussion of how this future nurse practitioner will utilize medication
pricing resource in future practice.
Assessment
Mr. Jones is a 60-year-old African American male that presents to the clinic for a 6
month follow up for hyperlipidemia and weight loss. Although he reports that he has been going
to the gym 3 to 4 times a week, walking on the treadmill, and lifting weights as recommended,
and adhering to dietary modifications “as good as he could remember” he has not lost any weight
and has gained 7 pounds. He reports increased fatigue for approximately 10 weeks, with
increased hunger and thirst. Over the past 2 months he has been experiencing an increase of
urinary frequency during the day, as well as having to get up during the night.He is concerned
about his increase in fatigue and his inability to lose weight.
, WEEK 5 CASE STUDY 1
His vital signs are: BP: 119/77; P: 80 & regular; R: 16 & regular; Ht.: 5’9.5”, Wt.: 210
lbs., BMI: 30.6 (U.S. Department of Health & Human Services, n.d.). Pertinent laboratory
findings include urinalysis with 1+ glucose; fasting blood glucose (FBG) 135, HgA1C of 6.9%,
as well as total cholesterol of 202 mg/dl, LDL 134 mg/dl, HDL 32 mg/dl, and triglycerides of
225. He has a PMH significant for hyperlipidemia and osteoarthritis of the right knee. Based on
the HPI, ROS, and objective findings an appropriate primary and secondary diagnosis can be
determined.
Primary Diagnosis: new onset Type 2 Diabetes Mellitus (T2DM), ICD-10 (E11.9)
PathophysiologyT2DM is a chronic condition that impairs the way the body metabolizes
glucose. In T2DM the body either resists the effects of insulin or does not produce
enough insulin. Common signs and symptoms of T2DM include polydipsia, polyuria,
polyphagia, as well as fatigue (ADA, 2020b).
Pertinent positive findings: Polyuria, polydipsia, polyphagia, increased fatigue, a 7-
pound weight gain, as well as 1+ glucose in urine, FBG 135, and HgbA1C of 6.9%(ADA,
2020b). African American adults are 60% more likely to be diagnosed with T2DM than
non-Hispanic white adults (U.S. Department of Helath & Human Services Office of
Minority Health, 2019). Mr. Jones has a BMI of 30.6 and obesity is a known risk factor
for the development of T2DM (ADA, 2020b).
Pertinent negative findings: He exercises regularly and tries to adhere to dietary
restrictions; he does not have a sedentary lifestyle. Negative ketones on urinalysis and he
has no known family history (ADA, 2020b). Skin is warm dry and intact with no
evidence of yeast like rashes or acanthosis nigricans. Acanthosis nigricans typically
occurs in persons who are obese or are diabetic; it is characterized by dark, velvety, areas
