Case study 3 Diabetes mellitus
Question one
Metabolic acidosis is one condition that develops when a patient has too much acid in their body fluids. This is majorly caused when the patient’s kidneys cannot remove the acid. The patient is already presenting with diabetic ketoacidosis, which develops some substances known as ketones that are acidic (Nasa et al., 2021). These substances build up in the fluids and cause metabolic acidosis.
Question two
The oral hypoglycemic agents are given immediately after the insulin injections have been withdrawn. This kind of therapy is known as combination therapy. In this patient, the glucose levels are high even when they fast. Confirmation of diabetes mellitus so that when the insulin is stopped, the oral hypoglycemic agents will be initiated to help lower the blood sugar levels (Corcoy et al., 2018).
Question three
This is a sixteen-year-old high school student. The life changes include a change in diet, including much less use of sugary meals. The increased blood sugar levels that are associated with ketoacidosis can lead to damage in some parts of the body. This includes heart-associated heart failures, the nerves, and the kidneys. The boy can also experience some hardening of the arteries (Nasa et al., 2021).
Question four
The parents might be hard on them, but they should encourage the patient more and assure him that he will be well. They should get the recommended medications and diet for the patient. They should get more involved in the patient’s day-to-day activity as he recovers and has a positive attitude. They should fully support the child and educate them on the management plan.
Case study 4 esophageal reflux
Question one
Caffeine and tobacco have been identified as some of the significant triggers of heartburn in some patients. They increase the secretions of acidic fluids in the gastric. They also relax the lower esophageal, which triggers the reflux and sometimes worsens it (Chatilaet al., 2020). It can trigger GERD symptoms in some complicated cases since it can relax LES.
Question two
Treatment of GERD involves medical management of 2 to 12 weeks, depending on the severity of the disease (Roark et al., 2020). In this case, the case is severe, and her vitals are abnormal. This then calls for long-term management even after the surgical procedure, that is, the laparoscopic reflux procedure. The six weeks of management help in ensuring that the reflux is suppressed and the patient does not represent with the symptoms. This also helps to evaluate if the medications given are working or not.
Question three
Gastroesophageal reflux is most commonly caused by increased acid secretion in the stomach. These anti-acids are essential in this case since they act by neutralizing the acids that have been produced in the stomach. This then reduces heartburn in the individual. The anti-acid liquid forms work faster (Roark et al., 2020).
Question four
If my patient has asked for another option of treatment is my duty to explain that she has already undergone efficient surgery to manage the complication. I would explain to them that the medication is essential on her healing journey and to help in the surgical procedure that has already been done. Explain the adverse effects of them not following the prescriptions given by the physician. Please encourage them to follow the instructions and prescriptions given.
References
Nasa, P., Chaudhary, S., Shrivastava, P. K., & Singh, A. (2021). Euglycemic diabetic ketoacidosis: A missed diagnosis. World journal of diabetes, 12(5), 514.ncbi.nlm.nih.gov/pmc/articles/PMC8107974/
Corcoy, R., Balsells, M., GarcÃa-Patterson, A., Shmueli, A., &Hadar, E. (2018). Pharmacotherapy for hyperglycemia in pregnancy–Do oral agents have a place? Diabetes research and clinical practice, 145, 51-58.sciencedirect.com/science/article/abs/pii/S0168822718305278
Chatila, A. T., Nguyen, M. T. T., Krill, T., Roark, R., Bilal, M., &Reep, G. (2020). Natural history, pathophysiology, and evaluation of gastroesophageal reflux disease. Disease-a-Month, 66(1), 100848.sciencedirect.com/science/article/abs/pii/S0011502919300288
Roark, R., Sydor, M., Chatila, A. T., Umar, S., De La Guerra, R., Bilal, M., &Guturu, P. (2020). Management of gastroesophageal reflux disease. Disease-a-Month, 66(1), 100849.sciencedirect.com/science/article/abs/pii/S001150291930029X
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