Review and comment on the two suggested patient scenarios/cases that have been attached
1- What do you think about the suggested scenario/case
2- Do you think this is a possible scenario (support your answer)
Reverse Interpreting Lab Results Table 87.2 A possible reason why the glucose and hemoglobin A1C levels are elevated is because the pancreas is not producing enough insulin to breakdown glucose. Because the pancreas is not effectively breaking down enough glucose, the excess glucose in the bloodstream causes nerve damage especially to the kidneys, where the blood is filtered. The lack of proper blood filtration because of kidney damage is the reason for the decreased levels of RBCs, platelets, hemoglobin, platelets, and hematocrit levels. This also is the reason for increased mchc, mcv, and INR values. Hdl levels are also decreased because of the cardiovascular issues associated with damage to the blood vessels from continuous high blood sugar. The reason for the decreased level of white blood cells would most likely be because the body is fighting a disease process most likely caused by uncontrolled elevated blood sugar levels for an extended period of time. Since most of the abnormal levels in this table are concurrent with abnormal values associated with type 2 diabetes that is not well controlled, a good scenario would be that the patient with these lab values has type 2 diabetes. The patient most likely does not control their blood sugar well and has most likely had issues with maintaining a decreased blood sugar for an extended period of time. The nurse would expect the patient to have a diet consisting of high sugars and carbohydrates. The nurse would also expect the patient to have really white gums, fatigue, lethargy, no energy, headaches, excessive thirst and hunger, and increased urine output.
Works Cited Gauci, R., Hunter, M., Bruce, D. G., Davis, W. A., & Davis, T. M. E. (2017). Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis. Journal of Diabetes and Its Complications, 31(7), 1169–1174. https://doi- org.ezproxy.hsutx.edu:4443/10.1016/j.jdiacomp.2017.04.002
Jin Ook Chung, Seon-Young Park, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung, Chung, J. O., … Chung, M. Y. (2017). Anemia, bilirubin, and cardiovascular autonomic neuropathy in patients with type 2 diabetes. Medicine, 96(15), 1–4. https://doi- org.ezproxy.hsutx.edu:4443/10.1097/MD.0000000000006586
Reverse interpreting results For this assignment I chose table 87.2. The table shows that the patient has a high blood glucose and HbA1c. A high blood sugar result is caused by eating too much sugar and carbohydrates or because of diabetes mellitus. According to Huether (2017), in a person with diabetes their pancreas does not produce enough insulin to break down the glucose, so the excess ends up in the blood stream (p. 473). She also states that high HbA1c levels are caused by poor control of one’s blood sugar. The excess blood sugar in the blood stream causes damage to the kidneys which in result can lead to anemia. WebMD suggests that anemia can result from kidney damage because the kidneys do not send out enough erythropoietin. Anemia can result in low red blood cell count, platelet count, hemoglobin and HCT; as well as high MCHC, MCV and INR, which the table shows abnormal as well. HDL levels are low in the table. Huether states that these labs tend to be low in patients with diabetes. In the case of table 87.2, the patient demonstrates signs of anemia and diabetes mellitus because the results in the table show labs that you would expect in a patient with anemia and diabetes mellitus. The nurse would expect that the patient is not adequately controlling their blood sugar levels and therefore is showing signs of anemia. The patient may state they are consuming an unhealthy, carb and sugar loaded diet. She would also expect to hear the patient complain of fatigue, short of breath, excess thirst and hunger, frequent urination and tingling or numbness of extremities.
References Huether, Sue E., and Kathryn L. McCance. Understanding Pathophysiology. Elsevier Mosby, 2017.Diabetes and Anemia: Know Your Risks and the Warning Signs. Retrieved from https://www.webmd.com/diabetes/diabetes-and-anemia#1
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