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Posted: September 16th, 2024
Gastrointestinal Function Case Study
R.H., a 74-year-old black woman, presents with symptoms of constipation and heartburn. This case study explores the risk factors, clinical manifestations, and management strategies for her condition.
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Defining Constipation and Risk Factors
Constipation is characterized by infrequent bowel movements, typically fewer than three per week, accompanied by hard stools and straining. Risk factors include advanced age, low dietary fiber, physical inactivity, and certain medications such as NSAIDs (e.g., naproxen). Dehydration and changes in routine or lifestyle can also contribute.
Clinical Manifestations in R.H.
R.H. reports bloating, infrequent bowel movements, straining, and hard stools, which align with constipation. She does not experience abdominal pain or a sensation of incomplete evacuation, which are also common symptoms. Her recent colonoscopy ruled out structural causes like tumors.
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Recommendations for Managing Constipation
Dietary Adjustments: Increase fiber intake through fruits, vegetables, and whole grains.
Hydration: Encourage drinking plenty of fluids to soften stools.
Physical Activity: Gradually reintroduce exercise, such as walking, to stimulate bowel function.
Medications: Consider over-the-counter options like fiber supplements or stool softeners if lifestyle changes are insufficient.
Anemia Consideration
While constipation itself does not directly cause anemia, chronic gastrointestinal issues can sometimes lead to it. However, there is no indication of anemia in R.H.'s case based on the provided information.
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Conclusion
Addressing lifestyle factors is crucial in managing constipation. R.H. should focus on dietary changes, hydration, and physical activity to alleviate her symptoms.
Endocrine Function Case Study
Introduction
C.B., a 48-year-old woman from the Winnebago Indian tribe, presents with symptoms suggestive of diabetes mellitus type 2 (DM2). This case study examines her symptoms, potential complications, and management strategies.
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Prevalence of Diabetes Mellitus Type 2
DM2 is more prevalent among Native Americans, African Americans, Hispanics, and Asian Americans. These groups have higher rates due to genetic, environmental, and lifestyle factors.
Clinical Manifestations in C.B.
C.B. exhibits signs of DM2, including elevated fasting blood sugar, recent weight gain, increased thirst (polydipsia), frequent urination (polyuria), and numbness in her foot. These symptoms indicate possible neuropathy and hyperglycemia.
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Impact of Bacterial Pneumonia on Glycemia
Infections like pneumonia can cause stress-induced hyperglycemia due to increased cortisol and catecholamine levels, which elevate blood glucose. C.B.'s glycemia values would likely rise during an infection.
Management Strategies
Non-Pharmacologic: Implement lifestyle modifications, including a balanced diet low in carbohydrates and high in fiber, regular physical activity, and weight management.
Pharmacologic: Initiate metformin as a first-line treatment, considering its efficacy and cost-effectiveness.
Conclusion
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Early intervention with lifestyle changes and appropriate medication is essential in managing DM2 and preventing complications. C.B. should focus on sustainable lifestyle adjustments and adhere to prescribed treatments.
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Gastrointestinal Function:
R.H. is a 74-year-old black woman, who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, some-times going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard. She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occur-ring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep. On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.
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Case Study Questions
In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.
Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.
Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?
Endocrine Function:
C.B. is a significantly overweight, 48-year-old woman from the Winnebago Indian tribe who had high blood sugar and cholesterol levels three years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed that her fasting blood sugar was 141 and her cholesterol was 225. However, she felt “perfectly fine at the time” and could not afford any more medications. Except for a number of “female infections,” she has felt fine until recently. Today, she presents to the Indian Hospital general practitioner complaining that her left foot has been weak and numb for nearly three weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. However, she reports that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 65 pounds since her last pregnancy 14 years ago, 15 pounds in the last 6 months alone.
Case Study Questions
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In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.
If C.B. develop a bacterial pneumonia on her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.
What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?
Submission Instructions:
You must complete both case studies.
Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources.
No websites can be cited. References must be no more than 5 years old.
Discussion is going to go through a turnitin and ChatGPT/AI plagiarism checker. The percentage has to be less than 20% of plagiarism please.
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