Case Overview

George Paul is a vulnerable adult; 62-year-old obese male without an adequately defined income source was presented for treatment of recurrent episodes of diabetes and other complications.

Primary Diagnosis

Blood Test

• Blood sugar level

This is the insufficiency of insulin in the blood thus not allowing sugar to enter the blood cells hence raising the blood sugar level and as the body’s fats and proteins. This may also cause an increase in the blood sugar levels.

• Ketone level

Ketones are produced due to the body’s breakdown of protein and fats in the body thus leading to the acidic components in the blood hence making the blood acidic; the process known as acidosis.

• Blood Acidity

Blood acidity is termed as having the excess ketones in the blood which cause acidosis thus altering the normal blood function in the body.

Secondary Diagnosis

Form some of the ways the doctor can opt to have in the diagnosis;Blood test; this is one of the primary criteria used to measure the blood sugar level, the ketones level, and the blood acidity. The other tests include; urinalysis, chest x-ray, blood electrolyte tests and electrocardiogram, which involves a recording of the heart’s electrical activity.

Abstract

Obese That Responds To Diabetes

The client has had a history of several diabetic infections including diabetic retinopathy, nephropathy, and neuropathy, the condition of the diabetic has been reported to not been well controlled. The patient was also diagnosed with a Stage 2 foot ulcer on the left leg which he has not been able to seek proper care on the same. Six months ago he had made two visits to the emergency room where he had unilateral weakness and chest pain and left knee injury.

The wife, who was to take care of the twin fell ill of Amyotrophic Lateral Sclerosis (ALS) two years ago, and this eventually led to Mr. Paul having anxiety and depression that was caused by the worries of caring for the family and wife, he had to be administered on Lisinopril 40mg to help in the management. Mr. Paul was unable to comply with the dietary control thus was under drug management too.

The condition was managed by the administration of the drugs Simvastatin 40mg daily as the dietary plan could not work for him. Hyperlipidemia complications evidenced this.

The essential potent cover-up in the study is to make Mr. Paul understand more clearly the precepts of life despite the aging part and to be able to use the readily available products; dietary to keep the levels of diabetes at bay and other primary etiological conditions. Take right measures at the appropriate time to be able to escape the preventable diseases of health like polio onto that one can plan for the aging period to be able to prevent overdependence of their stamina that has almost depleted.

Relevant Needs of the Family

Mr. Paul is the bread-winner; the family entirely depends on him for the provision of basic needs like food, shelter, and clothing. From the look, these items can be entirely unavailable unto them due to his deformity and the wife’s illness.

Guidelines Used in the Management

The information attained from a physician will determine the priority given on the management process. The urgent or routine priority will have a repulsive effect on the timeframe of the patient going to be handled;

Immediate: this category of the patient goes directly to the emergency room as the fatal and deranged complications if left, would call for the need for a direct, e.g., acutely decomposed Type 1, foot ulcer with infection.

Urgent: the timefor making an appointment is at a range of 30 days; it is at this stage when the metabolic complications are mostly expected to drop drastically. Examples; acute foot ulceration without active infection. Diabetes symptoms that make it hard to do the daily routinely programs. Cases; marked hyperglycemia that’s not responsive to the therapy given, recurrent hypoglycemia, painful neuropathy, and poorly controlled hypertension.

Routine: wherebythe time frame is more than 30 days as per the clinical need. Examples Type 1 or 2 having an optimal control on diabetes or HbA1c>7.0%, diabetic neuropathy

Screening Criteria

The screening criteria are implemented when a patient is diagnosed with hyperglycemia or excess acids in the blood. Patients with moderate or severely elevated blood sugars of around (glucose >350mg/dL) usually undergo screening. The serum glucose of the patient with acidosis may also be measured. The last stage of testing is getting the anion gaps or ketones of the patient with normal antipsychotics.

Treatment and Therapies of the Patient

The therapy involves fluid replacement, whereby fluids are taken either orally or intravenously until rehydration is attained, to help dilute excess sugar in the blood and also replace the excess fluid lost through excessive urination. Electrolytes are substances in the body that usually produces electric charges and they have cations and anions. Electrolyte replacement may also be done by injecting them through the vein. Lastly, insulin therapy may be done to increase the blood sugar level.

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