Reason For Referral: Misdiagnosis

Have you ever wondered what your aunt went through, what her life was like? Do you think that she wanted to die a horrible, rotting death? Like me, she probably had plenty of people saying to her, “Just take your medicine and watch what you eat. You’ll be OK. Those terrible things only happen to diabetics who don't take care of themselves.”

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

The Characteristics of the diabetes are very distinctive and in some cases they are unnoticed. The Center for Disease Control and Prevention (2014), recommends individuals contact their physician if they

Over this last week, I have received a patient named Sherman “Red” Yoder. He is an 80-year-old male farmer, who lives alone in the farmhouse that he had grown up in. Red was married for 50 years and has been a widow now for 10 years. Red has one son, Jon, who takes care of the farmhouse and the land. He has one daughter-in-law, Judy, who is in involved with his care. Red was diagnosed with diabetes six months ago. Diabetes mellitus is a chronic condition that affects your body 's ability to use the energy found in food. As of only a few weeks ago, Red has been managing his diabetes with insulin. Insulin is a hormone that controls blood sugar. Before he began using insulin, he managed his diabetes with oral medication. After carefully assessing Red’s chronic illness, diabetes, many red flags were presented that could interfere with his management. In turn, this would cause further complications.

This class also helped me finally begin to understand Diabetes, and that it was a metabolic disorder that affects the Endocrine system by not producing enough insulin, producing no insulin, or causing cells that do not respond properly to insulin produced by the pancreas (Pakistan & Gulf Economist, 2011); and to distinguish between the different types of diabetes. This once again set the foundation for me to begin to understand exactly what occurred in my grandfather’s situation. Understanding what I now know, as I write this paper, I realize that it was in this class where I began to put together that we are not necessarily sentenced to a life of disease simply because we have a familial predisposition to it (Cirino & Ho, 2013). Heredity can predispose us to things such as diabetes, high cholesterol, and cardiovascular

John is an 82 year old gentleman who lives alone in sheltered accommodation. John’s son and daughter live close and take it in turns to visit daily. John is an ex-smoker who gave up 20 years ago, has long standing hypertension and is overweight having a BMI of 30 kg/m.

Amputations were intended to prevent gangrene, which is a deadly complication resulting from obstructed circulation or bacterial infection ("History of Medicine," 2011). When legs were amputated, patents waited for artificial limb designs to be accommodated for them. Around 150 patents were issued for artificial limbs between 1861 and 1873, the industry then expanded to benefit the veteran population ("History of Medicine," 2011). It costed veterans $75 to buy an artificial leg and $50 for an arm, the Confederacy then provided financial assistance in 1864 for purchases ("History of Medicine," 2011). Gunshot and explosive wounds carried many types of injuries with them like comminuted fractures, compound fractures, and wounds of joints ("The Call," n.d.). Comminuted fractures are where the bone is broken, splintered, or crushed into different pieces, which demands amputation ("The Call," n.d.). While compound fractures on the other hand are when bone comes through the skin; May require amputation if in a large limb like a leg, thigh, arm, or forearm ("The Call," n.d.). Injuries that almost always needed amputations were wounds to the joints such as the knee joint, elbow joint, shoulder joint, wrist, ankle, and hip joint. Most of all of these injuries could have been treated with better care with the medical procedures we have

Mr. R J is a 70-year-old Mexican American male with a history of type 2 diabetes and hypertension. He came to the emergency room with a left lower extremities blanching, erythema, mild swelling and warmth from dorsum of his foot to lateral calf. He is 5’5’’ tall, and his body mass index (BMI) is 36.6. After he had been admitted to the Medical/Surgical Unit, I walked into his room and introduced myself to him. I let him know that I would be his student nurse for the shift, and I would like to talk about his current medical problem, diabetes.

Mrs. J. was diagnosed with type2 diabetes one year ago, and has been on treatment since then. She manages her own medication, and has a case manager who regularly checks up on her to ensure that her medications are up to date, as well as her physical exercise regime. However, the admission into the emergency room a week ago is an indication that she has not been taking enough water and observing her diet, which has resulted into the observed symptoms. Her diagnosis is: Hypernatremia related to excessive loss of water and elevated sodium consumption as

Mrs. Jameson was diagnosed with type 2 diabetes one year ago, and has been on treatment since then. She manages her own medication, and has a case manager who regularly checks up on her to ensure that her medications are up to date, as well as her physical exercise regime. However, the admission into the emergency room a week ago is an indication that she has not taken enough water and observing her diet, which has resulted in the observed symptoms. Her diagnosis is: Hypernatremia related to excessive loss of water and elevated sodium

Norma James is a 65 years old widow who lives alone. Mrs. James has a medical history of Type 2 diabetes mellitus and hypertension and has also been diagnosed with atrial fibrillation. Mrs. James has been a smoker since her 20s and smokes about a ½ pack of cigarettes per day. She has two adult sons who lives far and has minimum contact with them. She does not work and has a very limited savings. She relies on Old Age Security Benefits for income. She has been living in the same neighbourhood for years but has only few individuals who she considers friends. She prefers to spend her time alone at home watching television, reading or watching over her six cats.

History of present illness: 50 year old African American female presents to the clinic today to follow up on her Diabetes. Patient diagnosed with Diabetes in 2000. Last Diabetes checkup three months ago. Patient reports that she takes all of her medications as prescribed. Patient is currently on metformin and Lipitor. Patient denies any episodes of hypoglycemia. Patient denies experiencing symptoms of polyuria, polydipsia, and polyphagia. Patient reports that she has been checking her

A. Bob concluded “Sometimes I feel like everything aggravates it”. He seemed to be moved emotionally, which was evident when he said: “It was kind of a devastating”. Not obeying a carbohydrate free diet, sedentary lifestyle, and not being compliant with medication regimen were the top things that could really exacerbate his diabetes. Additionally, stress can aggravate his condition, because it elevates the glucose level. When Bob is under a lot of stress, he is also less

Further, Mrs. Freel has Type 2 Diabetes, however, she has not taken her medicine within the past 24 hours. This has affected her endocrine system, leading to her experiencing elevated blood sugar

Patient G.M. is a four-year-old female from a middle class family living in San Diego. She originally presented with her mother and father to her general practitioner with lethargy and several vomiting episodes in the past few days. Her father stated concern after realizing her frequent urination in the past week. Her vital signs upon initial assessment were HR 140 RR 22 Temperature 102.7 degrees Fahrenheit, BP 70/62, O2 saturation 97%, 32 pounds, and 40 inches tall. Her General practitioner was concerned about type I diabetes and performed a blood sugar check. Upon assessment the monitor read HI, indicating that the level was above 500 and too high for the monitor to read. The doctor informed them she needed immediate treated in the closest pediatric ER due to the potential for diabetic ketoacidosis.