Z. J. is a 55-year-old Hmong postmenopausal woman presenting with Type II diabetes mellitus, hypertension and urinary incontinence.

This week if your last name begins with A-L complete case 1 and reply to two peers in case 2.  If your last name begins with M-Z complete case 2 and reply to two peers in case 1.

Case 1:

Z. J. is a 55-year-old Hmong postmenopausal woman presenting with Type II diabetes mellitus, hypertension and urinary incontinence. She reports that she often cannot get to the bathroom in time when she feels the urge to urinate. She also wets herself when she laughs or sneezes. She is very embarrassed about this problem and has decreased her excursions from the house because of it. She drinks six cups of coffee a day. She does not follow a special diet, She takes hydrochlorothiazide for hypertension, and metformin for DM. Today her HgbA1C is 12.  She wants treatment for her urinary complaints.

Diagnosis: Uncontrolled Type II DM, HTN, and urinary incontinence

In this discussion forum:

Discuss specific goals for pharmacotherapy for treating C. J..

Discuss the drug therapy a CNP would likely prescribe and why.    

Discuss the parameters for monitoring success of the therapy.

Discuss health promotion recommendations you would consider for C. J.

Case 2:

Mr. Z is a 36-year-old construction worker who presents to the nurse with fatigue and a foot ulcer. He is a smoker with type 1 diabetes for 25 years, and he take 20 units of

70/30 insulin twice a day. He lost his meter a year ago. He is very thin, although he eats constantly on the job because he is worried about hypoglycemia; he cannot remember the last time he had hypoglycemia, but it was years ago.  He recently received a call from the office because his TSH level was greater than 10 and he was told he has “thyroid” problems.  He thinks this may be the cause of his fatigue.

In this discussion forum:

Discuss specific goals for pharmacotherapy for treating Mr Z

Discuss the drug therapy a CNP would likely prescribe and why.    

Discuss the parameters for monitoring success of the therapy.

Discuss health promotion recommendations you would consider for Mr Z.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria.