Gastrointestinal Case Study
The Mayo Clinic (2023) defines constipation as infrequent or difficult bowel movements that are characterized by straining, hard stools, and a sense of incomplete evacuation. Just as in any other condition, there are risk factors for constipation that include natural aging, decreased physical activity, inadequate fluid and fiber intake, certain medications (pain), and medical conditions (McCance & Huether, 2019). In the case of R.H., some of the factors that contribute to constipation include reduced physical activity related to arthritis, potential dehydration, and possible side effects from medications like naproxen.
Gastrointestinal Case Study
Constipation management for R.H. includes increasing dietary fiber by eating fruits, vegetables, and whole grains that are rich in fiber and ensuring adequate hydration. R.H. can participate in modified exercises suitable for arthritis as physical activity can improve bowel motility. Additionally, establishing a consistent bowel routine and using stool softeners or fiber supplements may also provide relief. If the aforementioned lifestyle changes are not effective, a laxative could be considered under medical supervision as they can lead to electrolyte imbalances and dependence (American Gastroenterological Association, 2020). In my experience with constipation, daily use of pre/probiotics and lactobacillus have proven effective in contributing to regular bowel movements and improving the gut microbiome.
Clinical manifestations that are compatible with constipation include a reduction in bowel movements, prolonged straining, and hard stools. Other symptoms that are commonly associated with constipation include abdominal pain, bloating, nausea, and an incomplete evacuation sensation (McCance & Huether, 2019).
A potential complication of chronic constipation is anemia, especially if related to a GI bleed. In the case of R.H. there are no reported symptoms of fatigue, pallor, or rectal bleeding that would indicate anemia. Obtaining hemoglobin and hematocrit levels could be useful in ruling out any underlying issues.
Endocrine Case Study
According to the Centers for Disease Control and Prevention (2022), Diabetes Mellitus Type I is more prevalent in certain racial and ethnic groups, including Native Americans, African Americans, Hispanic Americans, and Pacific Islanders. C.B., who is Native American, falls into a high-risk category for developing DM Type II.
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Clinical manifestations that C.B. has include polydipsia, polyuria, unexplained weight gain, and neuropathy symptoms in the left foot. Her female infections can indicate a predisposition to opportunistic infections which is common in diabetes related to immune system impairment (American Diabetes Association, 2022). If C.B. developed bacterial pneumonia, her blood sugar would increase because of the physiologic stress response. Managing the blood glucose and adjusting her medications would be essential because infection induced insulin resistance results in elevated glycemia levels which necessitates temporary intensification of diabetes management (Moghissi et al., 2009).
Therapy for C.B. would include lifestyle modifications, dietary changes- low-glycemic index foods, increased fiber intake, and regular exercise should become a priority. Weight loss can significantly improve glycemic control. Medication treatment can begin with metformin, which is a front-line medication for Type II DM due to the effectiveness and safety (American
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