Title of Assignment: 

Module 6: Endocrine pathophysiology

Purpose of Assignment:

Complications from endocrine disorders can result in wide systemic effects. Analyzing disorders related to endocrine for the nurse is complex and orders provided to treat the client’s condition can sometimes be puzzling. Consideration of an endocrine case study will help the student learn the complexities of understanding the pathophysiology of an endocrine disorder

Course Competency(s):

· Determine pathophysiologic alterations that affect the reproductive and endocrine systems

Content:

Diabetes case study

A 21-year old female (A.M) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, note that her skin in warm and flushed and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink. 

You get more information from A.M. and learn

· She had some readings on her glucometer which were reading ‘high’

· She vomits almost every time she takes in fluid

· She hasn’t voided for a day but voided a great deal the day before

· She’s been sleeping long hours and finally woke up this morning and decided to seek care

Current labs and vital signs:

1. What is the pathophysiology for thecondition you believe A.M. has?

2. Relate the etiology and clinical manifestations for the condition you identified for A.M.

The practitioner at the urgent care facility makes the decision that A.M. needs to go to the hospital by ambulance. Once at the Emergency Department (ED), the ED physician orders these items:

a. 1000 ml Lactated Ringer’s (LR) IV stat

b. 36 units NPH (Humulin N) and 20 units regular (Humulin R) insulin SQ now

c. CBC with differential; CMP: blood cultures X2 sites; clean-catch urine for UA and C&S; stool for ova and parasites; Clostridium difficile toxin, and C&S; serum lactate; ketone; osmolality; ABGs on room air

d. 1800 calorie, carbohydrate controlled diet

e. Bed rest

f. Acetaminophen (Tylenol) 650 mg orally Q4 hrs PRN

g. Furosemide (Lasix) 60 mg IV push now

h. Urinary output every hour

i. VS every shift

The orders above — which are questionable related to her condition and which are appropriate?

3. What are the expectedtreatmentsfor this condition?

Instructions:

Summarize the questions above and formulate what may be happening with A.M. and how you would improve her condition. 

Use two evidence-based articles from peer-reviewed journals or scholarly sources to support your findings. Be sure to cite your sources in-text and on a References page using APA

Case study adapted from: 

Harding, M.M. & Snyder, J.S. (2015). Winningham’s critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from:

https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336

. 

Grading Rubric:

Levels   of Achievement

Criteria

Emerging

Competence 

Proficiency

Mastery

Pathophysiology

(15 pts)

Did not include discussion   on the pathophysiology of the endocrine system disorder. 

Failure to provide pathophysiology will result in   zero points for this criteria.

Briefly identify the   pathophysiology of the an endocrine system disorder.

Clearly identified the   pathophysiology of an endocrine system disorder. 

Thoroughly identified the   pathophysiology of an endocrine disorder.

Points: 10

Points: 13

Points: 14

Points: 15

Etiology

(15 pts)

Did not include discussion on the etiology   of the endocrine system disorder. 

Failure to provide etiology will result in zero   points for this criteria.

Briefly discussed etiology   of the endocrine system disorder.

Clearly discussed etiology   of the endocrine system disorder. 

Thoroughly discussed   etiology of the endocrine system disorder. 

Points:   10

Points:   13

Points:   14

Points:   15

Clinical Manifestation

(10 pts)

Did   not provide examples of the clinical manifestation of the endocrine system   disorder. 

Failure to provide clinical   manifestation will result in zero points for this criteria.

Briefly   provided examples of the clinical manifestation of the endocrine system   disorder. 

Clearly   provided detailed examples of the clinical manifestation of the endocrine system   disorder. 

Thoroughly   provided detailed examples of the clinical manifestation of the endocrine system   disorder. 

Points:   6

Points:   8

Points:   9

Points:   10
 

Treatment

(5 pts)

Did   not present treatment for endocrine system disorder. 

Failure to provide treatment will   result in zero points for this criteria.

Briefly   provided treatment options for the endocrine system disorder. 

Clearly   provided treatment options for the endocrine system disorder. 

Thoroughly   provided detailed treatment options for the endocrine system disorder. 

Points:   2

Points:   3

Points:   4

Points:   5

APA,   Spelling and Grammar

(5   pts)

Six or more APA,   spelling or grammar errors. Detracts   from the readability of the submission. 

No   more than five APA, spelling or grammar errors, minimally detracts from the   readability of the submission. 

No more than three APA, spelling   or grammar errors. Does not detract   from the readability of the submission. 

No APA, spelling or grammar   errors.

Points: 2

Points: 3

Points: 4

Points: 5

Points:  30

Points:40

Points:45

Points:50