留学生健康学Health assignment代写 临床实习

本文将举例说明一个案例研究，这是选择在两个星期的临床实习。介绍病人的病史，关注目前的健康状况，讨论社区卫生护士的主要职责。H。S是一位74岁的阿联酋女性，已婚，有3个女儿和5个儿子。她在2011年2月24日被转到健康家庭护理中心。患者既往病史为轻度间歇性哮喘、肠易激综合征、急性胃炎、食管反流、获得性甲状腺功能减退、广泛性焦虑障碍、原发性高血压、1型糖尿病、慢性舒张功能衰竭、视力模糊、听力下降。病人对灰尘和青霉素等药物过敏。她的手术史对胆囊切除术有重要意义。此外，她接受了植骨手术，以修复右前臂因交通事故造成的伤口。目前的药物包括孟鲁司特(singulair);口服10mg每日一次，类固醇500mg每日一次，胰岛素早晚各34个单位，cozaar 50mg每日一次。目前，该患者患有无法控制的糖尿病。空腹血糖239 ~ 455 mg/dl，既往餐时血糖、就寝时血糖240 ~ 598 mg/dl。这项作业将阐明其中一个慢性疾病的病人，糖尿病，包括病理生理学，体征和症状，危险因素，流行病学，诊断和治疗。此外，还将阐述社区卫生护士对糖尿病患者的作用。

留学生健康学Health assignment代写 临床实习

This paper is going to illustrate a case study, which has been chosen during the two weeks of clinical practicum. It will present the medical history of the patient, focus on current health status and discuss the main responsibilities of community health nurse.

H.S is a 74 years old Emirati, female, married and has 3 daughters and 5 sons. She has been referred to health home care setting on 24/2/2011. The patient’s past medical history included mild intermittent asthma, irritable bowel syndrome, acute gastritis, esophageal reflux, acquired hypothyroidism, generalized anxiety disorder, essential hypertension, diabetes mellitus type-1, chronic diastolic failure, blurred vision and impaired hearing. The patient has allergies from dust and medication like penicillin. Her surgical history was significant for cholecystectomy. Also, she had grafting surgery that done to repair the wound at right forearm which resulted from road traffic accident. Current medications include montelukast (singulair); 10mg orally once daily, steroids 500mg orally once per day, insulin 34 units in the morning and 32 units on evening, and cozaar 50mg once daily. Currently, the patient is suffering from uncontrolled diabetes. The fasting blood glucose ranged from 239-455 mg/dl and the past prandial glucose and bed time glucose ranged from 240-598 mg/dl. This assignment will shed light on one of the chronic disease which the patient has, diabetes, including pathophysiology, sign and symptoms, risk factors, epidemiology, diagnosis and treatment. In addition, it will illustrate the community health nurse roles regarding diabetic patient Diabetes mellitus is a worldwide epidemic disease. It is a metabolic disorder manifested by elevation of blood glucose level due to an absolute shortage of insulin production and action (American Diabetes Association, 2004). The two main classification of diabetes are type 1, this type represents insulin dependent diabetes, and type 2, non-insulin dependent diabetes (Meetoo & Allen, 2010). Additional types of diabetes mellitus include gestational diabetes, maturity once diabetes of the young, diabetes resulted from cystic fibrosis, and cushing’s syndrome diabetes (Meetoo & Allen, 2010). As our patient is suffering from diabetes type-1, the nurse must understand the pathophysiology of this type in order to provide optimal care. Type-1 diabetes is found to be a result of an autoimmune mediated damaging of B-cells, pancreatic cells responsible for insulin production. Destruction of these cells will lead to insulin deficiency, which will result in increase of blood glucose and glycosuria. Mainly it is symptomatic disorder unlike type-2 diabetes (Meetoo & Allen, 2010). Type-2 diabetes is considered silent killer; most people with such disease are unaware because it is asymptomatic in many cases. It is characterized by abnormal insulin production, insulin resistance, and alteration in glucagon synthesis (Casey, 2011). Elevation in blood glucose caused by limitation of insulin in transporting glucose into the cells for energy synthesis. High glucose level enhances insulin production. So that, people with this type of diabetes often characterized by excessive insulin production (Casey, 2010). Diabetes’ symptoms might slightly vary according to the type.