Diabetes. Differential Diagnosis. Health, Medicine, Nursing Case Study (Case Study Sample)

Student
Course
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Mrs Wu, a 59 year old Asian female, presents to the office for a planned 3 month follow up visit for her recently diagnosed right knee arthritis. She is experiencing less pain and increased mobility with the treatment plan but reports some new concerns today. She reports that she has been experiencing increased fatigue for about the last 12 weeks. She is also gaining weight since menopause 4 years ago. She has a health club membership and attends twice a week. She walks on the treadmill at least 30 minutes as you directed and lifts light weights but she has not lost any weight, in fact she has gained 4 pounds. She doesn’t understand what she is doing wrong. She reports that exercise seems to make her even more hungry and thirsty, which is not helping her weight loss. She requests evaluation as to why she is so tired and get some weight loss advice. She reports she has to go to the bathroom more often- she is waking up during the night to urinate and seems to be urinating more frequently during the day. This has been occurring for about 3 months too. This is irritating to her, but she is able to fall immediately back to sleep.
Current medications: Tylenol 500 mg 2 tabs in AM for knee pain. Daily multivitamin and turmeric
Introduction
This case study aims to apply diabetes guideline to diagnose and create appropriate patient management plan for based on the analysis and interpretation laboratory data, subjective and objective data provided. In addition to that, the case study demonstrates the use of disease prevention techniques and health promotion guidelines in managing the case study patient. The SOAP note format will be used to identify differential, secondary and primary diagnoses. These diagnoses are used to develop plan of care and interventions. Evidence-based practice has been integrated in the care of the case study patient.
Assessment
This assessment was based on Mrs. Wu’s chief complaints (increased fatigue, increased thirst, increased hunger, inability to lose weight and frequent urination), her objective findings and her negatives to ascertain what to examine with respect to diagnostic and laboratory evaluation.