How to Answer Case Study Pediatric Questions (Complete Guide)

This question focuses on applying theory to practical scenarios.

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How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

This topic involves case study pediatric. A strong answer should include explanation, application, and examples.

Original Question

Case Study-The Pediatric Client with Diabetes Your patient assignment for today is Miguel Ortiz, a 14-year-old Hispanic student who has been newly diagnosed with Type I Diabetes Mellitus. Miguel was admitted with a blood glucose level of 745 mg/dL. At that time, he displayed typical symptoms of diabetic coma. After treatment with IV insulin, Miguel is feeling much better and is in the process of learning to manage his diabetes to prepare for discharge to home. Physician orders Monitor blood glucose QID (ac and hs) Up ad lib / encourage activity 1800 cal diabetic diet Diabetic teaching Humulin N 22u / Humulin R 7u in am Humulin N 16u / Humulin R 5u in pm Preclinical preparation As you prepare for the clinical day to take care of this young man who has just been diagnosed with Type I diabetes explain the pathophysiology at the cellular level so that you will understand how this type of diabetes works so you will be prepared to answer questions for this client. I want you to also discuss the pathophysiology of Type II diabetes as well as compare the two types of diabetes. Because this young man is of Hispanic descent you will also need to research how the care of a Hispanic child could vary from a Caucasian child. As you research Hispanic beliefs in disease and illness it will be important to understand who makes the decisions in the family regarding healthcare, who will need to be educated regarding his diabetes, and what type of healers do some Hispanic persons utilize other than the medical profession. What are the risk factors associated with diabetes and why is the Hispanic population more at risk for diabetes? Assessment You enter the room to check the blood glucose before breakfast. As you perform your initial assessment, you look for signs and symptoms of DKA (diabetic ketoacidosis). As you progress through the case study and answer the questions please support your response with appropriate rationale or support for your response. Some of the questions will be a response to the patient so you should write your response to those questions as if you were addressing this young patient. What signs and symptoms are you looking for regarding diabetic ketoacidosis? Miguel asks what normal fasting blood glucose would be, what is your response? You discuss the onset of Miguel’s illness with him. Miguel describes his symptoms, and you note they were typical symptoms of most people during the onset of diabetes. What symptoms would you expect your patient to describe regarding the onset of Type I Diabetes? How do these symptoms differ from what the symptoms of Type II Diabetes might be? You explain to Miguel that these symptoms were caused by the blood glucose level being higher than normal, and that if his blood glucose level is not controlled, he will experience these symptoms again. Miguel asks what can cause his blood glucose level to become uncontrolled. What is your response? Miguel asks why the body needs insulin. What is your response? Insulin Administration You prepare to administer Miguel’s morning dose of insulin. You explain everything as you prepare the insulin, so Miguel will learn to properly administer his insulin at home. Miguel asks why you are rolling the insulin instead of just shaking it. What is your reply? You explain the process of preparing a mixed dose of insulin. Which insulin do you draw up first? When you have drawn up both the N and R, how many units of insulin will be in the syringe? Miguel asks why the insulin is now being given by injection when before it was given IV. How do you respond? Miguel asks why the physician has prescribed two types of insulin for him. How do you respond? Discuss the differences between the various types of insulin including rapid acting, short acting, intermediate acting, long acting, mixed insulin (example 70/30). Are there any other treatment options for Miguel? Diabetic teaching When Miguel’s breakfast tray arrives, he just looks at the food and says, “I think I’ll just drink the milk and juice. I’ve never been a breakfast eater at least not this kind of food.” What is your best response? Miguel asks what will happen if the CHO intake is less than what is needed to balance the insulin. What is your reply? Miguel ponders your reply and then asks, “How will I know if this is a problem?” You know that Miguel needs to know the symptoms of hypoglycemia and this is a good opportunity to review this information with him. What will you tell him? After breakfast, Miguel takes a shower and takes a long walk around the hospital. When he returns he states, “I feel so nervous, shaky, and weak. My vision is a little blurry.” You note that Miguel’s skin is pale and moist. What action should you take? After you explain the relationship of exercise to the blood glucose level, Miguel states, “I play football, basketball, and baseball at school. I suppose I won’t be able to do that anymore.” What is your best response? When you deliver Miguel’s lunch tray, he states, “I’ve been wondering why the doctor won’t just let me take the insulin pills like my uncle does. He’s diabetic and gets by just fine on the pills. I suppose it’s a difference in the doctor’s ideas of treatment.” How will you respond? Discuss the action that each of the following antidiabetic agents utilizes and give an example of each; Alpha-glucosidase inhibitors, Biguanide, Insulin Stimulators, and Insulin Enhancing Agents (Thiazolidinediones or Insulin Sensitizers). In the early afternoon, you sit down with Miguel to discuss the long-term complications which have an increased incidence in those with diabetes. What complications will you discuss? Miguel asks, “How can I avoid these complications?” What information will you give him? Miguel sighs and looks unhappy. “What did I do to get this disease?” Now you must keep in mind that the Hispanic culture may have different views about disease and illness so keeping those in mind how will you answer his questions? What information can you give Miguel regarding the cause of type I diabetes? What other resources can you suggest for Miguel’s support once he has been discharged? You let Miguel know that you will be leaving soon. Miguel thanks you for all the information you have given him today, and has no further needs at this time. You proceed to document the items on which you have done patient teaching. List some of those topics? Besides working with Miguel to understand his diabetes and all the elements that impact his care who else needs to be involved in his care? Explain how you would facilitate this involvement. Again, you must keep in mind his ethnic background and realize that there are key people that must be integrated into his care if he is to be successful with management of his diabetes. This client is 14 years old based on that, what tasks are age appropriate for him regarding his diabetes care? Based on other ages in the pediatric group please describe how this scenario would be different if the child were a toddler, preschooler, and elementary aged child. How would your care and education be different? What tasks are appropriate for each age group of a toddler, a preschooler, and elementary aged child regarding diabetes care? Please provide some references also

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