Instructions: Respond by extending, refuting/correcting, or adding additional nuance to the post. Must be at least 210 words, in curre APA format, with at least two academic sources cited. Must be grammatically correct.
In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.
Constipation is an alteration in bowel pattern leading to the inability to defecate. Some of the risk factors that can lead to constipation include, lack of physical activity, frequent use of laxatives, a low fiber diet, inadequate fluid intake, older age, certain medication use (narcotics, sedatives, antidepressants, antihypertensives) and mental health and neurologic disorders. Some of the recommendations for a patient suffering from constipation include lifestyle modifications such as increasing fluid intake, increasing dietary fiber into their dietary fiber supplements, increasing physical activity, restraining the use of laxatives, not ignoring the initial urge to defecate, avoid consumption of processed sugar, red meat and white flour. In addition, I have found that training your bowel to specific times and familiar settings have worked for patients in the past, creating a routine will help in having regular bowel movements and prevent constipation.
Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.
On R.H. case study, the signs and symptoms presented that are compatible with the diagnosis of constipation include, recent changes to her bowel movements to sometimes once weekly, straining and taking over 10 minutes to have bowel movement, having extremely hard stools, decreased in physical activity, and the use of naproxen and aluminum hydroxide tablets. Additionally, other signs and symptoms include painful bowel movements, no bowel movement for longer than 3 days, hypoactive bowel sounds, hemorrhoids, fistulas, anal tear, intestinal obstruction, impaction, diverticulitis and electrolyte imbalance.
Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?
As an associate diagnosis and a complication of constipation patients can develop anemia; however, in R.H. case there isn’t sufficient information that would lead to think this could be the case. Based on the colonoscopy the patient had there were no lesions, additionally the constipation is acute, and the patient has only been experiencing the symptoms for about a month. If the constipation worsens for R.H. she may develop anal tears, hemorrhoids and lesions which can then cause bleeding to a degree sufficient to lead to iron-deficiency anemia.
Case Study 2
In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.
Diabetes mellitus (DM) is more prevalent among African Americans, Hispanic/Latino Americans, American Indians or Alaska Native (CDC, 2020). Based on C.B. clinical manifestations the signs and symptoms that she is exhibiting that are compatible with the diabetes mellitus type 2 diagnosis include obesity, increased thirst and urination, weakness and numbness to her left foot, elevated fasting blood glucose and elevated cholesterol, as well as the frequent “female infections” reported.
If C.B. develop a bacterial pneumonia on her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.
If C.B develops bacterial pneumonia on her right lower lobe she would be expected to have elevated glycemic values. Infection causes a stress response in the body which lead to an increase of cortisol and adrenaline. These hormones counteract the action of insulin, which then leads the body to increase glucose production causing high blood sugar levels. When blood sugar levels are elevated, the white blood cells (WBC) are not able to wipe off the bacteria because they cannot reach the infection site quickly to surround and destroy the bacteria. In people who do not have diabetes the extra insulin is produced to counter these effects.
What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?
The best initial non-pharmacologic therapy for C.B. include dietary changes and exercise, weight loss and glucose self-monitoring. In addition, some pharmacological initial therapy for C.B. include oral or noninsulin injectable hyperglycemia medications like sulfonylureas, amylin mimetics and biguanides among others. Also, in C.B case HMG CoA reductase inhibitors work by lowering her cholesterol thus providing a good initial therapy for diabetes.
