Case studies 3/4

Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

 Case Study 3 & 4 change every semester. Topics will be delivered at due time.

The answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use past students' work as all files submitted in this course are registered and saved in turn it in the program.

Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. "No Straight forward / Simple answer will be accepted". 

Some answers from the book First Case

1. Why was this patient in metabolic acidosis?

Because of the lack of insulin in this newly diagnosed young man, his body could not use free glucose for energy. Instead, he began to burn fatty acids for energy. This process produces acidic ketones.

2. Do you think the patient will eventually be switched to an oral hypoglycemic agent?

Type 1 diabetics are rarely treated successfully with oral hypoglycemic agents. Insulin is almost always required in adolescent diabetics.

Case

1. Why would the patient be instructed to avoid tobacco and caffeine?

Nicotine and coffee (caffeinated and decaffeinated) have been associated with greater incidence of heartburn because they decrease LES sphincter tone.

2. Why did the physician recommend 6 weeks of medical management?

While surgical procedures are more rapid and effective in reducing gastroesophageal reflux, these procedures are associated with risks not seen with medical therapy. Therefore, only patients who fail medical therapy should be considered candidates for antireflux surgery.

3. How do antacid medication work in patients with gastroesophageal reflux?

Esomeprazole (Nexium) is a proton pump inhibitor that decreases the amount of acid production in the stomach. Decreased pH in the stomach is a strong stimulant to gastrin. Gastrin increases LES sphincter tone and esophageal reflux is diminished.