Pertinent Positive and Negative Findings in the Patient Assessment
Pertinent positive findings include a blood pressure of 190/101, a blood sugar of 405, and a heart rate of 102. Furthermore, the patient reports about polyuria, which affects the normal water and electrolyte balance in the body and can physiologically trigger dizziness (Davies et al., 2018). The pertinent negative findings that can be obtained from the patient’s report are headaches and blurred vision.
List of Differentials with Rationales for the Patient
Diabetes Mellitus
As reported by the patient, he had been urinating more in the last few days accompanied by incessant thirst. These are major symptoms that can indicate that the patient is suffering from diabetes mellitus (Siavash et al., 2017). From the case study, the patient reports that he had been using Lantus and Metformin, and these are drugs which are usually prescribed to manage diabetes Mellitus.
Cardiovascular Accident
There are also indicators of a cardiovascular accident in the case study. It is shown that the patient had suffered a second episode of CVA that had left him with general weakness. There is, therefore, a possibility that the ensuing dizziness and nausea could have been triggered by another episode of CVA. Moreover, it is indicated that he had been struggling to get out of bed and that the symptoms worsened in any attempt. This is a sign that the pathophysiological effects of CVA are influencing the normal physiological functions of the body.
Hypertension
The possibility that the ensuing dizziness and nausea are triggered by hypertension is indicated by the blood pressure that is at 190/101. Such levels can lead to poor perfusion in the brain and cause dizziness, which is reported by the patient (Goldstein et al., 2013). Furthermore, the hypertension makes the heart pump faster and demand more oxygen-rich blood, but the inadequacy makes it difficult to maintain normal blood flow.
The Medication Regimen for the Patient Based on His Financial Status
The patient needs to be given insulin injection, which is cheaper in comparison to Metformin and Lantus and will not result in such side effects as nausea that the patient is suffering from. The direct absorption into the bloodstream will quickly compensate for the declining levels of insulin in the body, and this will have a physiological effect on all the other symptoms (American Diabetes Association, 2018). This medical option is, therefore, affordable to the patient, and he can plan to obtain it with very little financial strain.
The Priority Concern for the Patient
The priority concern for this patient is to lower the blood sugar levels from 405 to the normal range. Hyperglycemia can result in the damage of blood vessels that supply critical organs in the body such as the heart and increase the risk of developing other complications such as kidney failure and vision problems, among others (Davies et al., 2018). It is, therefore, imperative to contain this situation and avoid the development of a life-threatening situation.
The Patient’s Comorbid Diagnosis and Its Impact on His Current Symptoms
Hypertension can lead to poor tissue perfusion in the brain and other tissues in the body. The resulting neurological complications can make it difficult for the brain to perform its normal physiological functions and lead to dizziness and nausea (Goldstein et al., 2013). The underlying cardiovascular problem can also cause a poor supply of oxygen to the body tissues and organs. This results in general body weakness, which is reported by the patient as one of the symptoms.
The Patient’s Health Beliefs, Culture, and Behavior and Their Impact on the Potential Outcome
Health beliefs have a great impact on the patient’s compliance with the prescribed medication. If the patient does not believe that the treatment will provide relief, he is likely to adopt behaviors such as not taking the required dose at the right time (Yoo et al., 2018). Moreover, if the patient does not stick to the provided instructions, all the indicated interventions may not result in the desired outcome
References
American Diabetes Association. (2018). Standards of medical care in diabetes—2018 abridged for primary care providers. Clinical diabetes: A Publication of the American Diabetes Association, 36(1), 14–37.
Davies, M.J., D’Alessio, D.A., Fradkin, J., Kernan, W.N., Mathieu, C., Mingrone, G., Rossing, P., Tsapas, A., Wexler, D.J. & Buse, J.B. (2018). Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes care, 41(12), 2669-2701.
Goldstein, F. C., Levey, A. I., & Steenland, N. K. (2013). High blood pressure and cognitive decline in mild cognitive impairment. Journal of the American Geriatrics Society, 61(1), 67-73.
Siavash, M., Tabbakhian, M., Sabzghabaee, A. M., & Razavi, N. (2017). Severity of gastrointestinal side effects of metformin tablet compared to metformin capsule in type 2 diabetes mellitus patients. Journal of Research in Pharmacy Practice, 6(2), 73-76. Web.
Yoo, S. W., Kim, J., & Lee, Y. (2018). The effect of health beliefs, media perceptions, and communicative behaviors on health behavioral intention: An integrated health campaign model on social media. Health Communication, 33(1), 32-40. Web.