Nu632U13peerresponseTaylor

The first part of the discussion board is to identify all pertinent positive and negative information.

Positives: increased thirst, urinary frequency, abdominal cramping, nausea, decreased activity level, weight loss

Negatives: burning or blood with urination, vomiting, fever, chills, diarrhea, sexual activity, bloating, loss of appetite, temperature intolerance

What other questions may you want to ask the patient?

I would like to know if the patient has become shaky, excessively sweaty, confused, or weak in the past week, what type of illness did the patient just recover from, when the mother began menarche, and what type of diabetes does the mother and maternal grandmother have. A study into family history of diabetes found that children in the study with a family hx of type 2 diabetes were diagnosed with type 1 diabetes at an older age (Parrkola et al., 2021). Type 1 and type 2 diabetes were also found to have a â€œshared aetiopathogenetic factorâ€ that was in pediatric and adult family members (Parrkola et al., 2021).

How will you address these findings?

Order a urinalysis and urine culture to r/o infection and check for protein or glucose in urine.

Order blood labs: CBC, CMP, TSH, and T4.

I would refer the patient to endocrine to assess hormonal function and address thirst and late menarche.

Now create a plan utilizing clinical practice guidelines for the priority diagnosis.

Plan:

Phone review labs once resulted with parents and patient. If the patientâ€™s lab results indicate type 1 diabetes as suspected, I would ask the patient to return to clinic to explain and provide hard copies of information about type 1 diabetes, expected findings, treatment options, and dietary instructions. The patient should have a MedicAlert bracelet with emergency contact information in the event the patient gets sick and is not responsive (Garzon et al., 2025). The patientâ€™s coaches should be informed of the diagnosis so that the patient has time to rest, check blood sugar, and eat snacks if needed to prevent hypoglycemia (Garzon et al., 2025). I would place an additional referral to Nutrition to assist the family with appropriate dietary choices and expedite the Endocrinology referral for Type 1 Diabetes management. Nutrition education is important because children with type 1 diabetes achieve “greater glycemic stability” when they have a varied diet of glycemic-index foods (Quarta et al., 2023). This is necessary to prevent continued hyperglycemia, which can cause systemic inflammation of bodily tissues and blood vessels, and micro damage that is detrimental to long-term health (Quarta et al., 2023).

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