Fluent Essays

Please review the complete instructions. 9/27/21, 1:18 AM Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16877161_1&rubric_id=_2591859_1 1/5 Rubric Detail Select Grid View or List View to change the rubric's layout.   Excellent Good Fair Poor Name: NURS_6521_Week5_Discussion_Rubric EXIT Grid View List View 9/27/21, 1:18 AM Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16877161_1&rubric_id=_2591859_1 2/5   Excellent Good Fair Poor Main Posting 45 (45%) - 50 (50%) Answers all parts of the discussion question(s) expectations with re�ective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) - 44 (44%) Responds to the discussion question(s) and is re�ective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) - 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are super�cially addressed. Is somewhat lacking re�ection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) - 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or super�cially addresses criteria. Lacks re�ection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) - 10 (10%) Posts main post by day 3 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) Does not post by day 3 9/27/21, 1:18 AM Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16877161_1&rubric_id=_2591859_1 3/5   Excellent Good Fair Poor First Response 17 (17%) - 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is e�ectively written in standard, edited English. 15 (15%) - 16 (16%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is e�ectively written in standard, edited English. 13 (13%) - 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack e�ective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) - 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack e�ective professional communication. Responses to faculty questions are missing. No credible sources are cited. 9/27/21, 1:18 AM Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16877161_1&rubric_id=_2591859_1 4/5   Excellent Good Fair Poor Second Response 16 (16%) - 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is e�ectively written in standard, edited English. 14 (14%) - 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is e�ectively written in standard, edited English. 12 (12%) - 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack e�ective professional communication. Responses to faculty questions are somewhat answered, if posed. . Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) - 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack e�ective professional communication. Responses to faculty questions are missing. No credible sources are cited. 9/27/21, 1:18 AM Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16877161_1&rubric_id=_2591859_1 5/5   Excellent Good Fair Poor Participation 5 (5%) - 5 (5%) Meets requirements for participation by posting on three di�erent days. 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) 0 (0%) - 0 (0%) Does not meet requirements for participation by posting on 3 di�erent days Total Points: 100 Name: NURS_6521_Week5_Discussion_Rubric EXIT **THIS DISCUSSION IS DIVIDE IN TWO PARTS – 1. MAIN DISCUSSION POST BY WEDNESDAY 9/29/2021 BEFORE 8:00 PM EST 2. TWO REPLIES BY FRIDAY 10/01/2021 BEFORE 8:00 PM EST Discussion: Diabetes and Drug Treatments Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes. To Prepare · Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. · Select one type of diabetes to focus on for this Discussion. · Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment. · Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments. Discussion Week 5 – Instructions 1. Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. 2. Select one type of diabetes to focus on for this Discussion. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. 3. Include dietary considerations related to treatment. 4. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. 5. Be specific and provide examples. 6. At least 5 references **THIS DISCUSSION IS DIVIDE IN TWO PARTS – 1. MAIN DISCUSSION POST BY WEDNESDAY 9/29 /2021 BEFORE 8:00 PM EST 2. TWO REPLIES BY FRIDAY 10/01 /2021 BEFORE 8:00 PM EST Discussion: Diabetes and Drug Treatments Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untr eated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes. To Prepare · Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile di abetes. · Select one type of diabetes to focus on for this Discussion. · Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment. · Think about the short - term and long - term impact of the diabetes you selected on patients, including effects of drug treatments. Discussion Week 5 – Instructions 1. Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. 2. Select one type of diabetes to focus on for this Discussion. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration o f this drug. 3. I nclude dietary considerations related to treatment. 4. Then, explain the short - term and long - term impact of this type of diabetes on patients. including effects of drug treatments. 5. Be specific and provide examples. 6. At least 5 references **THIS DISCUSSION IS DIVIDE IN TWO PARTS – 1. MAIN DISCUSSION POST BY WEDNESDAY 9/29/2021 BEFORE 8:00 PM EST 2. TWO REPLIES BY FRIDAY 10/01/2021 BEFORE 8:00 PM EST Discussion: Diabetes and Drug Treatments Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes. To Prepare  Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.  Select one type of diabetes to focus on for this Discussion.  Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.  Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments. Discussion Week 5 – Instructions 1. Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. 2. Select one type of diabetes to focus on for this Discussion. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. 3. Include dietary considerations related to treatment. 4. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. 5. Be specific and provide examples. 6. At least 5 references Instructions: Respond to your colleague by who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. **minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end** Chioma Murphy  Week 5 discussion main post Top of Form             Essentially, diabetes is a disorder of carbohydrate metabolism (Rosenthal, L. D., & Burchum, J. R., 2018). Symptoms of diabetes are caused by cellular insulin resistance, or a deficiency of insulin and the primary sign of diabetes is sustained hyperglycemia due to increased glucose production and impaired glucose uptake (Rosenthal, L. D., & Burchum, J. R., 2018). Based on etiology and clinical presentations, diabetes is broadly classified into three types, type 1 diabetes, type 2 diabetes, and gestational diabetes (GDM). Monogenic diabetes and secondary diabetes are other types of diabetes, but are less common (Goyal, R., & Jialal, I., 2021).   Brief explanation of the differences between Types of Diabetes Mellitus             Type 1 diabetes was previously called juvenile diabetes (because it was thought to develop only in juveniles) or insulin-dependent diabetes (Centers for Disease Control and Prevention., 2021). Type 1 diabetes can develop at any age in life, but it is mostly diagnosed in childhood or adolescence stage of life (Centers for Disease Control and Prevention., 2021). Type 1 diabetes characterized by autoimmune destruction of beta cells in the islets of the pancreas which are responsible for producing insulin (Goyal, R., & Jialal, I., 2021). The result is absolute deficiency of insulin (Goyal, R., & Jialal, I., 2021). The autoimmune activities are thought to be triggered by genetic and environmental factors (Goyal, R., & Jialal, I., 2021). Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes most common with type 1 diabetes, where in the absence of insulin to provide the cells with sugar, the body breaks down fat for energy and the by-product of ketone bodies (Centers for Disease Control and Prevention., 2021).   Type 2 Diabetes Mellitus             Type 2 diabetes mellitus (T2DM) accounts for 90% to 95% of diagnosed cases of diabetes (Rosenthal, L. D., & Burchum, J. R., 2018). Unlike type 1, T2DM are capable of producing insulin, but just not enough. T2DM is more frequently diagnose in middle age and progresses gradually (Rosenthal, L. D., & Burchum, J. R., 2018). But essentially, the symptoms of T2DM are primarily from combination of insulin resistance and impaired insulin secretion (Rosenthal, L. D., & Burchum, J. R., 2018). Also, unlike type 1 diabetes, T2DM are at risk of Hyperosmolar hyperglycemic syndrome (HHS) a serious and life-threatening complication of type 2 diabetes (Kondamudi, A. A., 2021). long term complications of T2DM are like those of type 1 and they include impairment of organs that creates susceptibility to stroke, retinopathy, heart disease, neuropathy, and nephropathy (Bonikowska, I., et al., 2021).   Gestational Diabetes Mellitus:             Unlike other types of diabetes, gestational diabetes mellitus (GDM) is hyperglycemia, that first develops during pregnancy, usually in the second and third trimesters. (Goyal, R., & Jialal, I., 2021). Gestational diabetes happens due to the changes and processes in pregnancy which causes the body to require more insulin and impairs the patient’s ability to use insulin effectively, a condition known as insulin resistance (Centers for Disease Control and Prevention., 2021).   Monogenic Diabetes             Unlike other types of diabetes, monogenic diabetes is caused by a single mutation in an autosomal dominant gene (Goyal, R., & Jialal, I., 2021). In most cases monogenic diabetes presents before 25 years of age, and it is thought to be genetic (Goyal, R., & Jialal, I., 2021). Examples of monogenic diabetes are neonatal diabetes mellitus and maturity-onset diabetes of the young (Goyal, R., & Jialal, I., 2021).   Secondary Diabetes             Unlike other types of diabetes, secondary diabetes as the name depicts happens because of other diseases affecting the pancreas or could be drug induced (Goyal, R., & Jialal, I., 2021). Factors that cause secondary diabetes are drugs like corticosteroids, or diseases like pancreatitis, or Cushing disease (Goyal, R., & Jialal, I., 2021).   Diet Interventions and in Gestational Diabetes Mellitus             In addition to glucose monitoring, nutritional interventions in diet are an important part of treatment and management of gestational diabetes (Dolatkhah, N., et al., 2018). Treatment guidelines for patients with GDM have advised that patients with GDM should be referred to a nutritionist for specialized medical nutrition therapy (MNT) to plan the patients’ meals with controlled carbohydrate levels to adequately fulfill nutritional needs and prevents Ketosis (Neda Dolatkhah, et al., 2018).   Metformin Administration in Gestational Diabetes Mellitus             Metformin does not actively reduce blood glucose levels and does not stimulate insulin release from the pancreas (Rosenthal, L. D., & Burchum, J. R., 2018). It lowers blood sugar by inhibiting glucose production in the liver, reducing absorption of glucose in the gut and increases glucose uptake by sensitizes insulin receptors in target tissues. Therefore, there is low risk of hypoglycemia with metformin (Rosenthal, L. D., & Burchum, J. R., 2018). Using metformin in GDM has similar effective outcomes with patients who used insulin to manage their GDM (Rosenthal, L. D., & Burchum, J. R., 2018).             Metformin is available in immediate release (IR) as Glucophage in 500, 850, and 1000 mg; extended release (ER) Glucophage XR, Fortamet, and Glumetza in 500, 750, and 1000 mg, and in an oral solution as Riomet in 500 mg/5 mL (Rosenthal, L. D., & Burchum, J. R., 2018). Metformin is also available in fixed-dose combinations with other diabetes medication. For IR tablets and oral solution, the recommended initial dosage is 500 mg twice daily (taken with the morning and evening meals) or 850 mg once daily, taken with a meal (Rosenthal, L. D., & Burchum, J. R., 2018). Recommended maintenance dose is 850 mg twice daily (Rosenthal, L. D., & Burchum, J. R., 2018). Recommended highest dosage is 850 mg 3 times a day (for adults) or 2000 mg/day (for children 10–16 years old) (Rosenthal, L. D., & Burchum, J. R., 2018). Recommended dose for ER tablets is initial dose of 500 mg daily or 1000mg daily for Fortamet (Rosenthal, L. D., & Burchum, J. R., 2018). Recommended highest dose for ER is 2000 mg (or 2500 mg for Fortamet and ER should be taken with evening meals to enhance absorption (Rosenthal, L. D., & Burchum, J. R., 2018).   Short-Term and Long-Term Impact of Gestational Diabetes and Effects of Metformin Treatment             Possible short-term outcomes for GDM patient are hypertension, preeclampsia, hydramnios, macrosomia which may lead to early childbirth and cesarean section (Goyal, R., & Jialal, I., 2021). Possible fetal short-term outcomes in GDM includes respiratory distress syndrome, hypoglycemia following birth, risk of shoulder dystocia, congenital anomalies and neonatal admission following birth (Goyal, R., & Jialal, I., 2021). Long-term outcomes of GDM for the patient includes increased chances of obesity, hypertension, diabetes type II and subsequent gestational diabetes (Goyal, R., & Jialal, I., 2021). Long-term fetal outcomes of GDM are increased chances of respiratory distress syndrome, congenital anomalies, cardiometabolic problems, obesity, and diabetes type II (Murray, SR, Reynolds, RM., 2020).               Short-term effects of metformin include gastrointestinal (GI) side effects, possible drug interactions with alcohol, cimetidine, and iodinated radio contrast media, or possible risk of lactic acidosis (Rosenthal, L. D., & Burchum, J. R., 2018). Also, because metformin is capable crossing the placenta it has similar concentrations in fetal as with maternal circulations (Murray, SR, Reynolds, RM., 2020). Long-term effects of metformin include, possible renal complications, also metformin has Blackbox warning of severe metabolic acidosis when metformin accumulates in the body (Rosenthal, L. D., & Burchum, J. R., 2018). Metformin has drug interactions with alcohol, cimetidine, and iodinated radio contrast media (Rosenthal, L. D., & Burchum, J. R., 2018).     References Bonikowska, I., Szwamel, K., & Uchmanowicz, I., (2021). Analysis of the Impact of Disease Acceptance, Demographic, and Clinical Variables on Adherence to Treatment Recommendations in Elderly Type 2 Diabetes Mellitus Patients. International Journal of Environmental Research and Public Health, 18(16).  https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph18168658   Centers for Disease Control and Prevention, (2021). Diabetic Ketoacidosis.  https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html   Centers for Disease Control and Prevention, (2021). Gestational Diabetes.  https://www.cdc.gov/diabetes/basics/gestational.html   Centers for Disease Control and Prevention, (2021). What Is Type 1 Diabetes?.  https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html   Dolatkhah, N., Hajifaraji, M., & Shakouri, S. K., (2018). Nutrition Therapy in Managing Pregnant Women With Gestational Diabetes Mellitus: A Literature Review. Journal of Family and Reproductive Health, 12(2).   Goyal,  R., Jialal,  I., (2021). Diabetes Mellitus Type 2. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513253/   Kondamudi, A. A., (2021). Hyperosmolar Hyperglycemic Nonketotic Coma., StatPearls Publishing.  https://www.ncbi.nlm.nih.gov/books/NBK482142/   Murray, S. R., Reynolds, R. M., (2020). Short- and long-term outcomes of gestational diabetes and its treatment on fetal development. Prenatal Diagnosis. 40(1085– 1091).  https://doi.org/10.1002/pd.5768   Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants. St. Louis, MO: Elsevier   Bottom of Form Instructions: Respond to your colleague by who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. **minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end** David Maniago  Main Post COLLAPSE Top of Form As many of us know, diabetes is an endocrine disorder that affects millions of Americans. There are several types of diabetes, and it is vital to understand the differences in pathophysiology to distinguish between each type. In Type 1 Diabetes Mellitus (DM I), onset is usually early and gradual. On a physiological level, beta cells are defective or insufficient. Beta cells are located in the pancreas and are responsible for producing insulin. Therefore, in DM I, insulin levels are low. It is also important to note that DM I was formerly called juvenile-onset diabetes. However, this implies that it is strictly children who are affected in DM I. In Type II Diabetes (DM II), the affected people are usually over 40 years of age, but it is becoming more common in children. Hence, juvenile-onset is no longer the term used to describe DM I as it affects both primary forms of diabetes (Rosenthal & Burchum, p. 397, 2021). Lastly, gestational diabetes is a form of diabetes that occurs commonly during pregnancy and terminates at the end of gestation. In this type, hyperglycemia is caused by several factors. Mainly, insulin resistance is due to the placenta releasing hormones that inhibit insulin action. Second, the production of cortisol, a glucocorticoid, is increased during pregnancy. This contributes to hyperglycemia (McCance & Huether, 2019). It is essential to note that glucose passes freely between the mother and the fetus, so when glucose levels are high in the fetal circulation, the fetus will release more insulin. Rosenthal & Burchum (2021) explain that the hallmark for blood glucose treatment in gestational diabetes requires regular monitoring of glucose levels. Glucose levels should be managed with diet (limiting fat intake, eating fruits and vegetables), physical exercise, weight control, and insulin subcutaneously. Metformin, an oral medication, can be used to treat glucose as well. Metformin is the only exception to PO agents. Any other oral medication must be discontinued during pregnancy. Metformin works by decreasing gluconeogenesis in the liver while increasing tissue sensitivity to insulin. The primary goal of managing gestational diabetes is to prevent short-term consequences such as hyperglycemia (diabetes untreated) and hypoglycemia (too much insulin received or too little glucose). When left untreated, chronic hyperglycemia to the maternal side can lead to long-term effects, damaging the heart, kidneys, and neuropathy. It can also lead to diabetic ketoacidosis, a metabolic emergency that causes ketone buildup in the body, placing the body in an acidotic state. This is a life-threatening that must be managed aggressively. In the fetus, hyperglycemia can lead to congenital disabilities (Stanford Children’s Health, 2021). Moreover, if insulin is taken subcutaneously, diligent monitoring of blood glucose levels is warranted. Hypoglycemia, characterized by glucose levels less than 70 mg/dL, brain damage can occur as there is not enough glucose to supply to the brain. The brain requires oxygen and glucose to function. Insufficient levels can lead to irreversible damage.   References   McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier. Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier. Stanford Children’s Health. (2021). Diabetes during pregnancy. Lucile Packard Children’s Hospital Stanford. https://www.stanfordchildrens.org/en/topic/default?id=diabetes-and-pregnancy-90-P02444 Bottom of Form