Review and comment on the two suggested patient scenarios/cases that have been attached

• 1- What do you think about the suggested scenario/case
• 2- Do you think this is a possible scenario (support your answer)

Reverse Interpreting Lab Results Table 87.2
A possible reason why the glucose and hemoglobin A1C levels are elevated is because
the pancreas is not producing enough insulin to breakdown glucose. Because the pancreas is not
effectively breaking down enough glucose, the excess glucose in the bloodstream causes nerve
damage especially to the kidneys, where the blood is filtered. The lack of proper blood filtration
because of kidney damage is the reason for the decreased levels of RBCs, platelets, hemoglobin,
platelets, and hematocrit levels. This also is the reason for increased mchc, mcv, and INR values.
Hdl levels are also decreased because of the cardiovascular issues associated with damage to the
blood vessels from continuous high blood sugar.

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The reason for the decreased level of white blood cells would most likely be because the body is fighting a disease process most likely
caused by uncontrolled elevated blood sugar levels for an extended period of time.
Since most of the abnormal levels in this table are concurrent with abnormal values
associated with type 2 diabetes that is not well controlled, a good scenario would be that the
patient with these lab values has type 2 diabetes. The patient most likely does not control their
blood sugar well and has most likely had issues with maintaining a decreased blood sugar for an
extended period of time. The nurse would expect the patient to have a diet consisting of high
sugars and carbohydrates. The nurse would also expect the patient to have really white gums,
fatigue, lethargy, no energy, headaches, excessive thirst and hunger, and increased urine output.

Works Cited
Gauci, R., Hunter, M., Bruce, D. G., Davis, W. A., & Davis, T. M. E. (2017). Anemia
complicating type 2 diabetes: Prevalence, risk factors and prognosis. Journal of Diabetes
and Its Complications, 31(7), 1169–1174. https://doi-
org.ezproxy.hsutx.edu:4443/10.1016/j.jdiacomp.2017.04.002

Jin Ook Chung, Seon-Young Park, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung,
Chung, J. O., … Chung, M. Y. (2017). Anemia, bilirubin, and cardiovascular autonomic
neuropathy in patients with type 2 diabetes. Medicine, 96(15), 1–4. https://doi-
org.ezproxy.hsutx.edu:4443/10.1097/MD.0000000000006586. Reverse Interpreting Lab Test Results Nursing Paper

 Reverse interpreting results
For this assignment I chose table 87.2. The table shows that the patient has a high blood
glucose and HbA1c. A high blood sugar result is caused by eating too much sugar and
carbohydrates or because of diabetes mellitus. According to Huether (2017), in a person with
diabetes their pancreas does not produce enough insulin to break down the glucose, so the excess
ends up in the blood stream (p. 473). She also states that high HbA1c levels are caused by poor
control of one’s blood sugar. The excess blood sugar in the blood stream causes damage to the
kidneys which in result can lead to anemia. WebMD suggests that anemia can result from kidney
damage because the kidneys do not send out enough erythropoietin. Anemia can result in low red
blood cell count, platelet count, hemoglobin and HCT; as well as high MCHC, MCV and INR,
which the table shows abnormal as well. HDL levels are low in the table. Huether states that
these labs tend to be low in patients with diabetes.
In the case of table 87.2, the patient demonstrates signs of anemia and diabetes mellitus
because the results in the table show labs that you would expect in a patient with anemia and
diabetes mellitus. The nurse would expect that the patient is not adequately controlling their
blood sugar levels and therefore is showing signs of anemia. The patient may state they are
consuming an unhealthy, carb and sugar loaded diet. She would also expect to hear the patient
complain of fatigue, short of breath, excess thirst and hunger, frequent urination and tingling or
numbness of extremities.

 References
Huether, Sue E., and Kathryn L. McCance. Understanding Pathophysiology. Elsevier Mosby,
2017.Diabetes and Anemia: Know Your Risks and the Warning Signs. Retrieved from
https://www.webmd.com/diabetes/diabetes-and-anemia#1