The process of making a medical diagnosis is largely influenced by objective as well as subjective information that is collected when a patient presents himself in the emergency department or a medical care facility. Objective data encompasses the information that can be observed in addition to being measured through diagnostic and laboratory testing as well as physical examination and observation. Additionally, subjective information encompasses the information that a patient provides through interviews. In the case of Gami, it would prove useful to collect both objective and subjective data to assist in providing appropriate care attention.
The subjective information that I would collect from Gami includes family, social, medical, and surgical history. I would also seek to know how long she has suffered from loss of memory as well as seeking to know if she has ever had head trauma. Further, it would prove useful to seek information regarding how long she has been using herbal supplements and how often she exercises coupled with her dietary composition. Finally, I would seek to understand whether Gami uses tobacco products, alcohol, or other illicit drugs. Subjective information has been cited as significantly undervalued while making clinical assessment and management of patients. However, collecting the subjective information from Gami will assist in determining the severity, irritability, and nature of the illness while attempting to identify the potential predisposing factors.
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Objective data that I would collect from Gami would include the vital signs that would be significant in indicating the state of the critical body functions. Additionally, it is useful to obtain the BMI, weight, and ethnicity as well as waist measurement which plays an essential role for assessing the type 2 diabetes risk factors ( Goldstein & Mueller-Wieland, 2016) . A “Memory Impairment Screen” or “General Practitioner Assessment of Cognition” would be used in assessing the cognitive functions “ Screening for Memory Loss, Alzheimer's Disease, and Dementia”, 2016) .
Position on use of alternative supplements for memory and diabetes
Regarding Gami’s use of alternative supplements including cassia cinnamon and ginseng I would not advise her to stop using it noting that even though there is no scientific research proving their use, studies have pointed out that cassia cinnamon is useful in controlling blood glucose levels ( Goldstein & Mueller-Wieland, 2016) . Additionally, ginseng has been shown to have positive impacts in boosting memory. Further, there are no known adverse effects of the traditional supplements thus are safe and cannot counteract other prescriptions.
Additional tests
Additional tests that would be recommended for the patient include the A1C test to monitor the previous three months management of the type 2 diabetes. Further, a b12 and folic acid levels would be assessed to determine any secondary causes for memory loss. It would prove useful to evaluate the kidney, liver, and electrolytes functioning in a comprehensive metabolic panel regarding prescribed medications. Finally, a test for complete blood cell count would come in handy to assess anemia for Coumadin therapy.
Treatment plan
A prescription for 850 mg metformin taken orally once in a day with meals for two weeks increased to 1500 mg per day after two weeks. Metformin belongs to the biguanides class of drugs with a four to eight hour, and it decreases the production of hepatic glucose and increases the target cell insulin sensitivity. The drug may exhibit side effects in diarrhea, physical weakness, and flatulence as well as vomiting and nausea. Metformin is not metabolized and has been known to be excreted through the urine. Metformin has a “risk of lactic acidosis” black box warning.
Preventive education
In the case of the treatment plan, I would advise Gami to avoid heavy alcohol use and undertake to exercises regularly. Additionally, Gami needs to eat a healthy balanced diet with more fruits, high fiber foods, and vegetables while cutting back on salt use. Further, I would advise her to check with her doctor for routine checkup continually. Besides, it would serve her well to get enough sleep.
References
Goldstein, B. J., & Mueller-Wieland, D. (2016). Type 2 Diabetes: Principles and Practice, Second Edition . Boca Raton, FL: CRC Press.
Screening for Memory Loss, Alzheimer's Disease, and Dementia. (2016). Memory Loss, Alzheimer's Disease, and Dementia , e5-e10. doi:10.1016/b978-0-323-28661-9.00037-8
