Q.1
Indeed, they are several subjective and objective information I will inquire from Ms. Gami. First and foremost, I will require her compliance information for the self-administered medication. Secondly, I will need information about the side effects she might have experienced and if it was the cause for noncompliance to her prescription (Kawatra & Rajagopalan, 2015) . More so, her diet or exercise routines are also vital. I will also need to know her progress in terms of her memory and maintain balanced sugar levels.
Q.2
I will advise Ms. Gami against the use of Cinnamon and Ginseng due to the effect it has on her glucose level. Having type II diabetes, Ms. Gami is at the risk of getting hypoglycemia as when Ginseng mixes with Coumadin, it increases or decreases coagulation, thus affecting insulin production (Kawatra & Rajagopalan, 2015) . Additionally, coumarins a component in cinnamon are toxic.
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Q.3
Yes, since the patient has type II diabetes, I will recommend a test for the level of glucose in the blood, including A1C since it requires monitoring. The additional analysis will include clotting tests(PT&INR and PTT) ( Food and Drug Administration, 2018) . Studies show cinnamon aggravates liver disease. Hence I will also recommend liver tests together with cell count to check for any new infections.
Q.4
After checking her results and determining her glucose level, I will start her on Jardiance, a type II diabetes medication. Jardiance lowers blood sugar and goes well with proper diet and exercise, plus it lowers the risk of getting cardiovascular disease. Jardiance is an oral 10mg tablet taken once a day unless the patient develops tolerance, then we can administer the 25mg tablet ( Food and Drug Administration, 2018) . The medication helps the kidneys to remove excess sugar through the urine.
Q.5
If Ms. Gami adamantly refuses to comply with her prescription patient education will be vital as it will give her scope for her choice of medication. Therefore, I will first inform her how she can use cinnamon effectively in terms of quantity, effect, and treatment of her condition. Cinnamon contains coumarin, which is toxic (Kawatra & Rajagopalan, 2015) . Thereby, the patient should use small bits of it to avoid adverse effects on the liver. She should also understand that cinnamon does not provide a long term solution. Therefore, it will be better for her to s witch to medical prescriptions.
References
Food and Drug Administration. (2018). Research Deviations in FDA-Regulated Clinical Trials: A Cross-Sectional Analysis of FDA Inspection Citations. SAGE , 579-591.
Kawatra, P., & Rajagopalan, R. (2015). Cinnamon: Mystic powers of a minute ingredient. Pharmacognosy research 7.Suppl 1 , S1.
