pcfm mang berto

8/6/2019 PCFM MANG BERTO

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Based on the Story of

Mang Berto


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Mang Berto, a 50 year old sari-sari store owner, is

accompanied by his wife for his first visit to your clinic.Mang Berto complains of a 24 lb weight loss over a 3-month

period. His wife reports that he was eating more than usual.

Mang Berto estimates that he drinks up to 3 L of softdrinks

at work daily and urinates frequently. He also complains of

getting out of bed at least 3 times to urinate at night and

does not know whether his decreased energy level is

related to the interrupted sleep. There were no increased

home or work demands.

Mang Berto and his wife are married for 10 years, andthey have 2 kids, ages 5 and 9 years old. His wife is a 48

year old jolly woman who has no medical problems before.

Given Mang Bertos symptoms, type 2 Diabetes Mellitus

would be your working diagnosis.


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Primary Level

It is primarily concerned with the prevention of entrance or

onset of an infection or any diseases.Secondary LevelSecondary Level

There is successful entrance of an agent or infection. Signs

and symptoms may or may not manifest. The primary

concern is to have early diagnosis and eventually treatmentin order to prevent the infection / disease from becoming

severe and to prevent any complication as well.

Tertiary LevelTertiary Level Its primary concern is the total/whole rehabilitation of the

individual and its social surrounding - to prevent the

reoccurrence or complication of the infection or disease in

order for the individual to do again his/her social duty/role.


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a. Assess needs forHealth Educationa. Assess needs forHealth Education

b. Planb. Plan c. Implementc. Implement

d. Conduct evaluationd. Conduct evaluation


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Foods provide energy (calories),Foods provide energy (calories),nutrients, and other substances need fornutrients, and other substances need for

growth and healthgrowth and health

CategoriesCategories ofof nutrients:nutrients: Carbohydrates

Proteins Fats

Vitamins

Minerals

Water

((The uptake of food to be utilized as energy by mangThe uptake of food to be utilized as energy by mangberto is more than what is needed by the body. He isberto is more than what is needed by the body. He isdeprived by the benefits of exercise)deprived by the benefits of exercise)


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-- type A or type B personalitytype A or type B personality

-- lifestylelifestyle

LifestyleLifestyle a. Sleep and Resta. Sleep and Rest

b. Exerciseb. Exercise

c. Health habitsc. Health habits

d. Smokingd. Smoking e. Alcoholic usee. Alcoholic use

f. Drugsf. Drugs


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MangMang berto lacks exercise as expectedberto lacks exercise as expected

fromfrom a store owner who just sits thea store owner who just sits thewholewhole dayday..

He didntHe didnt meet the demand of his bodymeet the demand of his body

to take a rest and sleep due to that heto take a rest and sleep due to that he

always wakes up about 3 timesalways wakes up about 3 timeseverynight to urinate. Deprivation ofeverynight to urinate. Deprivation of

the benefits of rest andthe benefits of rest and sleeping.sleeping.

((no record of being an alcoholicno record of being an alcoholicdrinker, smoker or using illegal drugs.)drinker, smoker or using illegal drugs.)


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RecreationRecreation

Reduces Obesity

Diminishes Risk of Chronic Disease Boosts Immune System

Increases Life Expectancy

Reduces Depression Relieves Stress Improves Quality of Life

Self-Esteem


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encourage completing immunizationsencourage completing immunizations

((no record of immunization undergone)no record of immunization undergone)


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CleanlinessCleanliness

((personal hygiene might be practiced bypersonal hygiene might be practiced by mangmang

BertoBerto being a sari sari store owner who talksbeing a sari sari store owner who talks

and sees different people everyday)and sees different people everyday)


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-- clean and safe surroundingsclean and safe surroundings

-- Free from pollutionFree from pollution

((No record of the status of his environmentNo record of the status of his environment

but it can be assumed that the sari2 storebut it can be assumed that the sari2 store

ofof MangMang BertoBerto is clean or else no one willis clean or else no one will

buy at his store)buy at his store)


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--foodfood pyramidpyramid

((uncontrolled uptake of food. Especiallyuncontrolled uptake of food. Especially

mangmang bertoberto eats more than usual and heeats more than usual and he

drinks up to 3L ofdrinks up to 3L of softdrinkssoftdrinks(seems like(seems like

water is replaced bywater is replaced by softdrinkssoftdrinks HeHe doesntdoesnt

have a balanced amount of Nutrientshave a balanced amount of Nutrients

every time he eats.)every time he eats.)


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high blood sugar, either because the body does not produceenough insulin, or because cells do not respond to the insulinthat is produced.

As in the case of mang berto he has a type 2 diabetes

Type 2 diabetes: results from insulin resistance, a condition inwhich cells fail to use insulin properly, sometimes combined withan absolute insulin deficiency. (Formerly referred to as non-insulin-dependentdiabetes mellitus, NIDDM for short, and adult-onsetdiabetes.)

Symptoms include polyuria (frequent urination),

polydipsia (increased thirst)

polyphalgia (increased hunger)

Weight loss is most noticeable in type 1 diabetes


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The physician should have properknowledge about the disease andshould carefully note the history ofdisease.

The patient must immediately tell hisfamily of what he is feeling so that hisfamily will know. That upon theoccurrence of symptoms they should

urgently seek a doctor for earlydiagnosis and treatment of suchdisease.


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Weight loss ( as in case of mang

berto he loss 25 lbs in 3 months time in

contrast to that he eats more than what

is right)

Frequent Urination ( Mang berto

wakes up trice per night just to urinate)


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The best screening test for diabetes,

the FASTING PLASMA GLUCOSE (FPG)

y Normoglycemia - plasma glucose levels


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y Normal:


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1. ti l l l l 7. l/ (126 mg/ ).

2. l magl 11.1 mmol/ (200 mg/ ) t o ouraft ra 7 goral glucose loadas i a glucose tolerance test.

. l cated emoglobin ( b 1 ) 6. %

Bl t ty used tomeasurebloodglucose levelsy primar test fordiagnosingdiabetes

Random lood ar t ty blooddrawnat any time t roughout theday, regardlessofwhen

you last ate

y

bloodsugarof200mg/dL (11.1mmol/L) orhigherandsymptomsofhighbloodsugar, is li ely that diabetes ispositive.

Fasting loodsugar t sty Blood test doneafternot eatingordrinking for to12hours

(usuallyovernight)

y normal - less than100mg/dL ( . mmol/L)

y requested if randombloodsugar ishigh


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Diabetes Mellitus is diagnosed iftwoconsecutive fasting blood sugaris in the

abnormal range

Hemoglobin A1C testy blood test measures your average blood sugar

level over the past two to three monthsy help patients monitor how well they are

controlling their blood glucose levels

y done at any time of day (before or after eating)

y Normal values for A1C are 4 to 6 percent

Normal: Less than 5.

Pre-diabetes: Between 5. - 6.4

Diabetes: 6.5 or higher


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1.Metformin is generally recommended asa first line treatment as there is goodevidence that it decreases mortality.

2. Injections of insulin may either be addedto oral medication or used alone.

3.Other classes of medications used totreat type 2 diabetes

are sulfonylureas, nonsulfonylureasecretagogues, alpha glucosidaseinhibitors, and thiazolidinediones


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Primary goal is to rehabilitate MangBerto or to develop him to his fullest

physical, psychological, social and

educational potential consistent with

his ailment and to his environment; to

prevent reoccurrence of the infection

through proper guidance and

education.


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Diabetes doubles the risk of vascularproblems, including cardiovascular

disease. Other risks include amputations,cuts and bruises that take a long time toheal, blurred vision. Thus, rehabilitation isneeded to prevent the onset of these

risks and complications.

COMPLICATIONS:

Peripheral neuropathy chronic kidney failure

diabetic retinopathy


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FollowFollow medication regimen.medication regimen.

((since diabetes a chronic disease which issince diabetes a chronic disease which is

not curable drugs are needed to keep thenot curable drugs are needed to keep the

blood sugar level close to normal) refer toblood sugar level close to normal) refer to

treatementstreatements in secondary level ofin secondary level ofpreventionprevention


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ContinuousContinuous maintenance of diabetesmaintenance of diabetes

is very expensive therefore the supportis very expensive therefore the support

of each family member is neededof each family member is needed

especially the wife ofespecially the wife of mangmang bertoberto. This. Thiswill givewill give mangmang bertoberto a positive outlook ofa positive outlook of

life.life.


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Study shows that diabetic patients withneuropathic symptoms suchas numbness or tingling in feet or

hands are twice as likely tobeunemployed as those without thesymptoms. However, mang berto isthe (CEO) of his Sari2 store and still he canwork there even after being diagnosed to

have diabetes mellitus. He should also tryto do things that can serve as an exercisewhich will be good in his health


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pcfm mang berto

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