In particular Diabetes mellitus is a disease wherein the body cannot properly utilize or produce enough insulin. The pancreas produces the insulin which allows the body to use sugar from carbohydrates in the food. It also controls the sugar from being too high or low2. If the …show more content…
The patient is a 26 year old male, single but living with a younger brother and works as a freelance photographer. He doesn’t get enough sleep and rest at night because he has late photo shoot or he plays video games. He is on dialysis for 2 years, had 2 failed AVF on left arm and currently using AVG on his right arm. He is prescribed to use F80 hi flux dialyzer, blood flow rate of 250ml/min with 4 hours dialysis time with 3x per week frequency of dialysis. During dialysis his diet consists of Coca-Cola and 6 slices of pizza. He passes minimal urine of 5% ideal weight making it difficult to achieve his target weight post dialysis. Due to this, he usually complains shortness of breath when going to the dialysis clinic. For his physical assessment the PMI is 3cms left apex site was noted also with 2+ pitting oedema up to mid-calf and ascites together with a JVP >3cm above sternal angle. Upon auscultation crackles and wheezes were heard over lower lung fields. Recently he complains general weakness, shortness of breath and chest