PLEASE ANSWER TO MY PEERS IN THE

PLEASE ANSWER TO MY PEERS IN THE FOLLOWING 2 ESSAYS. DISCUSSION 1 MELANIE –In the case scenario, F.M., a 52 -year-old man, is suffering from psychogenic polydipsia, a condition characterized by high fluid intake and frequent execration of diluted urine. This condition is mainly in psychiatric patients, but with lifestyle changes, such as in the case of F.M., where he stays at home to cope with the negative impacts of the COVID-19 pandemic, it is increasing in the general population (Sailer et al., 2017). One of this condition’s most severe and acute complications is hyponatremia, which results when the intake of free fluids surpasses free excretion. While the kidney’s normal excretory capacity can sustain an intake of 15L per day and excrete 900mmol within 24 hours, hyponatremia disturbs impacts water excretion. Treatment interventions for psychogenic polydipsia take two approaches: pharmacological and non-pharmacological. In the case of F.M., the first non-pharmacological intervention that can be considered is a voluntary reduction of fluid intake, but compliance with this strategy is of great concern since the patient has a compulsive water-drinking behavior (Mc Donald et al., 2021). The pharmacological treatment of polydipsia depends on the cause of the condition. For example, if diabetes mellitus is the cause, a physician will prescribe medications to control blood sugar. However, if the condition is caused by a psychological factor, as seen in the case of F.M., the best medications are antipsychotic medications and mood stabilizers, such as clozapine, olanzapine, aripiprazole, and lithium (Bersani et al., 2007). Pharmacological treatment is the most preferred management approach because fluid restriction and behavior management therapy does not resolve the condition and is time-consuming and challenging to implement. As a result, Ahmed and Khan (2017) indicate that treatment with acetazolamide, a carbonic anhydrase inhibitor is the most effective since this medication improves hyponatremia and polydipsia. The physician ordered various laboratory tests on F.M. to establish the diagnosis. The following results were recorded: hematocrit:42%, random capillary blood glucose: 358mg/Dl, hemoglobin A1c:11.4%, specificity gravity:1.010, and pH:7.4. Various additional tests that should be conducted include a water retention test serum electrolyte, urine osmolality, and serum osmolality. The water retention test should be conducted to confirm or rule out differential diagnoses such as liver disease, diabetes Mellitus, and chronic renal failure. Notably, the water retention test distinguishes psychogenic polydipsia from diabetes insipidus (Sailer et al., 2017). PLEASE ANSWER TO THE ABOVE DISCUSSION, ADD REFERENCES DISCUSSION 2 LIANET– Mr. FM is having symptoms of excessive thirst, he has gained weight recently, his vision is blurred, and he frequently urinates, so there is a possibility that he has developed type 2 diabetes. His blood test reports support this diagnosis, Hemoglobin A1c 11.4%, which confirms that his body is having difficulty regulating blood glucose level, and glucose is present in the urine. Polydipsia is linked with the early symptom of diabetes, and it might be due to the diuretics (hydrochlorothiazide) he takes to manage his hypertension. What nonpharmacologic treatments should be recommended to FM? Regular physical activity or at least 30 minutes of moderate intensity is needed to control weight and improve insulin sensitivity. To maintain weight and blood glucose levels, the patient should be asked to maintain healthy eating habits, such as meals high in fiber and protein and low in carbohydrates. Moreover, he should be asked to limit high-fat foods and excessive carbohydrates such as white bread and sugary drinks and eat whole grains, vegetables, fruits, and lean protein (Raveendran et al., 2018). To manage weight, he must use measuring cups and spoons for the food scale. As mentioned in the case, the patient does stress eating, so he must be given stress management therapies such as meditation and yoga to improve his overall health and stress levels. He must also be encouraged to practice muscle relaxation and deep breathing. For obesity, he must be given social support so that his feeling of loneliness can be prevented. What pharmacologic treatments should be recommended or avoided in FM? To control glucose and reduce weight, Metformin 500mg once daily is prescribed. Trulicity 3mg IM injection once daily is suitable for Mr. FM as glucose is managed, and this drug decreases weight. His blood pressure is still high despite taking hydrochlorothiazide, and frequent urination is due to this diuretic, so he must stop it and take Amlodipine 5mg once daily to manage his hypertension. What additional laboratory tests should be recommended to FM? To confirm diabetes Oral Glucose Tolerance Test (OGTT) should be prescribed. The Comprehensive Metabolic Test (CMT) as he is having frequent urination, so his electrolyte level must be checked. RFT is recommended to check if he has any kidney problems (Ahmadi & Goldman, 2020) As the patient is complaining of blurred vision, so Comprehensive Dilated Eye Exam for diabetic retinopathy should be recommended. Lipid Profile: As the patient takes Atorvastatin, total cholesterol should also be checked. PLEASE ANSWER TO THE ABOVE DISCUSSION, ADD REFERENCES

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