a bit of help please?

DIabetes first, then renal and heart in either order depending onthe pt.

I am taking care of a 69 y/o F tomorrow.

Dx: CHF, metabolic encephalopathy, seizures, dementia, HTN, increase in renal disease (on hemodialysis), diabetes, prior CVA

okay, now my question. I am trying to figure out the basic patho.

diabetes leads to HTN, leads to renal disease/CHF.

sooo, my question is what would come first (if that is even applicable), because diabetes is linked both to renal disease and HF, would one probably appear first and exacerbate the other or are they unrelated in that way?

*bangs head on desk*

The first question for me is "what quality of life does this person have?" Dementia and dialysis-I bet that's a fun day...Read up a little on criteria for dialysis and look at the co-morbity and life expectancy tables.....Good luck