NR 603 WEEK 3 CASE STUDY

NR 603 WEEK 3 CASE STUDY NR 603 WEEK 3 CASE STUDY Three Months Ago: AIC 6.4% Fasting glucose 135mgs/dl Total Cholesterol: 230 (200-239; borderline high) 240 very high Triglycerides 180mgs/dl (less than 150) 150-199 is borderline high Ldl 180 (100 is normal) 130-159 is borderline high; 160-189 is very high Hdl 38 (40-59 is normal but higher is better) 40 is at increased risk of cardiac disease 5'8" weight: 220 pounds; BMI 33.5 vital signs: BP 146/90 P 70 Sao2 97% Random glucose finger stick in office: 130mgs/dl Less than 70 for LDL There’s no abnormal physical findings in the respiratory system to suggest early heart failure. But mild JVD present with trace edema in lower extremities. Eats out a lot - processed food, social drinking, occasional cigarette weekly; stopped Lisinopril one month ago, refuses HLD medication, will control with diet and exercise, allergy to METFORMIN 1. What Leads Demonstrate the ST Depression? 2. Is Lorene Hypertensive per ACA 2017 Guidelines? Compare the ACA guidelines to JNC 8 guidelines and discuss what treatment you recommend for her BP and why. 3. What is the Primary diagnosis causing Lorene's chest pain? Include ICD 10 codes (no differentials) 4. What other secondary diagnoses does Lorene have that should be addressed? (Include the rationale and a reference for your diagnoses) 5. Design a treatment plan and discuss how each intervention is applicable to Lorene's case. Consider the following interventions: ○ Labs ○ Durable Medical Equipment Diagnostic tests- discuss the goal/purpose ○ Any consultation with outside providers/services ○ Medications- discuss why you chose each specific medication 6. Referrals- who and why 7. Follow up- why and when 8. Education- specific and measureable 9. Lifestyle Changes- specific to her cultural preferences, values and beliefs Dr. Deering and class, 1. Leads I, II, and V2 to V6 demonstrate ST depression. 2. Lorene’s elevated blood pressure of 146/90 places her at stage 2 hypertension based on the American College