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Please answer question below with reference on APA 7th ed format
To elaborate, it’s critical to take into account the possible combinatorial effects of these risk variables. Uncontrolled diabetes, hypertension, and dyslipidemia may all work together to accelerate the development of atherosclerotic cardiovascular disease (ASCVD). While it is crucial to address each of these factors separately, a comprehensive strategy that focuses on the entire cardiovascular risk profile may produce better results.
About the suggested management plans for this patient, please let me know what measures or therapies would you recommend to maximize her cardiovascular health and lower her risk of ASCVD, given the complexity of her cardiovascular risk factors?
Scenario:
The 42-year-old female patient presents for follow up on lab results from her annual physical exam completed a week ago. The lab results are as follows: Triglycerides 225, LDL 170, HDL 22, HgBA1c 8.3%. The vital signs are as follows: BP – 148/92, HR – 76, RR – 18, Tempe – 97.2.
Patient history reveals a 20 pack-a-year smoking history and type 2 diabetes. The last labs done 18 months ago were normal. What is this patient’s cardiovascular risk based on these lab results? Describe how the FNP would clinically manage and follow up this patient. List the pharmacological and non-pharmacological interventions.
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Provide the most likely diagnosis based on the HPI and PE. In addition, provide your
interpretation of the cues found in the assessment. List at least 3 possible differential
diagnoses and justify your rationale. Develop therapeutic plan options based on quality,
evidence-based clinical guidelines.
From the scenario of the female patient, 42 years old, with a background of diabetes type
2, a history of smoking 20 packs of cigars a year, and abnormal results from the laboratory, the
focus will significantly involve evaluating her risk of cardiovascular diseases. The most likely
diagnosis in regard to the HPI and PE from the presentation of the patient, like the increased
triglycerides and LDL, decreased HDL, increased HgBA1c, and increased pressure of the blood,
signifies the risk of cardiovascular profile (Gallucci et al., 2020). In addition, the dyslipidemia
combination, poorly managed diabetes type 2, and hypertension outlines the high probability of
Atherosclerotic Cardiovascular Disease.
Dyslipidemia is mainly based on the increase in LDL and Triglycerides along with
decreased HDL and different signifiers of dyslipidemia, which is a risk variable for ASCVD (Purva
et al., 2020). The poor control of glycemic is signified through the increased HgBA1c at 8.3%,
which signifies the inadequate control leading to a risk of cardiovascular for patients living with
diabetes. Lastly, hypertension is signified through the increased pressure of blood at 148/92,
signifying unmanaged hypertension, thus indicating the risk of cardiovascular disease.
The possible differential diagnoses include Atherosclerotic Cardiovascular Disease due to
the dyslipidemia combination, poorly managed diabetes, and hypertension. The second diagnosis
is diabetic cardiomyopathy due to the underlying diabetes type 2 leading to cardiomyopathy,
contributing to the impairment of heart functionality. The third diagnosis is a metabolic syndrome,
in which the individual signifies multiple sections of the syndrome, such as hypertension,
resistance to insulin, and dyslipidemia.
Therapeutic Plan.
Modification of lifestyle: This involves the cessation of smoking by implementing a program of
smoking cessation for the patient and advising on increased diet and exercising that improve the
profile of lipids and control glycemic.
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Pharmacological Interventions: The use of Statins in addressing dyslipidemia and reducing the
risk of cardiovascular diseases.
Management of Diabetes Type 2: The control of diabetes will involve adjustment in diabetes
medication in order to acquire better control of glycemic with the aim of reducing levels of
HgBA1c.
Regular check-up: This will involve scheduling regular check-up appointments that will help in
monitoring the risk factors of cardiovascular diseases and having repeated tests such as HgBA1c
and lipid panel.
Monitoring: This will involve the regular monitoring of the changes, blood pressure, management
of glycemic and levels of lipids, thus helping in medical adjustment and interventions required in
regard to the progress of the patient.
References:
Gallucci, G., Tartarone, A., Lerose, R., Lalinga, A. V., & Capobianco, A. M. (2020, July).
Cardiovascular risk of smoking and benefits of smoking cessation. Journal of thoracic
disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399440/
Purva, A., Sharma, K., & Khan, Mohd. S. (2020). A review on dyslipidemia: Types, risk factors
and management. Asian Journal of Pharmaceutical Research and Development, 8(2), 96–
98. https://doi.org/10.22270/ajprd.v8i2.682
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