This is an in depth Cardiology/ Endocrine case study
Please read all the information provided in the word document.
There are 9 questions that must be answered based on the given information.
In APA format
Cardiology/Endocrine Case Study
Course Student Learning Outcomes
Upon completion of the case study, students will be able to …
1. Apply the principles of pharmacology relative to pharmacotherapeutics across age levels including the effect of race, gender, ethnic group, and special populations.
2. Describe the uses, actions, effects and nursing implications of general classifications of drugs and selected specific drugs.
3. Investigate media resources and information technologies to enhance knowledge base of pharmacology.
4. Analyze the responsibilities of the nurse when administering drugs.
5. Apply pharmacological research to nursing practice.
Purpose The purpose of this case study is to apply concepts from pharmacology and
pathophysiology, national guidelines, and evidenced based clinical practices in the management of chronic disease. Remember this paper must follow APA guidelines for font, in text citations, reference list etc. No abstract is needed. Provide headings for the different questions in your paper.
Setting This case study takes place in a primary care setting in a small rural hospital clinic that provides health care services to predominately Latino field workers and their families. The rural clinic serves children and adults for all medical needs including well care, acute care, and chronic conditions. Some clients have seasonal insurance, state health insurance, or no insurance. Many live below poverty level according to the federal guidelines. Most do not own a vehicle. Most do not speak English; so, a translator is provided at each visit. The clinic is one hour from the nearest city where higher level of care can be offered to patients in need of specialty care. The clinic is staffed by one family medicine physician, an internist, two nurse practitioners, an RN, two LVNs, a lab tech, eight MAs and support staff. Once a week a cardiologist, podiatrist, pain specialist, orthopedist and ophthalmologist service the clinic. There is an on-site lab and a pharmacy two blocks away. There are two ambulances servicing the entire south end of the county with poor availability for emergencies.
Jose is a 47 year old morbidly obese Latino male who presents to the clinic for follow up evaluation of headaches, dizziness, ringing in his ears and frequent urination. He reports having a headache that “comes and goes” with ringing in his ears and sometimes he sees spots. Jose has taken acetaminophen and states that seems to help. Due to his work schedule of six 12 hour days, Jose has not had preventive care. He reports fatigue and is depressed regarding his current income situation. Jose has just been laid off for the season and will lose his insurance in 30 days until the restart of the harvesting season in March. He is concerned about paying for any health care that may go beyond his benefit period. Jose lives with his pregnant wife, who does not work, and their seven children in a three bedroom one bath house that they share with his parents and his brother’s family of three.
Review of Systems Subjective Data
General: occasional fatigue, gradual weight gain over the past ten years
HEENT: (+) visual and hearing changes with HA; (-) cold or recent upper respiratory
changes, (-) rhinorrhea or nose bleeds,
Cardiac: (-) chest pain or tightness, no palpitations
Respiratory: no asthma, (+) snores at night
GI: (-) pain, nausea, vomiting, constipation, visible fecal blood, (+) GERD, reports occasional indigestion after meals,
GU: (+) frequent urinary for 1 month with increased thirst
MS: (+) chronic bilateral shoulder and low back pain for 7+/- years, takes ibuprofen prn.
Neuro: (+) headaches 2- 3 times a week relieved with acetaminophen, (+) dizziness, sees spots with HA which are not related to activity, (-) weakness, (+) numbness and tingling in both feet,
(-) changes in speech or memory
Skin: (-) rashes or lesions
Psych: (+) Depressed about income, wife is unable to work and is pregnant
7 children ages 2 years-13 years.
Past Medical History: Denies problems No preventative care. Only acute care for cold or flu.
Past Surgical History: None
Social History: (-) substance abuse, (+) ETOH, drinks 1-2 beers a day and 5-6 beers on the weekend with family on Saturday and Sunday. Drinks 2 cups of coffee with cream and sugar in the AM, does not exercise except working in the fields picking broccoli, likes to watch TV at night, eats a high carbohydrate diet of rice, beans, potatoes, corn and tortillas (8-10 a day) eats at home, does not eat out often. Drinks water, no sodas or junk food. Reports drinking freshly made jimaca (hibiscus) tea with sugar and fresh cucumber lime drink with sugar three times a week. Rarely eats deserts.
Family History: Parents and siblings all living. 2 brothers and 3 sisters. (+) hypertension – father and mother, 2 brothers and 2 sisters (+) diabetes-father, mother, 1 brother and 1sister, (+) coronary heart disease- father, mother, 1 brother, (+) hypercholesterolemia- father, mother, 1 brother, 2 sisters
Physical Examination – Objective Findings
Ht. 64 inches Wt. 294 lbs. BP 176/104 mmHg HR: 92 RR: 24 T: 98.8 F
General: Well appearing, well groomed, NAD, looks stated age, morbidly obese
Eyes: PERRLA, Fundoscopy with no AV nicking or copper or silver appearance, no
Neck: supple, (-) lymphadenopathy, (-) thyromegaly,
CV/Heart: RRR, (-) murmur, rubs or gallops, lifts or heaves, tenderness to palpate, (-) carotid bruits, (-) pedal edema
Lungs: CTA bilaterally, respirations equal and unlabored
Abdomen: (+) BS x 4, soft, round, non-tender, (-) masses, organomegaly, bruits
MS: (+) steady gait, FROM all EXT, no cyanosis, clubbing, pedal pulses present, feet warm, monofilament test abnormal at R great toe, 2+ patellar DTR,
Neuro: CN 2-12 grossly intact, (-) Rhomberg, (-) Pronator drift, (-) Dix Hallpike
Skin: (-) rashes or lesions, color even WNL, hair normal distribution
Psych: appears anxious
Previous Lab and Diagnostic Testing: None available. Reports labs done in Mexico 10 years ago, does not remember results.
Current Lab Test Results – Fasted 12 hours – completed 1 week prior to clinic
Complete Blood Count/ Basic Metabolic Panel
Creatinine 0.6 mg/dl
Carbon dioxide 25 mEq/L
Chloride 100 mEq/L
Potassium 4.0 mEq/L
Sodium 142 mg/dl
Calcium 9 mg/dl
BUN 16 mg/dl
Vit D 16
Clear, pale yellow
Specific gravity 1.021
Cardiology/Endocrine Case Study
Answer the questions below using current national clinical practice guidelines, your pharmacology course textbook, previous pathophysiology coursework, and other sources such as journal articles to support your answers. Please review the grading rubric that will be used to evaluate your submission (100 points = 20% of total grade)
1. Based on the patient’s labs and the Subjective and Objective data, what are the patient’s diagnoses? (Hint: There are at least 8.)
2. Briefly discuss the pathophysiology of the top three diagnoses.
3. Discuss the guidelines for diabetes management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Explain the importance of aspirin in diabetes. Describe how these medications work to stabilize and provide optimum health.
4. Discuss the JNC 8 guidelines for hypertension management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.
5. Discuss the AACE 2017 guidelines for dyslipidemia management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.
6. Discuss non-pharmacological interventions to assist Jose in reaching his optimal health. This includes supplements/alternative/integrative medicine….
7. List factors that increase the patient’s risk for cardiovascular disease (including labs).
Calculate Jose’s 10 year atherosclerotic cardiovascular disease (ASCVD) risk using the Framingham and Mesa calculators.
8. Discuss consequences of obesity as the one major cause of this patient’s problems that if corrected can impact all of his diagnoses. Explain how the related factors of his lifestyle affect his diagnoses. What type of diet is recommended according to the latest research? Is Jose a candidate for bariatric surgery and how does bariatric surgery help?
9. Jose has expressed his inability to afford all of the medications he needs. What medication is required and how can his other diagnoses be treated? List other disciplines that could provide a multidisciplinary team approach to assist Jose in reaching optimal health.
Why Choose Us
College Research Papers
We offer professionally written research papers to our clients. We ensure all instructions are followed and that your custom paper is perfect. For a custom research paper, we have expert writers to help you. They will write your paper and earn you good grades
Professional Academic Writers
Are you looking for professional essay writers? Do you need custom paper writers to do your assignment? College essays online is packed with experienced writers who will handle your write my essay request. Order today to get quality services
Free Unlimited Revisions
Do you feel like your paper did not meet the requirements? Is there some instructions that have been skipped? Do not panic. Resubmit your essay for free and unlimited revisions. College essays online work to ensure our clients are satisfied.
Do you have an urgent essay and you don't know what to do? Do you have very little to do your assignments. Visit our online essay writing service for assistance. We have professional essay writers who will take your urgent paper. We have the best turn-around timein the market
If you are looking for a place to find original and plagiarism-free papers, visit collegessaysonline.com. We write your essay from scratch following your instructions. We ensure that every requirement is met, be it quality, delivery time, instructions etc.
24/7 Customer Support
If you have any concern or request, contact us anytime. We have a large team of customer support that are available 24/7. If it's a revision, send the revision file and any additional instructions and we will take care. Do not hesitate, Place an order with us today!
Are you looking for help with an argumentative essay? Do you have difficulties writing an argumentative essay? College essays online is here to help you. We will write a custom essay that meets your requirements. Do not feel overwhelmed, visit our cheap college essay website for professional academic writing help.
Do you need help with a reflection paper? Are you feeling challenged when writing a reflective essay? Are you looking for someone to write my reflection essay help? College essay writers have the answer to your problems. Submit your reflective paper assignment and let our paper writers do the difficult work.
If you are looking for someone to write an award winning scholarship essay, you landed at the right place. Our custom essay writers are professionals and have a 10 year experience. We will write a scholarship paper that will impress the scholarship committee. Hurry to get 25% discount.
Are you looking for a critical analysis essay help? Do you need an online essay writing service to write your critical thinking essay? Visit our college essay website for help. We have professional essay writers who will develop a perfect critical essay for you.
Ethics is a prominent subject in many schools. Professors often ask students to reflect on a topic on ethics and write an essay. This requires a lot of research and knowledge. If you have been assigned an ethical research essay, contact essay writers at college essays online for assistance.
A narrative essay requires a student to tell a story about something. It might be historical or a present narration. This type of essay follows certain rules and instructions. When you face challenges writing a narrative paper, visit our narrative essay writing service.