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A Case Study Regarding Cardiology and Endocrine (Essay Sample)

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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.

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Content:


Cardiology/Endocrine Case Study
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Cardiology/Endocrine Case Study
Healthcare professionals in various healthcare institutions are responsible for offering customers high-quality, safe, and evidence-based treatment. Healthcare professionals might have a precise test and, as a result, create a care plan that thoroughly addresses the fundamental healthcare issue with a proper assessment of a person's objective and subjective data. When Jose comes in for a follow-up exam, the healthcare experts must evaluate him to learn more about his health. Even though accurate data is short and to the point, it is essential to use objective and subjective data. Regarding Jose, the article focuses on the patient's condition, the pathophysiology of diabetes and hypertension, recommendations for dyslipidemia care, causes elevating cardiovascular disease risk, the effects of obesity, and the question of medicines.
Diagnoses of the patient.
Obesity and diabetes.
To aid in the diagnostic process, Jose provides diverse health-related facts. Another nursing diagnosis is a diabetes-related electrolyte and fluid imbalance as shown by glucose 500 and K+ 4. A glucose level of 500 has been determined for Jose, which is substantially higher than the usual range. Nanda (2012) notes his impaired eyesight and excessive urination as other signs of diabetes. Uncontrolled weight growth (obesity) is a second diagnosis, as demonstrated by Jose's 294-pound bodyweight and 64-inch waistline CITATION Rob21 \l 1033 (Robinson, 2021). The client is obese because of his large waist and weight. An obese individual has a waist circumference of more than 37 inches in males and 31.5 inches in females. People who have rims greater than this are regarded to have obesity-related medical issues.
Dyslipidemia and Hypertension
Poor circulation is the third diagnosis, as shown by severe headaches, tiredness, and dizziness in addition to the high heart rate (176/104) CITATION Kuw18 \l 1033 (Kuwabara, 2018). Even though Jose might not even be aware that he has hypertension due to its slow onset, they may suffer from weariness, a headache, chest discomfort, heart problems, and breathing issues. On top of his family history, Jose has a blood pressure of 182/104 and headache and tiredness, all of which are signs of high blood pressure. In this case, the total cholesterol was 368 mg/dL, blood pressure was 176/104, and increased density lipoprotein (38) was less than 40 mg/dL.
Coronary Heart Disease and Depression.
Symptoms of depression include weight increase over time, financial difficulties, and being unemployed. Because Jose has seven children, and his wife is on the verge of expecting another, his stress rates rise. In addition, he has been sacked, and he is depressed about his financial situation. Heart disease-related atherosclerosis is shown by high cholesterol, hypertension, and diabetes. There is a risk factor for cardiovascular disease in the patient's 368 mg/dL cholesterol, excessive sugar levels, and hypertension.
Knowledge Deficit and Substance Abuse
Alcohol addiction results in poor health habits, as indicated by the weekly intake of at least six cans of beer. Despite his health, Jose continues to drink alcohol, which is a significant cause of heart disease. Lack of information about healthy lifestyles is linked to a knowledge gap, as demonstrated by less physical activities, inadequate rest time, and bad eating habits CITATION Kli17 \l 1033 (Klimas, 2017).
Pathophysiology of the Top Three Diagnoses.
Diabetes Pathophysiology
Diabetes type 2 is a blood glucose disorder characterized by high or low blood sugar levels. Insulin resistance causes an increase in pro-inflammatory cytokines and fatty acids in the blood, resulting in a reduction in glucose delivery to the body's cells CITATION Cor18 \l 1033 (Corbin, 2018). Insufficient insulin production and insulin resistance cause diabetes. Many variables play diverse roles in type 2 diabetes, all of which contribute to the disease's progression. Beta-cell malfunction can happen early on in the pathogenic process. Insulin production is decreased because of malfunction. Insulin resistance arises from glycemic control simultaneously and later, and fasting hyperglycemia occurs as suppressed. Elevated glucagon levels follow glucose intolerance in insulin resistance development. Individuals get diabetes after they become resistant to insulin and their beta cells malfunction, preventing insulin production. The initiation and progression of diabetes comorbidities, such as heart disease risk and cognitive impairment, is the final stage of the disease's progression.
Pathophysiology of Obesity
Obesity involves a variety of pathophysiological causes, and it can be hypercellular and hypertrophic. Hypertrophic obesity is a kind of abdominal obesity that is marked by increased fat cells in androids. This kind of obesity affects overweight persons like children, whereas hypertrophic obesity develops in adults and responds swiftly to weight loss treatments. Obesity is a condition that develops over time when a person begins to acquire weight and eventually becomes obese. Poor diet, hormonal influences on hunger, an individual's biological combinations, and other variables such as stress are all significant causes of obesity CITATION Zha18 \l 1033 (Zhang, 2018). Individual satiety factors, such as leptin, are thought to mutate, resulting in the fat phenotype. Pepin influences a person's appetite due to its action on the nervous system. The hypothalamus, which governs food intake and energy utilization in the body, is affected. Numerous stages of growth occur when one's eating habits are not under control. It is believed that being overweight is the initial step of obesity pathogenesis. BMI of 25 to 29.9 kg/m2 is considered overweight. Obesity at low risk is described as a BMI of 30 to 34.9, following by medium obesity, characterized as a BMI of 35.0-39.9. An individual with a BMI of 40.0 or higher is considered obese.
Pathophysiology of Dyslipidemia
Dyslipidemia is defined by abnormally high levels of lipids in the bloodstream. The condition is caused by various factors, including food, lifestyle, and elevated insulin levels, to name just a few of them. Among other diseases, insulin resistance has been linked to dyslipidemia and hypertension. According to research, people with metabolic syndrome are at an increased risk of getting dyslipidemia and insulin resistance CITATION Cha18 \l 1033 (Chaudhury, 2018). It's a pathophysiological condition caused by either environmental or hereditary factors or a combination of both. It's a pathophysiological condition caused by either environmental or genetic factors or a combination of both. Well-recognized lifestyle variables that contribute to dyslipidemia include physical activity and food choices. LDL cholesterol and triglycerides are higher in people with dyslipidemia.
Diabetes Management Guidelines.
Diabetes is a disease that requires extraordinary treatment measures to ensure the patient's wellbeing. Drugs are used to treat diabetes, as well as lifestyle changes CITATION Cor18 \l 1033 (Corbin, 2018). According to his client, Jose has high blood glucose levels, which may be due to insulin resistance or a lack of insulin synthesis in the body, resulting in higher blood sugar levels. Using short-acting, quick, intermediate-acting, and long-lasting insulin is critical to lowering blood sugar levels and preventing complications from diabetes. Jose's lifestyle may be changed to include physical activity, a healthier diet, and complete abstinence from alcohol. The usage of Humulin N and Novolin N might have a favorable influence on Jose's health because he has an insulin deficiency. You may find them both under the trade names of intermediate-acting insulin (insulin NPH), which lasts much longer than natural insulin (insulin A). Drug lowers blood glucose by ensuring that blood sugar is absorbed consistently from the veins and arteries into the body, thereby regulating or at least reducing the person's blood glucose level. Insulin levels in the body are raised after an injection, enhancing the absorption of carbohydrates from blood sugar levels. Jose may be able to produce more insulin if he is given a DPP-4 inhibitor instead of insulin. Jose might be administered a medication like alogliptin-metformin to help lower his glucose levels without inducing hypoglycemia. Due to the body's insulin production, low blood glucose is not feasible.
Hypertension Management Guidelines
A leading cause of stroke, kidney failure, and myocardial infarction, hypertension is among the most important avoidable causes of mortality and other illnesses in the United States. Pharmacological therapy is recommended for persons aged 60 and older to decrease their blood pressure (BP) to 150/90 mmHg. If you're between 30 to 59 years of age, you should begin pharmacological therapy to decrease your distal blood pressure to 90 millimeters of mercury (mmHg). CCB, ACEI, ARB, and a thiazide-type diuretic are useful for treating hypertension in non-black individuals. In contrast, thiazide-type diuretics are essential for treating hypertension in the overall population over 18.
Clients with hypertension might be prescribed a variety of medicines by their healthcare professionals. Jose's best bet is thiazide-type diuretics, which may be taken as monotherapy to treat his condition. Hypertension is treated explicitly with chlorthalidone (Hygroton). Benzothiadiazine is not always included in thiazides, although the medicatio...

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