Diabetic Case study Jack a 47-year-old white male presents to your… Diabetic Case studyJa

Diabetic Case study Jack a 47-year-old white male presents to your… Diabetic Case studyJack a 47-year-old white male presents to your office for a follow-up visit. He was seen 2 weeks ago for an upper respiratory infection and noted incidentally to have a blood pressure of 164/98. He vaguely remembered told in the past that his B/P was “borderline”. Labs were also done last visit and you are going over the results with him today. He brings his B/P diary in and it is showing elevated pressures from 144/94 to 176/96Today: V/S: Right arm: 172/98; Left arm: 170/96; P 76; resp 16; 70 inches tall weighs 210 BMI 29DOB: 3-12-7Labs from last week: CBC normal; CMP normal; A1C 7.4; TSH normal; Lipids:Total cholesterol is 250; LDL is 190; HDL 35; Trigs 170He feels fine, has no complaints.PMHBroken arm at age 12.Hernia repair 10 years agoNo eye examination for about 1.5 yearsMeds: zeroAllergies: NKDAFam hx:Father died of stroke at age 69; diabeticMother alive at age 69 with HTN, DM2 sisters ages 45 and 43; the older sister has DMSocial hx: Married. Son age 22 and daughter 20 both healthy. Sedentary job (Accountant) does not exercise. Smokes 1ppd for 10 years. Has “a couple of beers every weekend”ROS:Unremarkable except for abovePhysical examinationNo thyromegaly or lymphadenopathyFundoscopic exam reveals narrowing of the arteries, arteriovenous nicking, and flame-shaped hemorrhages with cotton wool exudates.Cardiac exam: PMI is displaced 2 cm left of midclavicular line. S1 and S2 are normal and no murmurs are auscultatedLung and abdominal examinations are normal.                                                  EKG shows nonspecific T wave changes; no acute ischemic changesAssessmentStage 2 HTNObesityDM type 2HyperlipidemiaTobacco abuse Should plug data in cardiac risk into ASCVD risk calculator: https://tools.acc.org/ASCVD-Risk-Estimator-Plus- use today’s b/p; he now has past hx of diabetes; go to view adviceSee AACE/ACE Guidelines posted in the readings in Module 6 What is the treatment plan for Jack today?  Must use evidence-based reference with citations on all questionsPharmacologic? This should include any OTC medicationsUse blank prescription document to write prescriptions for your pharmacologic treatmentsNonpharmacologic? This should also include any patient educationFollow up and Referral   Health Science Science Nursing NURS 5334 Share QuestionEmailCopy link Comments (0)

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