Question

2. A 62-year-old woman has been diagnosed with hyperlipidemia. Her total cholesterol, LDL cholesterol and triglycerides are significantly elevated. She has been trying diet and exercise for the last 6 months but her lipid levels remain elevated. Her family medical history is significant for both parents dying of cardiac disease and her brother age, 60 has just had an MI. She has also been diagnosed with atherosclerosis with moderate plaques noted in her right carotid artery.

a. What will you order including any diagnostic tests labs?

b. What are the guidelines you need to give her to prevent complications or adverse effects?  

c. Discuss pathophysiology of the disease or physiology of the organism that the drug(s) are addressing.

d. Rationales for using the specific orders, emphasize the APRN role in the assessment, diagnosis, and pharmacological interventions of clients. e. Indications, contraindications of the drug(s)

f. List the prices of three drugs to treat the selected problem from two different pharmacies.

g. Describe in detail the instructions the patient should receive for the selected drug(s). Write this at a fifth-grade level.

Answer 1

a, Diagnostic test labs include cholesterol screening, blood sugar test, ECHO, ECG, chest X-ray, CT scan, Doppler ultrasound, and stress test. these tests find the narrowed, hardened arteries and risk associated with atherosclerosis.
b, To prevent complications patient should follow less saturated fat and cholesterol and avoid fatty foods.
encourage patients to eat healthy fat and doing moderate exercise every week.
avoiding alcohol, smoking, and follow-up with a healthy lifestyle prevent plaque deposition.
c, Pathophysiology of atherosclerosis include accumulation of lipoprotein in the arteries that cause hardening of arteries by plaque buildup. this causes hardening, scarring, and inflammation of the artery that leads to stenosis, calcification, and thrombosis. Atherosclerosis has two parts that are atherosis that accumulation of fat along with several macrophages and sclerosis that smooth muscle cells, leukocytes and connective tissue composed with fibrosis layer. fibrinogen and CRP can cause extravascular inflammation that bound the microorganism phosphocholine and reinforces phagocytosis and joint with damaged foreign cells by macrophages that cause receptors for CRP. Monocytes, SMC and T are causing atherosclerosis plaques and produce IL-6, complete factors, cytokines, CRP. CRP is a plasma protein that affects the endothelial cells that cause cellular modulation and lipid accumulation.
d, APRN role in atherosclerosis assessment includes special knowledge and skills applied in this process by collecting history and making complete physical examination and detecting early symptoms of heart failure. they work with the physician and make direct work with patients under physician supervision. pharmacological intervention includes antiplatelet therapy, anticholesterol therapy, beta-blockers, and ACE inhibitors and diuretics are a common choice for the patient. APRN role in teaching patients with followup needs regular checkups and adherence.