Question

Comprehensive Case Study on COPD, Heart Failure, Hypertension, and Diabetes Mellitus

M. K. is a 45-year-old female measuring 5'5" and weighing 225 lbs. M. K. has a history of smoking about 22 years along with a poor diet. She has a history of type II diabetes mellitus along with primary hypertension. M. K. has recently been diagnosed with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increased urination at night. Her current medications include Lotensin and Lasix for the hypertension along with Glucophage for the type II diabetes mellitus.

The following are lab findings that are pertinent to this case:

Vitals

BP :158/98 mm Hg

CBC

Hematocrit: 57%

Glycosylated hemoglobin (HbA1c) :7.3 %

Arterial Blood Gas Assessment

PaCO₂ :52 mm Hg

PaO₂: 48 mm Hg

Lipid Panel

Cholesterol: 242 mg/dL

HDL: 32 mg/dL

LDL: 173 mg/dL

Triglycerides: 184 mg/dL

1. summarize the case.

2. What clinical findings correlate with M. K.’s

chronic bronchitis? What type of treatment and recommendations would be appropriate for M. K.’s chronic bronchitis?

3. Which type of heart failure would you suspect with M. K.? Explain the pathogenesis of how this type of heart failure develops. Include an overview of the disease and it's effects in the U.S. population.

4.According to the BP. value, what stage of hypertension is M. K. experiencing? Explain the rationale for the current medications for her hypertension.

5.According to the lipid panel, what other condition is M. K. at risk for? According to this case study, what other medications should be given and why? What additional findings correlate for both hypertension and type II diabetes mellitus?

6. Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function.

7.Provide a conclusion that summarizes your findings and discusses the effects of this disease in the U.S. population.

Answer 1

Answer :

Q. No 1. Answer : summarization of case :

Mrs. M. K is having history of smoking

Poor dietary habits

Primary hypertension

Type ll diabetes mellitus

Chronic bronchitis

At present symptoms includes

* chronic cough with sputum at morning times

* light headedness

* distended neck veins

* excessive peripheral edema

* poly urea.

So, she is having heart and lungs and endocrine problems.

* and client is in respiratory acidosis according to pco2 levels.

* if > 45 mm hg indicates respiratory acidosis. Here client value is 52 mm hg.

Q. No. 2.answer:

Clinical finding correlates with chronic bronchitis includes

* chronic cough and more severe in morning time with sputum

* light headednesa.

And abg analyais.

Treatment for chronic bronchitis :

* for these there is no particular antibiotic treatment.

* for cough advised client to use logenges.

* advice nonsteroidal anti inflammatory drugs .

* analgesics for pain. Ex ibuprofen.

* advice bhronchodilators like theophyllin,

* steam inhalation.

* educate regarding cessation of smoking.

* self remidies like salt water gargling and take lemmon with honey warm water.

Q. No. 3. Answer :

Congestive heart failure we can suspect because here client is having distended neck veins and excessive peripheral edema.

Pathogenesis :

Reminder angeotensin system may control the heart failure.

Due to alteration in this peripheral vaso constriction.

* so that increases the fluid load

* decreased the cardiac output.

* distention of jugular vein.

In us population sedentary life style and dietary habits may cause for this.

Q. No. 4.answer:

It is stage l hypertension.

Because 140- 159 systolic and 90-99 diastolic consider as stage l hypertension. So here client value is 158/ 98 mm of hg.

* at present she is using lotensin and lasix.

1. lotensin :

It inhibit the Angio tensin converting enzyme.

* so it causes the blood vessels to tighten.

* and lower the blood pressure

* then increases blood supply to the heart.

2. Lasix : it act like diuretic so, increases urine output and decreases the edema.

* it blocks the absorpton of sodium, chloride and water.

* so reduces the retention of fluids.

Q. No 5.answer: some other heart problems may come. Like coronary artery diseases and artherosclerosis.

By eating healthy foods and avoiding fatty diet and alcohol and by maintaining normal BMI they can maintain normal health.

Q. No 6. Answer :

HbA1C is up to 6 is normal.

* here client having 7.3 %.

* diabetic symptoms may increases and complications may occurs like diabetic neuropathy, nephropathy, retenopathy.

Q. No. 7. So, because of bad habits like alcoholism and smoking, sedentary life style, and unhealthy eating habits leads to these all disorders may come.