Question

Signature Assignment: Case Study 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 Ibs. M. K has a history of smoking about 22 years along with a poor diet. She has a history of type hypertension. M. K. has recently been di 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 following are lab findings that are pertinent to this case with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, The Vitals BP 158/98 mm Hg CBC 57% Hematocrit 73% Glycosylated hemoglobin (HbA1d) Arterial Blood Gas Assessment Paco PaO. 52 mm Hg 48 mm Hg Lipid Panel 242 mg/dL 32 mg/dL 173 mg/dl 184 mg/dL HDL LDL Triglycerides nces, with one non-Internet reference. Organize your analysis

Answer 1

1. Summary of the case :

M.K. is a 45year old female ,measuring weight 225 lbs ,height 5'5 inch . She has history of smoking for the past 22yeras and eating unhealthy diet . She has primary hypertension ,type 2 diabetes mellitus and is presented with signs and symptoms of chronic bronchitis . For hypertension she is taking Lasix and lontesin and for diabetes she is taking glucophage .

2. Signs and symptoms of chronic bronchitis are :-

- Chronic cough with sputum in the morning

- PO2 = 48%

- PCO2 = 52%

Type of treatment and recommendations for M.K are :-

- Bronchodilators

- antibiotics

- cough medications

- Corticosteroids ( after having view of its interaction with diabetes )

- cessation of smoking

- avoiding lung irritants

- use of a humidifier

- use of a face mask outside

3. The type of heart failure M.K is having is left side heart failure as it is indicated by lightheadedness , dizziness , distended neck veins , peripheral edema and increased urination at night , chronic cough with sputum . It's pathophysiology :-

heart unable to pump sufficient blood-

SNS response increases HR= decrease efficiency, impede filling, cardiac muscles get larger & walls of ventricles thicker

one side of heart fails first followed by other

R side: pulmonary valve stenosis, pulmonary disease

L side: infarction in left ventricle, hypertension

cardiac output/stroke volume decreases

backflow congestion: output of blood < input of blood

4. M.K is having stage 2 hypertension -mild hypertension from 140/90mmhg to 159/99 mmHg . The medications Lasix and lontesin is given for hypertension

Action of Lasix - it is a diuretic agent ,it acts by inhibiting the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle, by binding to the chloride transport channel, thus causing sodium, chloride, and potassium loss in urine. It's used in this case due to fluid retention caused by heart failure .

Action of Lontesin ( benazepril) -it is an ACE inhibitor and works by relaxing the blood vessels so that blood can flow more easily.