Question

NURS-60506: Module 2 Case Study Miller is a 44 year old female coming to your office to establish care with you bec h amedsa physical for work She has not seen a health care provider in "about 6 years 5: Denies any complaints Past Medical History: HTN 2014 Past Surgical History: Tonsillectomy, age 7 Family History: Father, 74; Alive: Mi at age 50, HTN Mother, 72; Alive: HTN, OM Grandmother, deceased at age 82: Breast Cancer diagnosed at age 80 Grandfather, deceased at age 51 from Colon Cancer Otherwise negative Social History: Smokes 1/2 PPD for 20 years Drinks 1-3 glasses of wine per week Denies illicit drug use Works as a receptionist at a local factory No regular exercise Does not watch what she eats Medications: HCTZ 50mg daily Allergies: NKDA ROS: Negative O: BP 162/98 Temp 98.2 Pulse 88 Resp 20 BMI 39% LMP: 2 weeks ago Assessment unremarkable 1. Based on the above, what bloodwork would you order for her and why? (7.5 points) 2. Based on the above, what diagnostic or screening tests would you suggest and why? (7.5 points) 3. What patient education is important for you to discuss with her? (5 points)

Answer 1

1.Some of the blood works which can be done for the patient are

• Cardiac profile :as patient is a known case of hypertension and on medications to rule out any changes in the cardiovascular disaese
• A comprehensive metabolic profile to assess risk for any diabetes and other medical conditions
• Serum electrolyte level as the drug HCTZ can lead to hyponatremia

2.Some of the screening or diagnostic test which can be suggested are

• ECG,2 D Echo to assess heart
• Mammogram to assess risk of any breast cancer
• Ultrasound abdomen to rule out any abnormalities in the abdomen
• Chest x Ray to rule out any respiratory active or past infections
• Urine routine test
• Urine pregnancy test as a part of physicals

3.The most important patient education to be discussed here are

• To maintain a normal blood pressure range to avoid long term complications
• To undergo a weight reduction program as she is morbidly obese and puts her at high risk for many disease related to cardiovascular, diabetes ,stroke,
• To strictly adhere to diet and exercise in daily life