Question

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

For your signature assignment, compose a 3- to 4-page case analysis, written in APA format with a title page and at least 3 references, with one non-Internet reference. Organize your analysis with headings that thoroughly answer the following prompts. Support your opinions with evidence from your readings and research. Review the rubric for complete grading criteria.

In your introduction, summarize the case.

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?

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.

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

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?

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

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

Answer 1

1.M.K is a 45 year old female is diagnosed with chronic brochitis and she is admitted in the hospital.In the physical measurements she is of 5.5 feet in height and she is weighing of 102 kg,and her B.P is about 158/98 mm Hg.Presently she is showing the clinical symptoms such as chronic cough with sputum mainly in morning,light headedness,distended neck veins,excessive peripheral edema and increased urination at night.In the lab studies her Hematocrit is 57%.HbA1c is 7.3%,in the ABG her PaCO₂ is 52mmHg and PaO₂ level is 48mmHg.In the lipid profile her cholestrol level is 242mg/dl,HDL is 32mg/dl,LDL level is 173mg/dl,triglycrides level is 184mg/dl.Her present medications are Lotensin and Lasix for the Hypertension and Glucophage for type II DM

2.Here M.K has a history of smoking about 22 years and presently she is showing the symptom of chronic cough,more severe in the morning with sputum.

If she is disturbed her sleep with cough during night we can try a cough suppresants during bed time.

Pulmonary rehabilitation (is a breathing exercise program) improves the breathing and overall well being

Education of the patient regarding the improvement in life style such as cessation of smoking.

Promote the physical activity of the patients strengthen the muscle that helps in breathing

3.We can suspect a congestive heart failure.Here the hear muscles or the myocardium doesnot pump to eject the blood from the heart to different parts of the body for its appropriate function.High blood pressure,coronaory artery disease,diabetes,and obesity are the worst conditions that results in heart failure.

Heart failure is a condition that results,when heart is unable to provide sufficient blood flow to meet metabolic requirements thus results in impaired venous return leads to peipheral edema etc.

Heart failure is a common condition that affects over 5 million people in the United States.

4.The normal bood pressure for an helthy human is 120/80 mm Hg.Here M.K blood pressure is about 158/98 mm Hg.Its a severe form of hypertension ,ie, Stage 2 Hypertension where systolic pressure is 140mm Hg or higher and the diassstolic pressure is 90mm Hg or higher.

Her present medications are lotensin and lasix.

Here lotensin (Benazepril) is using to manage her blood pressure,avoid heart attacks and complications of diabetes(frequent urination)

Lasix is also called as furosemide used to treat hypertension and is a potent diuretic used to treat peripheral edema and prevent heart attack.

5.According to her lipid panel her total cholestrol is showing high and the normal is less than 200,and the LDL cholestrol(bad Cholestrol) is showing the level of 173and the normal is less than 129 and HDL(good cholestol) is showing less that is 32 instead of more than 40mg/dl.triglyceride level is 184 and the normal should be less than 150mg/dl.These abnormal readings shows that she is risk for heart disease,heart attack and strokes.

We can iclude statins to her medication why because it are usually effective and well tolerated,and a most commonly prescribed drug to lower cholestol

In the people who having diabetes and type II diabetes are having the symptoms such as obesity,headedness and urination problems

Type II diabetes and hypertension increases the chance of developing other diabetes related diseases such as kidney disease and retinopathy

6.Here the M.K HbA1c shows that 7.3%,that shows that she is having chronic diabetes of Type II.The normal range of HbA1c is between 4 - 5.6%.This study tells the average blood sugar level over the past 2 to 3 months

7.We discussed regarding the case study of M.K with COPD,Heart disease and diabetes type II.Most of the populations in the U.S are suffered with these three conditions due to the unhealthy life styles and unhealthy eating habits and lack of exercise.Through the education regardin the improvement in the life style modifications such as cessation of smoking,follow healthy eating habits along with regular exercise promotes the health and well being of the individual with a a life free from disease and promotes the well being.Most of the research studies proven that .proper exercse is a management tool in most of the population with cardiology,pulmonology and endocrinology diseases along with following of healthy eating habits and healthy life styles to manage most of these conditions.