NRP507 Week 3 | Pharmacology in Health Care - University of Phoenix

NRP507 Advanced Pharmacology Week 3 Assignment Patient Case Study: Diabetes Mellitus, Hypertension, Hyperlipidemia This week you gained insight into diabetes, hypertension, and hyperlipidemia, and now it is time to apply your knowledge to complete a case study focused on a patient returning to review his labs. As clinicians, it is essential to be aware of the two main evidence-based guidelines, the American Diabetes Association® (ADA) and the American Association of Clinical Endocrinologists® (AACE), to help you manage patients. For this assignment, use the ADA evidence-based guidelines to answer the questions within the case study. All rights reserved. Case Study: Diabetes Mellitus, Hypertension, Hyperlipidemia Complete the case study by answering the questions associated with the scenario.

DOB: 2/14/72

George Garcia, a 48-year-old Hispanic male, presents for his 3-month follow-up type-2 diabetes mellitus (T2DM) lab review. He is a long-term patient in your practice. He works as an interstate truck driver, so he admits he doesn’t get a chance to exercise, eats a lot of fast food, and drinks 3 cups of coffee and 2 beers/day. He was diagnosed with T2DM 2 years ago and has maxed out on his metformin, refused to start a statin for “fearing the side effects” despite our discussions at each office visit. He has been taking his meds as prescribed and needs refills on everything. His blood pressure was suboptimal at his last visit 3 months ago and his lisinopril was increased from 20mg to 40mg, and he complains of constant throat clearing and an annoying dry cough. He complained of a mild cough in the past and always attributed it to allergies but states this is not allergies. He verbalizes he wishes he had some ideas on how he could make some health changes but finds it hard with his job. He feels sluggish and has decided he wants to try that medicine for cholesterol we discussed in the past. ROS is negative except for his dry cough The exam is normal except has frequent dry hacky cough during the visit ASCVD 10-year risk assessment is >15%. Eye exam: Current: no retinopathy Foot exam: Current: sensation intact to monofilament PMH: HTN, T2DM, Erectile dysfunction. FH: Father: T2DM, MI Mother: T2DM, obesity Sisters x 2: Obesity

Meds:

metformin XR 1000mg 2 tab with dinner lisinopril 40mg 1-tab daily Viagra® 100mg 1-tab prn Allergies: NKDA

VS: BP 142/90 P 82 R 20 BMI 28

CBC: Normal Case Study DM_HTN_HLP NRP/507 v5 Page 2 of 8 CMP: glucose: 116

GFR: 110

Creatinine: 0.9

BUN: 10

K: 4.0

LFTs: all normal urinary albumin-to-creatinine ratio normal

A1C: 7.5

Lipids: TC: 235 Trigs: 190

HDL: 32

LDL: 180

VLDL: 23

Part I: Hypertension (HTN) Analysis of Blood Pressure Control Using the most current ADA EBP guidelines, answer the following questions.