Cardiovascular Disorders Describe a Wide Range of Heart .

 

According to the CDC, 32.5% of people in the United States have hypertension, and 3.7 million patients have a diagnosis of essential hypertension (CDC/National Center for Health Statistics: http://www.cdc.gov/nchs/fastats/hypertension.htm [accessed March 26, 2016]). Hypertension is frequently managed in primary care, and its sequelae can be life altering for patients. Patients with hypertension may have other comorbid conditions, including diabetes, hyperlipidemia, and obesity.Cardiovascular Disorders Describe a Wide Range of Heart

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For this assignment, you must choose from one of the following patients and develop a treatment plan that addresses your chosen individual’s issue in total, which will help to optimize her or his health.

Case #1: A 46-year-old African American female with long-standing blood pressure of 180/110, treated intermittently because of insurance issues. The patient also has type 2 diabetes and a BMI of 27. She currently is employed and has a PPO. Her last blood pressure medication was HCTZ and she tolerated it well, but her blood pressure has never been lower than 170/80.Cardiovascular Disorders Describe a Wide Range of Heart .

Case #2: A 69-year-old Caucasian female with history of MI 20 years ago, currently on metoprolol and Norvasc. Her blood pressure readings on her last several visits have been 155–170/70–90 with a heart rate of 70–90. She has no chest pain. Her other medications are ASA 325mg, Prilosec 20mg, Lipitor 20mg, and Tylenol prn. She has a history of high cholesterol, and her lipid profile has been normal for the past 2 years.Cardiovascular Disorders Describe a Wide Range of Heart .

Case #3: A 59-year-old Hispanic male with type 2 diabetes on metformin 1000mg, Amaryl 4mg, Lipitor 40mg, lisinopril/Hctz 40/25, and Tricor. His last A1C was 12, and his current blood pressure is 170/88. Office urine microalbumin 100ug/mg.

Case #4: A 39-year-old Hispanic female with headaches for the past two weeks. She is new to you, but she has been to the office 3 times in the past 4 weeks. Your partner put her on HCTZ for a blood pressure of 188/90. Today, her blood pressure is 180/74, and her heart rate is 90. She continues to have headaches. Her lab work had the following abnormalities: Her lipid profile shows total cholesterol of 325, HDL of 30, LDL of 78, and triglycerides 322, A1C 8, and BMI of 33.

To prepare:
Review the chapter that discusses rational drug selection, diabetes mellitus, hyperlipidemia, and hypertension in the text (Woo & Robinson).
Consider the medications that are used for patients with diseases outlined in the patient problems listed above, taking into consideration age, gender, and culture.
Think about the pathophysiology of comorbid diseases.

To complete:
Write a minimum 4-page paper in APA format (excluding cover page and references) that addresses the following:

Briefly describe the disease processes of your chosen patient.

Describe the approach to the pharmacological treatment plan for the patient that should optimize this patient’s health.

Describe your optimal goal for your chosen patient and discuss the national guidelines that support your goals.

Describe the potential pharmacological interactions of your chosen plan and the education necessary for the patient in regards to these potential interactions.

Describe the interdisciplinary team that might be involved in the care of the patient and how working collaboratively as a team affects patient outcomes.

Discuss the nonpharmacological educational needs for this patient.
Discuss the health maintenance needs for this patient to maintain optimized health.Cardiovascular Disorders Describe a Wide Range of Heart .

Include four or more appropriate scholarly sources from the last five years throughout the paper.

Cardiovascular disorders describe a wide range of heart and circulatory system problems. These disorders are acquired over time or congenital and are believed to kill approximately 954,000 people every year. Hypertension is one of the cardiovascular abnormalities affecting about 32.5% of the United States population (CDC, 2017). It results in severe complications and heart risks which often causes deaths and strokes. The illness is comorbid with obesity, hyperlipidemia and diabetes and hence it is a notable health concern. This paper seeks to develop a treatment plan that addresses the patient in case #4 as described below.
“Case #4: A 39-year-old Hispanic female with headaches for the past two weeks. She is new to you, but she has been to the office 3 times in the past 4 weeks. Your partner put her on HCTZ for a blood pressure of 188/90. Today, her blood pressure is 180/74, and her heart rate is 90. She continues to have headaches. Her lab work had the following abnormalities: Her lipid profile shows total cholesterol of 325, HDL of 30, LDL of 78, and triglycerides 322, A1C 8, and BMI of 33.”
The client is suffering from hypertension comorbid with obesity, hyperlipidemia and type 2 diabetes. This is evident in her lab results and the HCTZ findings. The normal blood pressure for a healthy person is below 120/80. However, the client presents a blood pressure of 188/90 which is extremely high and poses dangers to the blood vessels. There is a probability of leaking blood from the vessels to the organs causing the blood-brain barrier that consequently results constant headaches reported by the client.Cardiovascular Disorders Describe a Wide Range of Heart .
Hyperlipidemia signals the presence of increased concentrations of lipids in the body. These include cholesterol and triglycerides whose deposits accumulate in the arteries causing their blockage this in turn increases the blood pressure of an individual due to the narrowing of the blood vessels. In this case, the client’s tests show borderline high cholesterol levels of 325 mg/dL. The normal levels of cholesterol in an healthy patient are usually below 200mg/dL. The client is also obese with a BMI of 33 and manifests evidence of type 2 diabetes from A1C above 8. Any recording of above 6.5 indicates the presence of diabetes which is occasionally comorbid with obesity. These conditions increase the risk of having multiple cardiovascular disorders in the client.
Moreover, the patient has a high level of triglycerides of 322 milligrams per deciliter compared to the normal levels considered to be below 150 mg/dL. This elevated level risks the presence of heart diseases and can also signal metabolic syndrome. The LDL levels of the client are within the normal range of below 100 while the HDL readings are relatively low. The normal level for women adults’ ranges from35 to 80 mg/dL and therefore, this amount of good cholesterol suggest the risk of coronary heart disease.Cardiovascular Disorders Describe a Wide Range of Heart .
Pharmacological treatment plan
Aspirin thins the blood thus preventing the occurrence of clits which disrupt the blood flow to the brain causing headaches in the client. In this case, it is effective for the treatment. More so, Cholesterol-modifying medications help to reduce LDL levels and increase the HDL levels to prevent the deposition of cholesterol on the wall of the arteries. These drugs include bile acid sequestrates, fibrates, niacin and, statins. On the other hand, beta blockers will decrease the blood pressure and heart's demand for oxygen thus slowing down the heart rate. Notably, Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can be administered to the patient to alleviate the coronary artery disease progression as well as reduce the blood pressure (McManus & Mant, 2018).Cardiovascular Disorders Describe a Wide Range of Heart .
Optimal goal for the patient, national guidelines supporting the goals
The optimal goal of the treatment plan for the client is to reduce the blood pressure, manage the levels of cholesterol, alleviate the suffering and manage the clients BMI. The national guidelines classify the client’s condition as hypertensive urgency where the anxiety and r intensify antihypertensive drug therapy is given. The management of lifestyle facilitates the treatment of obesity with 90 to 150 minutes of physical exercise that guarantees a reduction of 1mmHg for every one kilogram of weight lost. The national guidelines also propose the use of thiazide diuretics, CCBs, and ACE inhibitors or ARBs for initial first line therapy of the patient. Moreover, the goal of diabetes management is to drop the levels to <130/80 mm Hg according to the 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (Rubenfire, 2018). I will therefore develop a current, detailed and clear evidence-based treatment plan that reflects the national and self-management goals of the patient’s disease.
Potential pharmacological interactions of the planand necessary education
Drug interactions undermine the treatment of patients. it defines the reaction of drugs with other drugs as well as drugs with different food supplements. In this case, the patient will be educated on the potential pharmacological interactions present in their treatment plan to ensure their safety. This will minimize adverse side effects and optimize the outcomes.
Interdisciplinary teams involved in care of the patient and the importance
The management of cardiovascular diseases demands interdisciplinary collaboration of experts from different fields. This helps in providing skills and knowledge essential in improving the patient’s outcomes. In this case, collaboration between the pharmacists and the nurse is essential. It helps increase patient satisfaction and trust through the reduction of cost and time of recovery. Additionally, this will prevent miscommunications which result in medical errors thus risking the client’s safety (Gobis et al., 2018). With effective team-work, the client will be more willing to take medical advice to optimize pharmacotherapy outcomes.Cardiovascular Disorders Describe a Wide Range of Heart .
Nonpharmacological educational needs for this patient
The patent needs to be educated on the effects of obesity on their health and as well trained on how to initiate their weight loss through healthy physical exercises. Moreover, diet restrictions should be taught including the intake of potassium, and sodium supplements in food. The consumption of low saturated and sodium levels in the diet with increased use of vegetables, fruits and grains also lowers the systolic blood pressure by about 11mgHg.
Health maintenance needs for this patient to maintain optimized health
The patient will require constant screening to monitor the recovery status. Moreover, they will require follow up through appointments as well as lifestyle and diet changes. This will involve undertaking intense physical exercise with the aim of reducing their BMI from 33 to the normal range of between 18 and 24.9. Modification of diet will ensure weight loss, prevent blockage of arteries and enhance the smooth flow of blood under normal pressure. Medicines will also be necessary to alleviate the symptoms, prevent blood clotting and dilate the blood vessels to reduce pressure.Cardiovascular Disorders Describe a Wide Range of Heart .