Nsg 482 Pathophysiologic And Pharmacological Evidence Based Nursing Care Research Paper
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Management of Hyperlipidemia and Hypertension
1. The patient was diagnosed with Hyperlipidemia and Hypertension as revealed by the significant findings drawn from patient’s subjective and objective health assessment.
Hypertension is defined as a medical condition concerning the abnormal elevation of an individual’s blood pressure (Kaplan & Ronald, 2014). As far as subjective data are concerned, the patient’s family history predisposed the patient to hypertension. Since both patient’s parents had a history of hypertension it, makes the patient at risk for the same condition (Skarfors, Lithell, & Selinus, 1991). After computation of patient’s BMI, it also revealed that the patient is obese at 40.4 BMI. According to studies, at least 2/3 of the overall cases of hypertension are obese thereby creating a strong correlation between the two variables (Krause, Winston, Fletcher, & Grundy, 1998). The patient is also a smoker, regular alcohol drinker and indulge in oily foods that are a risk factor for hypertension. Patient’s BP reveals elevated blood pressure at 166/98mmHg which can be interpreted as Stage 2 hypertension for the systolic. Interpretation of Stage 1 hypertension for the diastolic indicates the patient is also at a higher risk for cardiovascular disease because of his age (American Heart Association, 2015). Dyslipidemia, on the other hand, is the abnormal number of lipids present in the blood (Fredrickson & Lees, 1965). Indicative of patient’s pathophysiologic cause of dyslipidemia is patient’s diet being comprised mostly of fast foods and take-outs. Patient also lacks physical activities and exercise which does not facilitate for the burning of fats in the body. The laboratory findings indicated by the patient’s TC or total cholesterol was at 314 mg/dL can be interpreted as is elevated which places the patient at higher risk of heart disease. Triglyceride was at 199 which means is borderline high cholesterol. High Density Lipoproteins (HDL) was at 48 which is a good number or indicates to be within normal range (Cassoobhoy, 2014). Finally, Low Density Lipoproteins (LDL) was recorded at 180 which means is also considered high making the patient at risk for many cardiovascular illnesses (Cassoobhoy, 2014).
2. Patient was prescribed with Hydrodiuril, 12.5 mg and 10 mg of Atorvastatin taken orally, once daily. Hydrodiuril is diuretic. A diuretic allows the body to eliminate the excess water in the body (Cerner Multum, Inc., 2012). In addition, it also helps promote urine production by deterring salt absorption into the body that triggers water production and water retention (Mutschler, 1995). As a result, this helps lower the blood pressure helping the heart pump easier. Atorvastatin is a medication prescribed to the patient with elevated cholesterol level. This drug help prevents stroke and the risk of a heart attack. It also lessens and decreases the number of fatty substances and the high amount of cholesterol in the blood. Atorvastatin is classified as an HMG-CoA reductase inhibitors. Statins function by decreasing the production of cholesterol production to lessen the buildup of cholesterol in the arterial wall that could block blood circulation to the heart and brain (American Society of Health-System Pharmacists, Inc., 2014).
3. Base on the computation of the patient’s 10 year atherosclerotic cardiovascular disease (ASCVD) risk, it revealed that given the interventions prescribed for the patient, there had been a significant decrease in the risks identified as associated with the findings documented from the patient’s subjective and objective physical assessment. Recorded at 34.2, the 10 year atherosclerotic cardiovascular disease (ASCVD) risk of the patient is significantly decreased as when the patient is not under any treatment. Nevertheless, patient's lifetime ASCVD risk was recorded at 69.0. However, the lifestyle modification plan while insufficiently discussed and was only classified as Therapeutic Lifestyle Changes (TLC). For a health professional this may be clear, but for a patient this description might be miscommunicated. However, the prescribed medication might require constant monitoring and increasing the dose might be necessary depending on the patient’s response to the drug and dosage given.
4. If the patient would not abide by the therapeutic plan and the lifestyle modification guidelines prescribed specifically for his condition, this could potentially lead to the development of cardiovascular disease. In addition, if the patient pursues his present diet and no physical exercise, the fat buildup in the patient’s artery walls could amass thereby risking the patient for stroke or heart attack. This will also happen if the patient does not take Atorvastatin.
5. According to studies, the harmful effect of smoking is associated with the over activity of the sympathetic nervous. As a result this will increase the oxygen consumption of the myocardium which causes the blood pressure to rise same with the heart rate and the contractility of the myocardium . In another study relating smoking and alcohol to dyslipidemia, it reveals that smoking tends to lower the HDL and increase triglycerides and LDL . On the other hand, while alcohol consumption is believed to do well for the heart, the American Heart Association cautioned people that it has to be done in moderation. Similar with smoking, excessive alcoholism could increase the level of triglycerides found in the bloodstream .
American Heart Association. (2015, January 18). Understanding Blood Pressure Readings. Retrieved from American Heart Association Website: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp
American Society of Health-System Pharmacists, Inc. (2014, September 15). Atorvastatin. Retrieved from The National Institute of Medicine: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a600045.html
Cassoobhoy, A. (2014, March 25). Understanding Your Cholesterol Test Results. Retrieved from WebMD Website: http://www.webmd.com/cholesterol-management/cholesterol-tests-understand-your-results?page=2#1
Cerner Multum, Inc. (2012, March 5). HydroDIURIL. Retrieved from Drugs.com: http://www.drugs.com/mtm/hydrodiuril.html
Fredrickson, D., & Lees, R. (1965). A system for phenotyping hyperlipoproteinemia. Circulation, 321-327.
Kaplan, N. (2014, February 5). Smoking and Hypertension. Retrieved from Wolters Kluwer Health website: http://www.uptodate.com/contents/smoking-and-hypertension
Kaplan, N., & Ronald, V. (2014). Kaplan's Clinical Hypertension. Philadelphia: Lippincott Williams & Wilkins.
Krause, R., Winston, M., Fletcher, B., & Grundy, S. (1998). Obesity. Impact on cardiovascular disease. Circulation, 1472–1476.
Mutschler, E. (1995). Drug actions: basic principles and therapeutic aspects. Stuttgart, German: Medpharm Scientific Publication.
Skarfors, E. T., Lithell, H. O., & Selinus, I. (1991). Risk factors for the development of hypertension: a 10-year longitudinal study in middle-aged men. Journal of Hypertension, 217-223.
Web Diagnosis Staff. (2013, September 17). Ways in Which Smoking and Alcohol Cause Dyslipidemia. Retrieved from Web Diagnosis Website: http://www.webdiagnosis.com/ways-in-which-smoking-and-alcohol-cause-dyslipidemia
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