1. 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?
M.K. showed lots of characteristics that correlate with chronic bronchitis. Having productive sputum, especially in the morning because of the accumulation overnight, along with a cough and history as a heavy smoker for 22 years makes it very likely that she has chronic bronchitis. Since M.K. is a smoker, there is no doubt that she should automatically be stopping the smoking addiction as the top priority for the starting treatment. As for treatment of the chest, according to medlineplus.gov, “postural drainage is one way to help treat breathing problems due to swelling and too much mucus in the airways of the lungs. With postural drainage, you get into ay position that helps drain fluid out of the lungs.” Healthier diet would go for the diabetes portion, alongside with medications to possibly alleviate some weight off.
2. Which type of heart failure would you suspect with M.K.? Explain the pathogenesis of how this type of heart failure develops.
From the given case study on M.K., the distended veins in her neck and the excessive peripheral edema creates a theory behind it that shows that she has had a long history of hypertension. According to medlineplus.gov, its stated that “High blood pressure also leads to thickening of the blood vessel walls. When combined with cholesterol deposits in the blood vessels, the risk of heart attack and stroke increases.” It is also suggested that based on the long-term hypertension and M.K. having type 2 diabetes, there is a good chance that her kidney response will have a long time activating the rennin-angiotensi-aldostrone. Resulting in edema and fluid overload with congestion, provoking a possibility of heart failure.
3. According to the B.P. value, what stage of hypertension is M. K. experiencing?
Explain the rationale for her current medications for her hypertension. Also, discuss the impact of this disease in the U.S. population.
M.K. is in a mild-to-moderate type of hypertension as her diastolic blood pressure is under 100 mmHg. This is due to the reason of her medication for her edema; which makes sense as to why M.K is prescribed Lasix, which is to control the edema and her fluid overload. As stated in medlineplus.gov, “hypertensive heart disease is the leading cause of illness and death from high blood pressure.”
4. 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?
Other conditions that M.K. could be at risk for is hypercholetrolemia, heart attack, and stroke increase. With M.K. condition of having diabetes and hypertension, with a smoking history, there is no hesitation that there should be a cholesterol lowering medication that should be prescribed for her. According to healthline.com, they believe that “the combination of hypertension and type 2 diabetes is particularly lethal and can significantly raise a person’s risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease, and retinopathy (eye blood vessels), which may cause blindness.”
5. Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function?
As M. K’s diet is not good or healthy whatsoever, it is not surprising that her Hb A1C is not in the normal range or at its finest level because it should be around 6.5. This definitely has a negative impact on her life as she has all the major risk factors for ischemic heart disease, leaving her with the impairment of normal kidney function, as well as accelerated atherosclerosis in the heart and brain arteries.