The 42-year-old female patient presents for follow up on lab results from her annual physical exam completed a week ago. The lab results are as follows: Triglycerides 225, LDL 170, HDL 22, HgBA1c 8.3%
Patient history reveals a 20 pack-a-year smoking history and type 2 diabetes. The last labs done 18 months ago were normal.
Answer the questions:
1-What is this patient’s cardiovascular risk based on these lab results?
2-Describe how the FNP would clinically manage and follow up this patient.
3- List the pharmacological and non-pharmacological interventions.
APA format with intext citations
Word count minimum of 250, not including references.
References: 2 high-level scholarly references within the last 5 years in APA format.
The 42-year-old female patient presents for follow up on lab results from her annual physical exam completed a week ago. The lab results are as follows: Triglycerides 225, LDL 170, HDL 22, HgBA1c 8.3%. Patient history reveals a 20 pack-a-year smoking history and type 2 diabetes. The last labs done 18 months ago were normal.
- Cardiovascular risk Based on the lab results, the patient has an increased risk of cardiovascular disease. Elevated triglycerides and LDL cholesterol are well-known risk factors for developing heart disease. High-density lipoprotein (HDL) is considered “good” cholesterol, and a level of 22 is considered low. Additionally, the patient’s HgBA1c level, which reflects her average blood sugar level over the past three months, is elevated, indicating poor diabetes control. These factors, combined with the patient’s smoking history, place her at a higher risk of developing cardiovascular disease.
- Clinical management and follow-up As a family nurse practitioner (FNP), the first step in managing this patient is to educate her about her cardiovascular risk and the importance of making lifestyle changes. The FNP should advise the patient to quit smoking and make changes in her diet and physical activity. Additionally, the patient should undergo further evaluation for cardiovascular risk by obtaining a lipid panel and HgBA1c level.
The FNP should follow up with the patient regularly to monitor her progress in achieving lipid and glucose control. The patient may need referrals to a dietician and a diabetes educator to make necessary lifestyle changes. A referral to a cardiologist may also be necessary to evaluate her cardiovascular risk further.
- Pharmacological and non-pharmacological interventions The patient will need a combination of pharmacological and non-pharmacological interventions to manage her cardiovascular risk. The non-pharmacological interventions include quitting smoking, following a healthy diet, and engaging in regular exercise. The patient should also aim for a healthy body weight, which may require working with a dietician.
Pharmacological interventions may include lipid-lowering medications such as statins, fibric acid derivatives, niacin, or bile acid sequestrants to lower LDL cholesterol and triglyceride levels. Medications to control blood glucose levels, such as metformin, may also be necessary to improve diabetes control.
In conclusion, the 42-year-old female patient presents with elevated triglycerides, LDL cholesterol, and HgBA1c levels, placing her at an increased risk of cardiovascular disease. As a family nurse practitioner, the FNP should educate the patient about her cardiovascular risk and the importance of making lifestyle changes. The patient should undergo further evaluation for cardiovascular risk, and a combination of pharmacological and non-pharmacological interventions should be used to manage her risk. Regular follow-up appointments should be scheduled to monitor her progress in achieving lipid and glucose control.