Scenario:
A 77-year-old white male comes into your office complaining of feeling dizzy, short of breath, easily fatigued and having a sensation of his heart ‘skipping beats’.
- He reports he has had these same symptoms numerous times over the last year or so, but they only lasted for about a day.
- He thought since he has been experiencing them now for about 3 days he should come in and get checked out.
- He was diagnosed with type 2 diabetes twenty years ago and hypertension fifteen years ago.
- Current medications include Lisinopril 20 mg daily and Metformin 1000 mg daily.
- BP 172/100, P 123 irregularly irregular, R 20.
- Skin is warm, pale with a slight gray cast; lungs are clear to auscultation; heart irregular rhythm
Please develop a discussion that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.
Case Study
Mrs. Z is a 34-year-old female who come in with a complaint of diarrhea accompanied by abdominal pain. Onset of the symptom was about 4 days ago. She reports thinking she is running a fever but has not taken her temperature. She concerned that she is starting to feel weak.
When asked how about the characteristics and the number of bowel movements a day, she reports increased number of BMs over the last few months. In the last few days she reports averaging about 10 small volume watery stools with varying amounts of blood daily. A 77-year-old white male Get Big Picture Assignment Help.
She denies recent travel and reportedly has not been on any antibiotics in the past few weeks.
In reviewing her record, you notice that her health history is positive for history of ulcerative colitis. She has not been on any medications for this over the last few years as she had not been symptomatic.
Mrs. Z is on an oral contraceptive. She takes slippery elm capsules and has for the last several years. A 77-year-old white male She reports that she has been taking 2 to 3 doses of Benefiber prebiotic fiber for the last couple days.
Objective data:
BP 116/70 sitting, 100/66 standing; P 92; Temp 100.1
Abdomen – active bowel sounds all 4 quadrants, mild tenderness with palpation
Otherwise her exam is unremarkable for pertinent positives or negatives.
Labs – WBC 14,000; Hgb 11.9; Hct 35.7; Sodium 133; Potassium 3.3
Instructions:
Please prepare and submit a paper 3-4 pages [total] in length (not including APA formatted title and references pages) A 77-year-old white male answering the questions below. Please support your position with examples.
- What pharmacologic therapy would you prescribe for Mrs. Z?
- How will you evaluate the effectiveness of this therapy?
- What patient education would you provide for Mrs. Z relative to the pharmacologic agent you prescribed?
- Are there any pharmacogenetic considerations related to what you prescribed for the patient?
- Are there any alternative therapies or over-the-counter agents that might be of value to Mrs. Z?
- What, if any, lifestyle changes would you recommend?