NR 601 Week 5 iHuman Virtual Patient Attempt 3818807 - Cynthia Francis

Management Plan by Ashley Greathouse on case Cynthia Francis Management Plan: Create a comprehensive treatment plan using professional language. Include at least one appropriate, evidence-based, scholarly source to support your decisions. Include the following components: a. Diagnostic Tests: Obtain a CBC, CMP, UA, EKG, TSH, T4, a hemoglobin A1C, and a lipid panel composed of cholesterol, HDL, LDL, triglycerides, and VLDL. Much of the diagnosis will lie in the lipid panel, reflecting elevations in values that indicate hyperlipidemia. b. Medications: The use of statin therapy is a key player in achieving optimal LDL levels, especially important in four high-risk groups: patients with an ASCVD risk greater tahn 7.5%, those with a familial history of hypercholesterolemia, patients with a known history of atherosclerotic disease, and patients with diabetes mellitus. High-intensity statins, as well as adherence to diet and lifestyle modifications, have proven to be the most effective at preventing coronary events (Su et al., 2022). Begin Atorvastatin 10 mg PO daily c. Suggested Consults/referrals: At this time, I would likely manage this patient from a primary care point of care, without success achieved or at least marked improvement, I would then ordern consult/ refer her to cardiology and potentially endocrinology for better overall management and risk prevention. Withproper management, this patient's lipid panel/ other labs should remain stable or vastly improve for an overall lower risk of cardiovascular events. d. Client Education: Begin a heart-healthy diet, low fat, low sodium while increasing daily steps to at least 10,000 each day/ partake in at least 150 minutes of exercise weekly. Increase consumption of water. Patient is to take the medication once daily with or without food, dose begins low at 10 mg daily, and will increase as needed until desired labs are reflected. If unable to obtain, adjacent therapy will be initiated. Common side effects include: diarrhea, heartburn, gas, joint pain, forgetfulness or memory loss, and confusion. If any of these occur, update the provider for further evaluation and possible alteration in treatment. e. Follow-up: Follow-up appointment in three weeks to reevaluate lab values and assess side effects of Atorvastatin, with potential increase in dose if needed. Contact the clinic sooner if symptoms arise, or if after clinic hours, seek ER treatment if SOB or chest pain occurs. REFERENCE: Su, L., Mittal, R., Ramgobin, D., Jain, R., & Jain, R. (2021). Current management guidelines on Hyperlipidemia: The silent killer. Journal of Lipids, 2021, 1–5. https://doi.org/10.1155/2021/9883352