Addressing Cardiovascular Risks
Thank you for your response. Your inference to the case of the 42-year-old female lab reports states that the patient is at risk of cardiovascular diseases due to the existing condition of type 2 diabetes, a smoking history, hyperlipidemia, and low HDL. The lab reports exhibit abnormalities in the results: triglycerides 224, where the standard value is <150); LDL 170, but the standard value should be <100); HDL 22, but the standard value is >50) and finally, HgBA1c 8.3%, whose goal value for DM2 should be <7%). The patient is also at risk of atherosclerosis, myocardial infarction (MI), and cerebrovascular accident (CVA), as indicated by the lab results.
As the primary care provider, informing her about the health risks she faces concerning the abnormal lab results obtained from the assessment is essential. Your recommendations for a heart-healthy low-carb diet, cessation of smoking, and moderate exercises to reduce the effects can significantly enhance her health outcomes. It is also advisable to calculate her BMI to determine her ideal weight and question any existing medication allergies before prescribing any medications. Your prescriptions depend on the lab results and seem significant depending on the conditions. It is okay to prescribe her baby aspirin 81mg daily to help lower her risks of an MI and CVA.
The Niacin (vitamin B-3) and Omega 3 would also help lower her triglycerides and LDL (Patti et al., 2018). Medication of metformin (Glucophage) 500mg twice a day, one in the morning and one in the evening, preferably with meals, would help reduce side effects such as diarrhea and abdominal pain/discomfort. The other ways you suggest to help increase her HDL involve regular exercise, establishing a weight loss plan to lose extra weight, and maintaining a healthy diet. It is also advisable to use healthy fats such as olive/coconut oil and fatty fish. The explanation for that is based on research that indicates that elevated triglyceride levels are an independent risk factor for cardiovascular disease and increase the chances of heart disease and stroke.
Patti, A. M., Al-Rasadi, K., Giglio, R. V., Nikolic, D., Mannina, C., Castellino, G., … & Toth, P. P. (2018). Natural approaches in metabolic syndrome management. Archives of medical science: AMS, 14(2), 422.
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About the 42-year-old female’s recent lab results from a week ago. The following labs are abnormal: triglycerides 224 (average value <150), LDL 170 (average value <100), HDL 22 (average value >50), HgBA1c 8.3% (goal value for DM2 <7%). According to the American Diabetes Association (2021), “the goal for most adults with diabetes is an A1C that is less than 7%”. This patient is at high cardiovascular risk due to several factors, including type 2 diabetes, smoking history, hyperlipidemia, and low HDL. Some of the health conditions that she is at high risk for include atherosclerosis, myocardial infarction (MI), and cerebrovascular accident (CVA). As her primary clinician in the family nurse practitioner role, I would inform her of all the health risks related to her abnormal results. I would recommend a heart-healthy, low-carb diet, moderate exercise, and smoking cessation. I would also calculate her BMI and determine her ideal weight. Before prescribing/recommending any medications, I would ask if she has any medication allergies. I would then prescribe her baby aspirin 81mg daily to help lower her risks of an MI and CVA. Niacin (vitamin B-3) and Omega 3 may help lower her triglycerides and LDL. I would also start her on metformin (Glucophage) 500mg twice a day, one in the morning and one in the evening, preferably with meals to reduce side effects such as diarrhea and abdominal pain/discomfort. Some ways to help increase her HDL are to exercise more, lose extra weight, and eat healthy fats such as olive/coconut oil and fatty fish. Based on the journal by Overstreet (2018), research has shown that elevated triglyceride levels are an independent risk factor for cardiovascular disease. This increases the chances of heart disease and stroke.
Overstreet, N. (2018). Understanding Triglycerides: Strategies for Counseling Clients. Today’s Dietitian, 20(1), 42–47.
Understanding A1C | ADA. (2021). Retrieved 9 November 2021, from https://www.diabetes.org/a1c
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