Introduction
Prognosticating a patient’s condition is based on their medical history, symptoms, lifestyle, and family history. Doris is positive for Diabetes type 2, cardiac autonomic neuropathy (CAN), and systemic arterial hypertension (HTN) at the age of 57. As provided in the case study, Doris’s health conditions, particularly type 2 Diabetes, CAN, and HTN, merit proper examination through screening and safety measures such as lifestyle changes and immunization to protect her from further complications.
Screening
Systematic application of tests or inquiry is necessary to find out the risk condition of the patient. As per the expert opinion, healthcare practitioners should consider screening at the 3-year interval for patients aged 45 years and above and whose BMI is greater than 25 kg/m2 (Petrie et al., 2018). Considering Doris’s medical history, lifestyle, family history, and symptoms, appropriate screenings should be conducted, including fasting blood sugar and non-invasive cardiac imaging. Fasting Glucose screening is undertaken to supervise Doris’s diabetes type 2 and HTN progress (Petrie et al., 2018). Non-invasive screening should be carried out to monitor Doris’s CHF progress. Faragil et al. (2020) supported non-invasive screening as an effective tool for reducing the hospitalization of patients with CHF. Because of skin changes, Doris should be screened for hypertensive and cardiac retinopathy. As suggested by Liu et al. (2020), prolonged untreated hypertension can cause diabetic retinopathy.
Lifestyle Changes
Chronic complications are the cause of most type 2 diabetes severities and fatalities. Type 2 Diabetes surfaces after a long duration of elevated blood sugar levels. Before Doris’s complication spreads to other organs, she should be encouraged to take diabetes medications as prescribed by the doctor and other medications associated with risks such as HTN and CHF, regularly monitor blood sugar levels and exercise often (Solini & Grossman, 2016). Diabetes patients who are experiencing symptoms similar to the ones encountered by Doris should increase physical activity and have a better sleep schedule (Petrie et al., 2018).
Action for CAD and Persistent BP
Doris’s CAD disorder can be addressed through statin therapy, lowering the density of lipoprotein cholesterol (LC), and the usage of beta-blockers. Statin therapy should be utilized in a low-density LC, which is in the range of 70-100 mg (Shen et al., 2018). Similarly, the low-density lipoprotein LC should be lowered before trying to improve the high-density LC level. A medical practitioner should also consider using beta-blockers as a first-line antihypertensive agent. Besides the use of an antihypertensive agent, Doris should reduce their alcohol consumption rate to manage blood pressure (BP).
Interpretation of Doris’s BMI
Body mass index (BMI) is defined as the measure of the weight of a person adjusted for their height (Solini & Grossman, 2016). According to Khanna and Yates (2019), although many scholars consider BMI as an indicator of body fatness, it is a surrogate measure, instead, it is a metric of excess weight. Given that a BMI of 30 kg/m2 above shows an obese condition (Cooksey-Stowers et al., 2017), Doris’s BMI of 38 kg/m2 depicts a typical case of obesity.
Immunization
Old age, diabetes type 2, and obesity disorder are associated with a high risk of cardiovascular disorders (CVD). Since Doris is a woman whose age falls in the range of 55-79, USPSTF guidelines recommend that she take aspirin as an immunization against CVDs such as stroke and heart attacks (US Preventive Service Task Force, 2014). Aspirin is profoundly known for preventing blood clotting through blocking sites that produce a key chemical that promotes it. Moreover, because their Diabetes condition puts Doris at a high risk of serious flu complications such as bronchitis, and pneumonia, she should be given an Influenza vaccine.
Conclusively, Doris’s condition requires intensive collaborative care that involves regular supervision through screening, visiting healthcare practitioners, lifestyle management, and more. Combined intervention can help manage type 2 diabetes, blood pressure, obesity, HTN, and CAN. When BP is reduced aggressively, it reduces the risk of stroke at the expense of increasing cardiac side effects and events. Because Doris is suffering from concomitant diseases, she is frail and needs to set a personalized BP level and work towards achieving it.
References
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Khanna, D., & Yates, Z. (2019). Body Mass Index: A Critical Review.Journal of Obesity & Weight Loss Therapy, 9(2), 1-2. Web.
Liu, L., Quang, N. D., Banu, R., Kumar, H., Tham, Y. C., Cheng, C. Y.,… & Sabanayagam, C. (2020). Hypertension, blood pressure control and diabetic retinopathy in a large population-based study.PLoS One, 15(3), e0229665. Web.
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Shen, H., Chen, X., Lu, J., Yang, H., Xu, Y., Zhu, A.,… & Gu, Y. (2018). Effects of statin therapy on chronic kidney disease patients with coronary artery disease.Lipids in health and disease, 17(1), 1-7. Web.
Solini, A., & Grossman, E. (2016). What should be the target blood pressure in elderly patients with Diabetes?Diabetes Care, 39(Supplement 2), S234-S243. Web.
US Preventive Services Task Force. (2014). The guide to clinical preventive services, 2014: Recommendations of the US Preventive Services Task Force. Agency for Healthcare Research and Quality. Agency for healthcare Research and Quality. Web.