HPI: Patient African American 86 yr old , not feeling 100 percent, tired hungry and thirsty often from last month. Blurry vision. I take multivitamin statin and aspirin, also has pain in the feet, has cut hand and not heeling; both parents have DM type II; last bloodwork showed high cholesterol and was started on statin. No special diet.
History: Has a life expectancy of < 5 years, hypertension, chronic kidney disease, and history of CVA and MI.
Results from the blood test: Fasting glucose is 204 mg/dL and his A1C is 8.4%.
what treatment plan (RX) would you recommend for patient care? Why?
Diabetes, type 2
Diabetes can make you feel hungry, tired, or thirsty; you may urinate more than normal and have blurry vision.
Diabetes is associated with markedly increased cardiovascular risk, a risk compounded with imposition of chronic kidney disease (CKD).
Treatment:
multidisciplinary interventions including:
1) smoking cessation,
2) aspirin use,
3) exercise,
4) tight glycemic control,
5) dietary intervention,
6) lipid treatment,
7) vitamin and chromium administration.
- Control of hypertension in DKD requires a collaborative network among patients, primary care providers, endocrinologists, and nephrolgists.
- Careful blood pressure measurement, a multiple risk factor modification strategy, and persistent and judicious RAAS blockade in combination with diuretics and add-ons should result in good blood pressure control in a majority of patients.
- Engaging patients and their families through HBP, lifestyle modification, and collaboration with clinic nurses, advanced practice nurses, and clinical pharmacists will facilitate success, thereby reducing the extraordinarily high CVD risk burden of DKD and retarding progression to kidney failure.
HPI: Patient African American 86 yr old , not feeling 100 percent, tired hungry and thirsty...
Patient: S.J. HPI: pt African American 86 yr old , Not feeling 100 percent, tired hungry and thirsty often from last month. Blurry vision, , I take multivitamin statin and aspirin, also has pain in the feet, has cut hand and not heeling; both parents have DM type II; last bloodwork showed high cholesterol and ai was started on statin. History: Has a life expectancy of < 5 years, hypertension, chronic kidney disease, and history of CVA and MI. Results...
SC, a 53-year-old African-American male, presents to the Adora clinic. He complains of always being hungry (“I feel like I want to eat all the food in my refrigerator!!”) and thirsty, along with waking up, most nights of the week, to urinate. During your assessment, you see that SC keeps yawning and you inquire about this; he states that for the past 3 months, he has been feeling run down and tired all the time. He complains that he has...