Question

Mr. K, a 57-year-old man, presents w/CC of bilateral claudication provoked by moderate exercise. Pt also states extended sitting w/o support of lower extremities results in bilateral lower extremity erythema and occasional pedal paresthesia. Contributing Social hx: Smoker: 30 pack years; little to no regular exercise.

Physical examination reveals an overweight male appearing his stated age. Hyperthermia and anterolateral alopecia noted bilaterally in the lower extremities.

Blood Tests:

Hypercholesteremia

Hypertriglyceridemia

Differential Diagnosis: Peripheral atherosclerosis, CHF, and peripheral vascular disease.

1. Explain how the disease process and development of atherosclerosis resulted in the presentation and lab results of Mr. K.

2. Discuss the complications that might develop in Mr. K.

3. Identify possible plan of care options that may include patient education, treatment options, necessary referral(s) and/or further diagnostic testing for Mr. K.

Read the following scenario, including the Medication Review, then answer questions 4 and 5.

Mr. K was seen later that month where he was diagnosed with high blood pressure. A script for Lisinopril, 20 milligrams to be taken once a day by mouth was written. The following is how this was documented in Mr. K’s chart:

Medication Review
Prescription
Encounter Type	Medication/ Dose	Strength/ Form	Route/ Frequency	Status	Entry By	Date
Office Visit - Follow-up/Established Visit 12/13/17	Lisinopril Tablet - (Prinivil, Zestril)/1 Tab	20/Tablet	Buccal/BID	Active	Dr. Mills	12/13/2017

4.indentify the abbreviation errors made in this record. What is the proper notation that should be used?

5.identify the inaccurate information in the Route. What is the proper abbreviation that should be used?

Answer 1

Disease process and the development of atherosclerosis:

Patient is presented with risk factors such as,

- h/O smoking

- sedentary life style

- overweight

- advanced age

- hyperlipidemia

- hypertension

Which are resulted in the development of peripheral atherosclerosis and manifested as paresthesia, dependent erythema and alopecia.

Patient care:

Health education

- instruct to avoid maintaining one position for long time

- avoid wearing tight clothing

- reduce weight

-treat underlying disease conditions such as hypertension and hyperlipidemia.

- perform ankle exercises which promotes muscle contraction and prevents venous stasis.

Therapeutic Management:

- Arterial vasodilators and anti platelet agents.

- Bypass grafting

- Amputation if the vascular supply is severely impaired.

4. Abbreviation error:

Strength of drug must be mentioned in units.

Correct answer: 20 mg

5. Route of administration must be mentioned as oral.

Buccal is an inappropriate abbreviation used.