The 42-year-old female patient presents for follow up on lab results from her annual physical exam completed a week ago. The lab results are as follows: Triglycerides 225, LDL 170, HDL 22, HgBA1c 8.3%
Patient history reveals a 20 pack-a-year smoking history and type 2 diabetes. The last labs done 18 months ago were normal.
1) What is this patient’s cardiovascular risk based on these lab results?
2) Describe how the FNP would clinically manage and follow up with this patient.
3) List the pharmacological and non-pharmacological interventions.
Length: A minimum of 275 words, not including references
Citations: At least 3 high-level scholarly reference in APA 7 from within the last 5 years
The patient’s history reveals she has a 20-year smoking history and health history of type 2 diabetes. Although the last labs done 18 months ago were normal, the current patient’s lab indicates her Triglycerides is 225. The healthy Triglycerides levels for adults should be under 150. Her LDL is 170, HDL 22 and HgBA1c 8.3%. The healthy LDL cholesterol levels for adults are less than 100 mg/dL, and HDL should be above 60; in addition, the normal HgBA1c level should be below 5.7% (Noain et al., 2020). This indicates that the patient has high cholesterol levels and is diabetic. Therefore, based on her labs, she is at a significant cardiovascular risk.
The role of FNP in the clinical management of high cholesterol and diabetes includes providing patient education to help them make educated health decisions with a goal of cholesterol and diabetes self-management. The education includes providing patient information regarding the proper use of the prescribed pharmacotherapy, appropriate behavioral and lifestyle changes, and the importance of adhering to follow-up care. The education also includes the home-based screening of blood sugars. The role of nurses also includes screening the patients for cholesterol, blood sugars, and potential complications during follow-up care. Although follow-up care for diabetes should be monthly, follow-up for cholesterol check-ups should be at least once every year (Deepthi et al., 2017).
The pharmacologic intervention for the management of High triglyceride, LDL and HDL is the prescription of a statin such as simvastatin (Cao & Devaraj, 2019). For management of the high HbA1c level, the patient should be started on insulin. Non-pharmacologic management of high cholesterol and high blood sugar includes smoking cessation, regular exercise, healthy eating, including fruits, vegetables, and whole grains, and maintaining a healthy weight. In addition, stress management and regular blood glucose are essential (Noain et al., 2020).