The patient, in this case, is 5’5″ in height and weighs 225 lbs, and is reported in the patient’s clinical findings to suffer from chronic bronchitis. For the last 22 years, M.K. has been smoking and eating poorly. She has a family history of Type II diabetes with primary hypertension. Recently, she has been having symptoms of chronic bronchitis, such as lightheadedness, a cough that produces sputum, increased peripheral edema, dilated neck veins, and increased urine correlations. As a result of her hypertension, Lotensin and Lasix have been prescribed along with Glucophage to treat her Type II diabetes.
Chronic bronchitis is inflammation of the mucous membranes that line and protects the bronchial passages, a condition that is anticipated to contribute to Chronic obstructive pulmonary disease. The most common cause of this condition is long-term inhalation of irritant gases, such as smoke from a cigarette that ends up causing breathing difficulties and coughing, which is evident in M. K’s case (COPD, 2020). M.K. is at a higher risk of developing lung cancer and heart disease.
The unhealthy eating habits of M.K. and the fact that she is overweight are contributing factors to Type II diabetes. This type of condition occurs when insulin-resistant cells form in the liver, muscles, and fat. They do not take in enough sugar because these cells do not regularly interact with insulin (Type 2 diabetes – Symptoms and causes, 2021). Thus, Type II diabetes is caused by blood sugar levels being out of control due to improper eating habits that result in the pancreas not making enough insulin.
The clinical findings that correlate with M.K.’s chronic bronchitis
The clinical outcomes that correspond with M.K.’s chronic bronchitis include low partial pressure of oxygen in the blood at 48 mmHg and high partial pressure of carbon dioxide in the blood at 52 mmHg. The M.K.’s low PaO2 and high PaCO2 suggest abnormal blood gasses in the artery. Due to chronic bronchitis, the lungs are inflamed, resulting in low blood oxygen levels, lowering lung sufficiency. The carbon dioxide level in the blood is also high because of chronic bronchitis’s inability to exchange gases properly. The 158/98 blood pressure reading of M.K. is greater than the 116.5/73.5 mmHg range linked with a person of M.K.’s age, which is an indication of the condition (Pharm, 2021). In addition, according to the research, a woman’s hematocrit concentration was 57% higher than the typical range of 36-48%.
To begin treating M.’s bronchitis, it is recommended that she stop smoking since this is the root of her illness. Bronchodilators such as AccuNeb, Vospire, formoterol, and albuterol, among others, may help M.K. manage the issue by relaxing the bronchi muscles and expanding the central airways, as might other possible treatment options for this condition (Kim, 2017). The other therapy to treat chronic bronchitis is prednisone and methylprednisolone, which will clear up bronchial secretions and edema by lowering chronic inflammation.
The type of heart failure and its pathogenesis
Based on her physical and clinical characteristics, it seems that M.K. is more prone to left-sided heart failure, a branch of the more prevalent congestive heart failure in that the heart is not able to pump blood adequately. Systolic and diastolic heart failure are the two main types of left-sided heart failure. Systolic failure is due to left-sided heart failure, which occurs when the heart’s left chamber loses its capacity to pump blood due to a shortage of oxygen. To account for this, the left ventricle pumps harder and becomes weaker. Consequently, fluid accumulates in the lungs and other regions of the body due to blood flowing backward into the organs.
With intact ejection fraction, the condition known as diastolic heart failure develops when the left ventricle has become rigid and thick, reducing the volume of blood that the heart pumps into the body. Blood builds up in the lungs and left atrium, causing heart failure symptoms and fluid congestion over time. The PaO2 of M.K.’s clinical findings indicates that she is low on oxygen, thus lowering the capacity of oxygen-rich blood that can flow to the left side of M.K.’s heart. The left side of the heart fails when there is inadequate oxygen, resulting in pulmonary hypertension, the onset of respiratory symptoms, and pulmonary edema. M.K.’s clinical report shows that she also exhibits severe peripheral edema and swollen neck veins that might suggest left-sided heart failure. M.K.’s physical characteristics also suggest a cough that produces mucus, a sign of left-sided heart failure. This particular kind of heart failure is also linked to reduced urine, usually during the day, resulting in greater urination at night.
The rationale for the current medications for the hypertension
It is possible to detect abnormal pressure in a person without symptoms and monitor blood pressure control during therapy by taking blood pressure measurements regularly. A person’s blood pressure may be classified into four categories: normal blood pressure, prehypertension, stage 1 hypertension, and stage 2 hypertension. People who have hypertension have an abnormally high level of blood pressure. It is a significant medical disorder that raises the chance of brain, kidney, heart, and other ailments. A person’s general health may be badly impacted by low blood pressure, but high blood pressure (hypertension) is more serious. The heart, arteries, and kidneys are all affected by high blood pressure. There is a risk that, if left untreated, it can lead to cardiovascular disease and other serious health complications.
Concerning M. K’s case, she has stage 1 hypertension, whereby she is prescribed to use Lasix and Lotensin to treat hypertension. M.K. should take these medications since they help lower blood pressure and dramatically decrease the risk of a stroke or heart attack. These drugs are ACE inhibitors, making them ideal for heart attack prevention and hypertension (Carey et al., 2018). The drugs function similarly to ACE inhibitors by relaxing blood arteries to facilitate blood flow.
The United States has over 75 million adults above 18 who have high blood pressure, with only 37.5 million (54%) of those adults ensuring that their blood pressure is controlled (Malik et al., 2018). High Blood Pressure (B.P.) is linked to stroke and heart disease, which are the leading causes of death in the United States if it is not controlled. Complications and mortality among minorities and people with low socioeconomic status (SES) are higher. More than 410,000 Americans died in 2014 due to high blood pressure, which translates to more than 1,100 fatalities every day (Malik et al., 2018). The prevalence of high blood pressure in the United States is shown by these figures, demonstrating the seriousness of the issue.
Additional medications that should be given
A person’s lipid panel may be linked to a wide range of illnesses, including heart disease and diabetes. It’s possible to link the findings of M.K.’s lipid panel to a variety of other ailments she may have. M.’s lipid panel shows that his HDL level is 32 mg/dL, cholesterol level is 242 mg/dL, Triglyceride level is 1000 mg/dL, and his LDL level is 173 mg/dL. Considering that all of them are either over or below acceptable values, the patient is at increased risk of having further complications. She is at risk of cardiovascular problems since her cholesterol level is very low (less than 50 mg/dL). Obesity, myocardial infarction, and also hyperlipidemia are possible complications. The patient should be prescribed various drugs based on the lipid panel results and heart disease-associated risk. These abnormal cholesterol levels may be managed using “statins,” a class of medications that reduce the synthesis of cholesterol in the liver and absorb the cholesterol already present in the bloodstream. Fluvastatin, simvastatin, atorvastatin, and rosuvastatin are among the statins to consider. Cholesterol absorption inhibitors and bile acid-binding resins are some other drugs she may be given. Cholesterol levels may be reduced by using any of these drugs.
The significance of the lab value for HbA1c
The glycated blood hemoglobin (HbA1c) test measures a person’s average blood glucose levels over the last two to three months, corresponding to the prediction of the half-life of red blood cells (RBCs). This indicates that the HbA1c test can quantify glucose linked to the blood in three months lifetime of red blood cells. Testing and monitoring type 2 diabetes with the HbA1c is currently recommended as a standard of care (SOC). In the clinical results, M.K.’s Glycosylated hemoglobin (HbA1c) test revealed a 7.3 percent level. A person’s body generates glucose or blood sugar, which may also be absorbed by external sources. An accumulation of glucose in the blood causes the hemoglobin in red blood cells to bind with glucose. Hemoglobin present in the red blood cells carries oxygen throughout the body. The level of blood glucose determines whether or not a person’s body is functioning normally.
Based on M. K’s history, signs and symptoms, and certain clinical results, she has chronic bronchitis. Chronic bronchitis is a result of her long-standing habit of smoking. The high partial carbon dioxide pressure and the low partial oxygen pressure in her arteries, both indicative of aberrant partial blood gases, are correlated with her chronic bronchitis. As a result of her physical and clinical characteristics, she has stage 1 hypertension and is at risk for left-sided heart failure. Lotensin and Lasix are prescribed to her to regulate her hypertension and reduce the risk of a heart attack or stroke. Hyperlipidemia, atherosclerosis, and heart disease are all conditions that she is at high risk of getting. Drugs called “statins” may treat these problems by reducing cholesterol synthesis in the liver and absorption of the cholesterol already present in the bloodstream.
There is evidence that she has type II diabetes mellitus and a high HgA1c, indicating that her blood glucose levels are abnormal and that she is at risk for heart failure due to increased glucose-carrying capacity in her blood vessels. Consequently, it is vital that her doctor increase the existing Glucophage dose, prescribe more medicine, or order new medication to regulate her glucose level. As a result, her level of glucose must be controlled immediately. A balanced diet and regular exercise are essential for M.K.’s health and well-being and her treatment to alleviate her symptoms and avoid complications.
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and Control of Hypertension. Journal of the American College of Cardiology, 72(11), 1278–1293. Web.
COPD – Symptoms and causes. (2020). Mayo Clinic; Web.
Kim, E. K. (2017). Pathophysiology of COPD. In COPD (pp. 57-63). Springer, Berlin, Heidelberg.
Malik, E. Z., Abdulhadi, B., Mezue, K. N., Lerma, E. V., & Rangaswami, J. (2018). Clinical hypertension: Blood pressure variability. Disease-a-Month, 64(1), 5-13. Web.
Pharm, J. (2021). What Is the Normal Blood Pressure Range? MedicineNet; MedicineNet. Web.
Type 2 diabetes – Symptoms and causes. (2021). Mayo Clinic; Web.