Fill in order details

  • Submit your instructions
    to writers for free!

Chat with the writer

  • Chat with preferred expert writers
  • Request a preview of your paper
    from them for free

Editing

  • Project edited by the quality evaluation department

Download Your Completed Project

  • Download the completed project from your account or have it sent to your email address

SOLVED! Mr. EBR is a 74-year-old retired Hispanic gentleman

Mr. EBR is a 74-year-old retired Hispanic gentleman with known coronary artery disease (CAD)

Mr. EBR is a 74-year-old retired Hispanic gentleman with known coronary artery disease (CAD), who presents to your clinic with substernal chest pain for the past 3 months. It is not positional; it reliably occurs with exertion, approximately one to two times daily, and is relieved with rest, or one or two sublingual nitroglycerin (NTG) tabs. It is similar in quality, but is much less severe, than the chest pain that occurred with his previous inferior myocardial infarction (MI) 3 years ago. Until the past 3 months, he has felt well.

The chest pain is accompanied by diaphoresis and nausea, but no shortness of breath (SOB) or palpitations. He does not vomit. He denies orthopnea, paroxysmal nocturnal dyspnea (PND), syncope, presyncope, dizziness, lightheadedness, and symptoms of stroke or transient ischemic attack (TIA). An echocardiogram done after his MI demonstrated a preserved left ventricular ejection fraction (LVEF). Other medical problems include well-controlled type 2 diabetes mellitus (DM), well-controlled hypertension (HTN), and hyperlipidemia, with low-density lipoprotein (LDL) at goal. He also has stage 3 chronic kidney disease (CKD) and diabetic neuropathy. He no longer smokes and does not use alcohol or recreational drugs. His daily medications include: Atenolol 25 mg PO bid, Lisinopril 20 mg PO bid, aspirin 81 mg PO daily, Simvastatin 80 mg PO each evening, and metformin 500 mg PO bid.

Mr. EBR’s physical examination includes the following: height 68 inches, weight 185 lb, Blood pressure (BP) 126/78, heart rate (HR) 64, Respiratory rate (RR) 16, and temperature 98.6°F orally. He is alert and oriented, and in no apparent distress (NAD). His neck is without jugular venous distention (JVD) or carotid bruits. Lungs are clear to auscultation bilaterally. Cardiovascular: normal S1 & S2, RRR, without rubs, murmurs or gallops. Abdomen has active bowel tones and is soft, nontender, and nondistended (NTND). Extremities are without clubbing, cyanosis, or edema. Distal pedal pulses are 2+ bilaterally

  1. What would you add to the current treatment plan? Why?
  2. Would you discontinue any of the currently prescribed medication? Why or why not?
  3. How does the diagnosis stage 3 chronic kidney disease affect your choices?
  4. Why is the patient prescribed more than one antihypertensive?
  5. What is the benefit of the aspirin therapy in this patient?

ANSWER

Coronary Artery Disease (CAD) Treatment Plan

What to Add in Current Treatment Plan

Most of Mr. EBR’s medications are functioning well. For instance, Atenolol 25 mg PO bid and Lisinopril 20 mg PO bid given to him has helped in controlling his BP and thus improving his health in terms of Hypertension. Also, his diabetes has been improved by metformin 500 mg PO bid medication. However, a painkiller and heart-related treatment are not working well. Thus, I would recommend another treatment plan for the patient to reduce the effects of coronary artery disease. I would recommend other cholesterol-modifying medications, such as and also ask the patient to conduct more exercises.

Medication to Discontinue 

The only medication that I would discontinue is Simvastatin 80 mg PO. I would discontinue the medication because it is not helping the patient deal with the heart condition. Instead, I would recommend atorvastatin (Lipitor). Atorvastatin is a first-line treatment for the heart-related condition (Wang et al., 2019). I help the patient with lower cholesterol levels. I will not interfere with other medications because they show positive effects.

Effects of Stage Three Chronic Kidney on Medication

According to Bruchfeld and Lindahl (2019), stage three, CKD, is a condition where the patient’s kidney is moderately damaged. The condition might affect the nurse’s choice drugs because of the cost of drugs that treat kidney related-conditions. If provided with an expensive drug prescription, the patient might fail to all the medication. Another reason is the medications may be too many, and thus the patient might fail to take all of them. Lastly, my choice of drugs can be affected by side effects of atorvastatin and CKD drugs on the patient’s health.

Why the Patient Takes Many Antihypertensive

Antihypertensive are a group of medications used for treating high blood pressure. Healthcare professionals prescribe drugs, depending on the level of the disease. Also, the drugs may be prescribed based on the age of the patient. In this case, the patient was given many antihypertensive drugs because his blood pressure was too high. Also, the nurse may have recommended the drugs because the patient’s immune is low due to his age. The other diseases affecting the patient may have also contributed to the prescription of more than one antihypertensive drug.

Benefits of Aspirin Therapy

The first benefit of aspirin to this patient is that it reduces the risks of developing stroke and heart attack. The patient is an older person, and thus the risks suffering from dementia. According to Cahill et al. (2019), using aspirin can reduce the risk of suffering from the disease. The patient can also use the drug to relieve pain.

References

Bruchfeld, A., & Lindahl, K. (2019, March). Direct acting anti‐viral medications for hepatitis C: Clinical trials in patients with advanced chronic kidney disease. In Seminars in dialysis (Vol. 32, No. 2, pp. 135-140).

Cahill, K. N., Cui, J., Kothari, P., Murphy, K., Raby, B. A., Singer, J., … & Laidlaw, T. M. (2019). Unique Effect of Aspirin Therapy on Biomarkers in Aspirin-exacerbated Respiratory Disease. A Prospective Trial. American Journal of Respiratory and Critical Care Medicine, 200(6), 704-711.

Wang, X. L., Qi, J., Shi, Y. Q., Lu, Z. Y., Li, R. L., Huang, G. J., … & Li, Y. (2019). Atorvastatin plus therapeutic ultrasound improve postnatal neovascularization in response to hindlimb ischemia via the PI3K-Akt pathway. American Journal of Translational Research, 11(5), 2877.

Place your order now for the similar assignment and get fast, cheap and best quality work written by our expert level  assignment writers.Mr. EBR is a 74-year-old retired Hispanic gentleman with known coronary artery disease (CAD)

Use Coupon Code: NEW30 to Get 30% OFF Your First Order

What our customers say
_____

  • Essay was good; although need to do few amendments and add few things, overall it was good and justify money paid.

     

    FinanceProfessional assignment help services
  • it was good
    it has introduction, body paragraphs, and conclusion as well
    it was really helpful

    PsychologyProfessional assignment help services
  • Great service. Always provide quick response and best online support and have very very less plagiarism.

    EconomicsProfessional assignment help services
  • Thanks for giving my assignment on time. I really appreciated the work done. This keeps me submitting new assignments.

    HealthcareProfessional assignment help services
  • Thank you my writer. Good job and I really enjoy you fast response. I definitely will recommend to my friends.

     

    NursingProfessional assignment help services
  • Thanks for giving my assignment on time. I really appreciated the work done. This keeps me submitting new assignments.

    NursingProfessional assignment help services
  • Great service. Always povide quick response and best online support and have very very less plagiarism.

     

    Business LawProfessional assignment help services
  • Good writer that fulfil all the requirements that i have been told to the writer. The writer even called to discuss everything with me to continue my assighnment

     

    FinanceProfessional assignment help services
  • Great work on time delivered for work, good understanding well prepared. References was well written in APA format

    NursingProfessional assignment help services
  • The writer had clear communication and ensured to give me a brief overview of how my assignment was going to be structured including an average of the words used in each section in order to avoid going over the limit. Didn't need to escalate even once because the quality of the work was in line with the Standard quality that I chose.

    AccountingProfessional assignment help services
  • It was okay. Not bad, could do better! But marks were good, feedback was also good, so overall 4/5

     

    ProgrammingProfessional assignment help services
  • The solution was excellent and all the requirements was taken into consideration.

    ChemistryProfessional assignment help services
  • On time and the assisgment is veryy well done. thank you very much. i'm happy and this is not the last time of me getting help

     

    ManagementProfessional assignment help services
  • This is solid work thankyou for all the help with this PowerPoint; I m curious what grade ill get in it

     

    NursingProfessional assignment help services
  • Great Work Completed in under a Hour thank you so much. I got a 100 percent on my assignment.

    NursingProfessional assignment help services
  • I got 87%. Thanks for that. I am quite satisfied as You reviewed and changed when I ask for some changes.

     

    ChemistryProfessional assignment help services
  • I got a Distinction in this course. Highly satisfied with the expert work and effort.

     

    Business LawProfessional assignment help services
  • I am very happy with this assignment. Thank you very much to the expert who has done this for me.

     

    Business LawProfessional assignment help services
  • So far this is the highest marks I got for an assignment done by you guys. I got 42/50 for this assignment. The exact feedback from my lecturer was:
    Introduction: Good introduction to assisted dying, especially in relation to laws within Australia. Introduction was a little too long.
    Aim or Purpose: Good purpose but improved grammar needed. Good use of PICO.
    Method: The method, while explained is very out of order. Try to write a methods section that can be followed in a step by step fashion

    NursingProfessional assignment help services
  • You did a good job just some details were missed enough attention. To be honest, you did much better job than the other websites. I would like to have more experience with you then I can give you more detailed feedback.

     

    ManagementProfessional assignment help services

You cannot copy content of this page