Fnp Capstone Practicum And Intensive
(Chamberlain University)
, OMoARcPSD|15594445
1. Hypertension
Presentation: Most are not symptomatic, Occipital Headaches, headache on awakening in am, burry vision,
Diagnostic studies: EKG, fasting lipid profile, fasting blood glucose, CBC, CMP, and urinalysis.
Diagnosis: > 140/90 mm Hg start on B/P medication.
Non-pharmacologic Management:
• Lifestyle modifications: diet and exercise 30 minutes aerobic exercise 5 days per week.
• Limit alcohol
• stop smoking
• stress management.
Pharmacologic Management:
• hydrochlorothiazide (HCTZ) 25 mg/day
• ALTERNATIVE Amlodipine besylate 5 mg /day. I
• lisinopril 10mg/day complicated HTN
Follow up:
• 2-4weeks
Referral:
• Cardiology if EKG is normal
2. Hyperlipidemia
Presentation:
• Xanthomata (lipid deposits around the eyes)
• Corneal Arcus prior to age 50 years
Diagnostics:
• lipid profile
• Glucose,
• UA and creatinine (for detection of nephrotic syndrome which can induce dyslipidemia),
• TSH (for detection of hypothyroidism)
• CMP
Diagnosis: Pt with LDL >= 190mg/dL
Non-pharmacologic Management:
• Lifestyle Modification; diet and exercise.
Pharmacologic Management:
• Atorvastatin 10mg once a day
• Alternative Welchol 625 mg tab daily once a day.
Follow up: 6-8
Refer: Nutritionist
3. Diabetes type
2 Presentation:
• Polydipsia, Polyuria, Polyphagia,
• agitation,
• nervousness,
• obesity,
• fatigue
• blurry vision
Diagnostics: EKG, CBC, CMP, LIPIDS< Microalbuminuria, TSH, A1C
Diagnosis:
• Hgb A1C >or equal to 6.5%
• Fasting glucose>126mg/dl and confirmed on a different day
Non-pharmacologic Management:
• Monitor Blood glucose at home and diary
• Lifestyle modification: diet and Exercise
• avoid alcohol
• avoid smoking
Pharmacologic Management:
• Metformin 500mg twice a day.
• Actos 15 mg daily
• Levemir 10 units once a day
Follow up:
, • 2-4 weeks
Referral:
• Ophthalmologist
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