University of Texas Arlington College of Nursing and Health Innovation
Nursing 5334 Advanced Pharmacology for NPs
Lynda Jarrell, DNP, APRN, FNP-BC
, NURS 5334 DIABETES MELLITUS CASE STUDY 3
Assessment:
Patient is a 55 years old female with the symptoms of urinary frequency, urinary
urgency, and burning on urination with the history of urinary tract infection. Patient’s vital
signs are blood pressure 150/90 mm Hg, pulse 72, Ht 5 feet 5 inches, weight 180 lbs.
Furthermore, urinalysis confirms urinary tract infection and shows protein and high
glucose level in the urine. Patient has a random plasma glucose level of 220 mg/dL.
Patient has a family history of type 2 diabetes. Marion’s laboratory findings are as
follows:
• Fasting plasma glucose 180 mg/dL
Total cholesterol 250
• Triglycerides 350 mg/dL
• High-density lipoprotein cholesterol 35 mg/dL
• Low-density lipoprotein cholesterol 164 mg/dL
• HbA1c 7.4%
• Serum creatinine 1.2
• Glomerular filtration rate >60
• Thyroid function studies within normal limits
Based on the collected labs with the presenting symptoms, the assessment of the
patient are diabetes type II, hypertension, hyperlipidemia and obesity.
Plan:
The patient’s treatment plan will include an antihypertensive medication such as
Angiotensin coverting enzyme (ACE) inhibitor or an Angiotensin II receptor blocker
(ARB) to reduce blood pressure along with a statin to address the hyperlipidemia. In
addition, the patient will also require a glucose lowering agent to maintain glycemic
control. Patient education will be provided regarding to life style changes such as weight
loss, diet, diabetes self-management and physical activity. Cardiac risk calculation per
http://www.cvriskcalculator.com is 13.2%
Pharmacologic:
1. Metformin 500 mg by mouth twice a day for diabetes type II
2. Lovastatin 20 mg by mouth daily for hyperlipidemia
3. Lisinopril 10 mg by mouth daily for hypertension
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