Describe your assigned clients situation

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Reference no: EM133998418

Assignment

Konane Pelekia, a 65-year-old female client (DOB: 12/1/1959), presents to the clinic for a follow-up appointment to review the results of lab work performed earlier in the week. The NP sent the client for routine lab work as part of her yearly physical. The lab work revealed that the client's kidney function, potassium, and cholesterol were normal, BNP was 110, fasting blood glucose was 155 mg/dL, and hemoglobin A1c was 8.1% with glycosuria present on urinalysis. A point of care (POC) blood glucose at the clinic is 205 mg/dL. An echocardiogram reveals that the client's ejection fraction is 55%. The client has no complaints at the clinic, and the physical exam performed by the NP is otherwise normal. The NP diagnoses the client with type 2 diabetes and considers what medications are appropriate given the client's comorbidities.

Past Medical History: Hypertension, Stage C Diastolic (HFpEF) Heart Failure (NYHA Functional Class II)

Allergies: None

Medications: furosemide (Lasix) 20mg PO BID, lisinopril (Zestril) 10mg PO daily, metoprolol (Lopressor) 50mg PO BID, aspirin 81mg PO daily
Social History: She quit smoking cigarettes 40 years ago and does not drink alcohol.

Physical Exam:
1) Height: 5 feet 7 inches
2) Weight: 250 lbs
3) Body Mass Index (BMI): 39.2
4) Blood Pressure (BP): 129/84
5) Heart Rate (HR): 61
6) Respiratory Rate (RR): 18
7) Oxygen Saturation (O2 Sat): 96% on RA
8) Temperature (TEMP): 98.6 oral
An appropriate prescription for Konane is:

Name: Konane Pelekia
Date Of Birth: 12/1/1959
Date Prescribed: Current Date
Rx: canagliflozin (Invokana) 100mg
Disp: 30
Sig: Take one tablet by mouth once daily before breakfast
Refills (O-4): 2
Dispense as Written:
Generic Substitution Permitted:

Either Dispense as Written or Generic Substitution Permitted should be checked on every written prescription depending on what is best for each client.

Rationale: According to the CPG, clients with heart failure and type 2 diabetes benefit from receiving SGLT-2 inhibitors, such as canagliflozin, independent of glycemic targets and other treatments for type 2 diabetes. The CPG recommends beginning two agents for type 2 diabetes if hemoglobin A1c is above 7.5%. Since Konane's hemoglobin A1c was 8.1%, metformin (Glucophage) 500mg PO BID could be prescribed simultaneously. The CPG recommends rechecking labs to determine if the client has met their glycemic target, and if not achieved in less than three months, the dosage of the SGLT-2 inhibitor could be titrated to 300mg PO daily, or other glycemic agents could also be added (Rosenthal & Burchum, 2026; Samson et al., 2023).

Assess the client's case, the applicable clinical practice guideline (CPG), and the prescription writing activity for that client within the lesson.

Step I: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. Refer to the lesson for client information.

Step II: Reply to peers with a different assigned client. Get the instant assignment help.

Step III: Look back at your initial post and respond to peers and faculty that have commented.

Include the following sections:

Application of Course Knowledge: Answer all questions/criteria with explanations and detail.

A. Describe your assigned client's situation. Why are they presenting to the clinic? What medications are they currently taking?

B. Assess the applicable clinical practice guideline (CPG) for your assigned client linked on the same page in the lesson where the client case is located. What treatment is recommended by the CPG for your client's situation?

C. Discuss your personal professional assessment of the client's situation provided in the scenario. What pharmacological treatment is necessary and why?

D. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes?

Reference no: EM133998418

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