Dyslipidemia Diagnostics and Treatment Plan

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Table of Contents

Subjective Data
Objective Data
Differential Diagnosis
Etiology and Pathophysiology
Incidence/Prevalence
Diagnostic Studies
Treatment
Follow-up Needs and Patient Education
Patient Education
References

Subjective Data

A fifty-five-year-old patient with chief complaints about suspected dyslipidemia turned to the doctor. The man was referred by another specialist after conducting laboratory tests and receiving analyses for decoding and interpretation. Among the history of the present illness, the presence of diabetes mellitus, which was diagnosed five years ago, is noted. It is noted that the patient is overweight, has constantly been smoking for fifteen years and leads a low-activity lifestyle due to constant work in the office in front of the computer. One of the main symptoms is periodic dizziness, difficulty breathing and swelling of the lower extremities. In addition, the patient experiences heartburn almost on a regular basis, which causes him discomfort. Positive patients can include breathing difficulties and swelling of the legs, and negative ones include the fact that the patient denies the presence of chest pain and heart palpitations.

Objective Data

According to the results of the assessment, the patient’s condition is unsatisfactory. This fact was established due to too much excess weight; the man’s body mass index is 28.1, which borders on the mark of obesity. The examination does not require special techniques or maneuvers and involves researching the pertinent positives and negatives. To obtain a complete diagnosis, it is necessary to refer the patient for further examinations. Such procedures include the study of the patient’s family history of diseases, measuring serum lipids to determine the presence or absence of dyslipidemia and measuring the lipid profile (“Lipid management in diabetes”, n.d.). The analysis of such a profile includes total cholesterol (TC), Tfc, HDL cholesterol, and LDL cholesterol. It is also possible to refer the patient for examinations of the cardiovascular system and a blood test.

Vital signs are high levels of cholesterol, and the pertinent positive findings are in accordance with the symptoms that were mentioned earlier.

Differential Diagnosis

The primary diagnosis that is most possible in the case of a patient is dyslipidemia. The second diagnosis is a worsening of the symptoms of diabetes mellitus, which also has a reasonably high probability since the patient often neglects treatment, which leads to the occurrence of many symptoms. The third is ischemic heart disease, which is unlikely and may be a symptom of dyslipidemia since this kind of deviation cannot cause permanent edema from the lower extremities.

Etiology and Pathophysiology

Dyslipidemia is a severe disease that can only be determined by various laboratory tests. It consists of a violation of the balance of lipids, among which there are cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, and high-density lipoprotein (HDL). In other words, the concentration of these indicators in the blood is disturbed, which causes the disease.

The main characteristic of pathophysiology is the presence of excess weight or obesity in patients. Moreover, in some cases, insulin resistance may occur, which complicates the treatment process due to the danger of diabetes mellitus.

Incidence/Prevalence

As expected, the patient has dyslipidemia, which reflects the need for immediate treatment. This is due to the fact that this kind of disease is becoming increasingly common among the world’s population. A study by Xi et al. (2020) showed that “the age-standardized prevalence of dyslipidemia was 31.2% overall” (p. 2). In addition, the disease is more common in men than in women, while at the post-menopausal stage, women have a high risk of the disease.

Diagnostic Studies

Dyslipidemia is a pathological syndrome that is based on the transformation of lipid and lipoprotein metabolism. The main risk that this deviation may entail is atherosclerosis (Figure 1). Moreover, lipid deposits of plaque can form in the arteries, which also pose a danger to patients.

To accurately confirm the diagnosis, it is necessary to conduct specific diagnostic tests that will help refute differential diagnoses. Thus, among such tests, the patient will be assigned to undergo tests that will help “measure the level of cholesterol in the blood, as well as triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol” (Davidson & Pulipati, 2021, para. 26). This is the golden standard for detecting dyslipidemia. In addition, to make sure that the diagnosis is right, it is possible to implement the test concerning the level of blood glucose, liver enzymes, creatinine, and plasma.

Treatment

Advanced practice nurses or APRNs would choose the treatment to try according to the unique characteristics of the patient and the severity of the disease. In addition, the progression through treatment options will be done with the financial opportunities of the patient taken into account. Thus, among the recommendations that will be assigned to a man who has consulted a doctor is a change in the patient’s eating habits and general lifestyle. This is necessary for weight loss and the establishment of metabolism within the body, which can also contribute to the normalization of cholesterol levels in the blood.

As for the medical treatment of this disease, the statin is most often used in the treatment of dyslipidemia (“Management of dyslipidemias”, n.d.). The basis of the action of this drug is a change in the process of cholesterol production in the liver. Depending on the stage and severity of the disease, various statins are prescribed by medical specialists. In addition, other cholesterol medications may be prescribed to the patient to improve the effectiveness of treatment. Among these kinds of drugs may be ezetimibe, fibrates, like fenofibrate, or PCSK9 inhibitors (“Ezetimibe”, n.d.; “Fenofibrate”, n.d.). It is noted that bile acid-binding resins, nicotinic acid and fibric acid derivatives are also prescribed for the treatment of dyslipidemia. In exceptional cases, estrogen replacement therapy is used, and even surgery is used in dangerous cases for the health of patients.

Follow-up Needs and Patient Education

It is worth noting that prevention and constant monitoring of the patient is necessary to ensure the best course of treatment for the disease. Hence, after undergoing therapy, the patient will need to visit a doctor about once every six months, provided there are no complaints. Moreover, it is necessary to undergo examinations, especially at first, to make sure that the disease cannot return. The APRN expects to see positive trends and improvement in the treatment and regulation of cholesterol and related substances in the blood. In case of developing side effects from treatment, APRNs must diagnose the patient with new alternative measures. Consultations with medical treatment specialists should always be accessible when working in cases with an older population.

Patient Education

The patient’s education on the topic of a particular disease plays a critical role. Therefore, one of its advantages is awareness of the disease, risks and consequences, and methods of treatment. Moreover, such awareness will allow avoiding factors and conditions that may contribute to the recurrence of the disease, which is valuable since, in this case, a healthy lifestyle plays an essential role. In addition, it is also worth emphasizing that the advanced practice nurse should make sure that the patient has a sufficient level of education so that he understands the seriousness of the following treatment and attending follow-up appointments. APRN needs to teach the patient how to lead a healthy lifestyle and maintain cholesterol levels.

References

Ezetimibe. (n.d.). DynaMed. Web.

Fenofibrate. (n.d.). DynaMed. Web.

Lipid management in diabetes. (n.d.). DynaMed. Web.

Management of dyslipidemias. (n.d.). DynaMed. Web.

Xi, Y., Niu, L., Cao, N., Bao, H., Xu, X., Zhu, H., Yan, T., Zhang, N., Qiao, L., Han, K., Hang, G., Wang, W., & Zhang, X. (2020). Prevalence of dyslipidemia and associated risk factors among adults aged≥ 35 years in northern China: a cross-sectional study.BMC Public Health, 20(1), 1-9. Web.

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