Lila is 50 years old. She is morbidly obese, has HTN, diabetes, CHF, hyperlipide

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Lila is 50 years old. She is morbidly obese, has HTN, diabetes, CHF, hyperlipide

Lila is 50 years old. She is morbidly obese, has HTN, diabetes, CHF, hyperlipidemia, and depression. She is transferring her care to you as her insurance recently changed. Her current medications include:
Lisinopril 20mg daily
Atenolol 50mg daily
Lasix 20 mg daily
Simvastatin 20 mg daily
Glyburide 10mg BID
Actos 15mg daily
Fluoxetine 20mg daily
She complains today of fatigue and pain in her knees. She has shortness of breath with activity so she does not exercise. She does not work any longer and stays home most days contributing to her loneliness.
Lab data obtained for today’s visit include:
HgA1c 8.2%
BUN and creatinine within range
LFTs within range
Lipids: TC 260, HDL 35, LDL 170, Trigs 290
Vitals: BP 156/98; P 60; R 22; O2 sat 95% Height 5’1” 340 pounds
Questions
Provide as much information about this client and her medications as you can. Look for interactions, contraindications, adjustments, need for additions or deletions…Make sure you also include anticipatory guidance and patient education. This is a complex patient; it is your opportunity to put all the knowledge you have learned throughout the course together. Be specific about exactly what you want to do. At the end of your essay, write her prescriiptions out exactly as you will send them to the pharmacy.

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