What additional blood work would you like to complete at this point? Is there any additional information that should be collected from the patient? A.G.’s current diagnosis of diabetes will require additional testing. The current clinical findings of an increased A1c, elevated fasting blood sugar and increased total cholesterol require further investigation of A.G.’s current health status and to assist with the selection of the appropriate treatment for the new diagnoses of diabetes and hyperlipidemia. Both macrovascular and microvascular complications and changes may be present with diabetes and will require further labs be collected (American Diabetes Association (ADA), 2014). The vascular complications related to and exacerbated by diabetes
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A.G. will require further blood test including, a complete metabolic panel to evaluate both his liver function and kidney function secondary to the need for medications to improve his cholesterol and glucose. It is imperative to monitor liver enzymes and the blood urea nitrogen (BUN) and creatinine levels secondary to A.G.’s use of Lisinopril and allopurinol. In addition, other required testing will include both urinalysis to test for microalbuminuria an early indicator of renal function to estimate GFR and thyroid function tests consisting of thyroid hormone levels and Thyroid stimulating hormone (TSH) along with a uric acid level to ensure his current dose of medications are sufficient (ADA, 2014). Furthermore, with the increased vascular risk and A.G.’s current diagnoses of hypertension, now …show more content…
presents with a multitude of risk factors for cardiovascular disease with hyperlipidemia, hypertension and diabetes. With the new diagnoses of hypertension and hyperlipidemia A.G. would benefit from education to include lifestyle modifications related to self-monitoring related to nutrition, physical activity, blood glucose monitoring and planning for sickness (ADA, 2014). First, A.G. will understand the importance of nutritional decisions. This may require an additional resource including a dietician referral and a diabetic counselor. He will be advised of meal plans to include carbohydrates including 45 grams, with the addition of fiber and protein which should comprise 20%-30% of total diet intake and to use alcohol in moderation (Blair, 2016). Physical activity is also essential to the improvement of A.G.’s goal of glycemic control. He will be encouraged to incorporate a total of 150 minutes of exercise weekly and to assist with his cardiovascular risks and lower his BMI of 30 (Blair, 2016). Lowering weight can improve insulin resistance and assist with improving glycemic control (ADA, 2014). Most importantly, A.G. will be assisted with understanding his new conditions both diabetes and hyperlipidemia and to understand the importance of adhering to his new medications regimen which will require close monitoring of his blood glucose. It is imperative for A.G. to understand the testing of his glucose must be performed prior to meals and can utilize a glucometer
A.G. will require further blood test including, a complete metabolic panel to evaluate both his liver function and kidney function secondary to the need for medications to improve his cholesterol and glucose. It is imperative to monitor liver enzymes and the blood urea nitrogen (BUN) and creatinine levels secondary to A.G.’s use of Lisinopril and allopurinol. In addition, other required testing will include both urinalysis to test for microalbuminuria an early indicator of renal function to estimate GFR and thyroid function tests consisting of thyroid hormone levels and Thyroid stimulating hormone (TSH) along with a uric acid level to ensure his current dose of medications are sufficient (ADA, 2014). Furthermore, with the increased vascular risk and A.G.’s current diagnoses of hypertension, now …show more content…
presents with a multitude of risk factors for cardiovascular disease with hyperlipidemia, hypertension and diabetes. With the new diagnoses of hypertension and hyperlipidemia A.G. would benefit from education to include lifestyle modifications related to self-monitoring related to nutrition, physical activity, blood glucose monitoring and planning for sickness (ADA, 2014). First, A.G. will understand the importance of nutritional decisions. This may require an additional resource including a dietician referral and a diabetic counselor. He will be advised of meal plans to include carbohydrates including 45 grams, with the addition of fiber and protein which should comprise 20%-30% of total diet intake and to use alcohol in moderation (Blair, 2016). Physical activity is also essential to the improvement of A.G.’s goal of glycemic control. He will be encouraged to incorporate a total of 150 minutes of exercise weekly and to assist with his cardiovascular risks and lower his BMI of 30 (Blair, 2016). Lowering weight can improve insulin resistance and assist with improving glycemic control (ADA, 2014). Most importantly, A.G. will be assisted with understanding his new conditions both diabetes and hyperlipidemia and to understand the importance of adhering to his new medications regimen which will require close monitoring of his blood glucose. It is imperative for A.G. to understand the testing of his glucose must be performed prior to meals and can utilize a glucometer