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Asked by BrigadierWaterMonkey52

Mrs. W. is a 65-year-old female who presents for a physical exam. Her last appointment was 1 year ago. She takes Metformin for type 2 diabetes mellitus, which was diagnosed 3 years ago. She also takes atorvastatin for hyperlipidemia. Her last Pap smear was done at age 55 and was normal. She has never smoked cigarettes. Her husband was diagnosed with colon cancer 2 years ago at age 64. She had planned to retire this year from her job as a nurse but says she will have to continue working because the economic decline reduced the value of their savings. Although she considers herself to be healthy, she is concerned about having to work full time as she is getting older and fatigues more easily. 

Physical examination: Ht 64 in; wt 185 lb; BMI 31.8; BP 170/92; HbA1c 7.6; total cholesterol 239, HDL 39, LDL 170, triglycerides 220; TSH 3.0; CBC count WNL; fasting blood sugar 190. 

Questions 

1. What are the health problems that need to be addressed (with explanation/rationale)? 

2. What tests and screenings would you order at this visit (with rationale)?

3. What is your plan of care for this patient (with rationale)?

 

 

 

SCIENCE
HEALTH SCIENCE
NURSING
NURS 6633

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