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*Lippincott Advisor for Education was used for all citations
(n.d.). Retrieved April 29, 2022, from https://advisor-edu.lww.com/lna/home.do.

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Lowering her stress is so crucial because chronic stress can cause detrimental effects on body. Relaxation or taking days off to focus on self care is important to improving her life. She is a retired older adult , so she may not have the capability of taking time to herself because she is sole provider for grand kids. She may not also have time to improve her lifestyle because of this. Self care is just very important.

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Important for patients to lose weight and can help improve the effects of sleep apnea. Engaging in a healthier life improves overall well-being, but her environment and background play a big role in her sleep issues. Maybe changing to a different position can help with sleep.

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Important for this patient to know that losing weight minimizes fat distribution throughout the body decreasing her risk for cardiovascular disease. Important for her to minimize her stress and take her statins. Her environment and background are a reason for her being obese and experiencing dyslipidemia. African-Americans are a part of the minorities that don't have great access to health care and the opportunity to live healthy lifestyles. She should continue to take crestor, and most important to take it at night and avoid grapefruit juice. Patient should also watch out for signs of dark urine and muscle aches.

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This patient has diabetes, and she was at increased risk for it because of her background. A healthy lifestyle dramatically improves diabetes but managing it is very important because it can lead to complications, and it is important for her to be able to get medications and insulin. She is retired, so she may not be able to get the meds she needs if she doesn't have insurance. She is older and she may not be able to get the meds she needs. Plus, she is busy with her life. She is taking NPH insulin and metformin, and it is important to note that insulin can cause low blood sugar, and it is important to take it with food. Metformin can cause lactic acidosis, which is bad for the kidneys, so the patient should know not to take it with alcohol and look at the drug regimen to make sure cimetidine is not in it.

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This patient has a higher chance of not exercising because of her life and background. Getting up frequently and exercising can aid in strengthening the bones. Her obesity and life play a big role in what she is able to do for herself in terms of exercising. Cholecalciferol is vitamin D which will be helpful in aiding with her bone demineralization. Calcium is given to her as well to help build strong bones. We need calcium to help build the bones back.

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It is important to have a healthy lifestyle by exercising and having a heart-healthy diet. Exercising dramatically aids in minimizing blood pressure. Because of her race and age and background hypertension is more likely for her. Lotensin is an angiotensin 2 inhibitor, and it is important for the patient to know that this drug can cause swelling of the face and throat. It is important for the patient to watch for that. Also, for a persistent cough. It can also cause a sudden drop in blood pressure, so important to wait a few minutes sitting up before standing so the body can adjust. She is also given hydrouril which is a diuretic to aid in minimizing blood pressure. Important to note that it can cause dehydration and low blood pressure. Important to keep hydrated and sit for a few minutes before standing. Also, it can raise bad cholesterol which is bad in her case because she is obese. The statin should probably help combat that. This patient is also taking diltiazem a calcium channel blocker to aid in lowering her blood pressure, and it is important for her to know it can cause dizziness and headaches, and it can cause orthostatic hypotension. It can cause palpations and arrhythmias. Important for the patient to rise slowly or sit for a few minutes before standing to let the body adjust. If the patient notices anything weird with her heart, important to let healthcare providers know.

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Atherosclerosis can be minimized by changing one's lifestyle. Losing weight and keeping a healthy diet will decrease the effects of atherosclerosis. This patient needs to incorporate it into her lifestyle. This patient is African-American and older and she has an increased risk for health disparities. Her access to care and her life plays a big role in her changing her lifestyle. She was given a statin to help lower her ADLs which can potentially help her disperse the fat. It's for this patient to understand that this drug may cause myopathy as a side effect and she already has osteoporosis so I will tell her to watch for signs of dark urine and pain in the muscles. Important to take it at night since most cholesterol is synthesized at night and don't drink grapefruit juice.

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Those assessment findings are indicative of diabetes. Most type 2 diabetics are obese. Her weight did play a major role in her developing diabetes. The tingling and blurry vision can be complications of diabetes presenting itself. Her diabetes may have not been managed well resulting in her experiencing complications. Her A1C and fasting glucose are accurate for someone who has diabetes. Her ESR is also pretty high. Probably because she is experiencing some vascular issues that can cause it to be high. Diabetes can cause the blood to be more viscous and result in major issues.

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This patient is obese. Her weight-to-height ratio indicates that her BMI is high and she is obese. Because of her obesity, she has more fat distribution and that increases her risk for heart issues. The fat distribution can increase her risk for atherosclerosis. She is presenting some issues of the heart by having edema bilaterally in the extremities. Dyslipidemia may be an underlying cause of her heart issues.

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This patient complained of muscle aches and pain. This can be in relation to her history of osteoporosis. Osteoporosis may cause aches and pain in patients because of bone demineralization. If this patient lives a sedentary lifestyle or obesity is causing compression of the bone, she will lose bone mass.

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Her cortisol levels are pretty high, and this is indicative of her going through a lot of stress because of the responsibilities that she has in her life. Her everyday stress is reflected in her labs. Your body releases cortisol as a response to stress, but ongoing stress can cause cortisol levels to be consistently high. High cortisol levels can increase glucose in the blood and she is diabetic. Which can cause her diabetes to be even worse. She will be at increased risk for complications for diabetes.

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This patient receives about 3-4 hours of sleep every day. This is a major issue, and this can be related to her responsibilities or the fact that she is obese. Those who are obese have risks of sleep apnea. She may be experiencing it which may be affecting her sleep. Further assessment should be given to investigating if she has it or not.

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She may have atherosclerosis due to the fact that she is obese. People who are obese have a higher chance of developing plaques in their blood vessels which may cause them to be obstructed. It results in higher blood pressure in the vessels being constricted. Her blood pressure is high so she may have it. This can't be ruled out.

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Someone who has hypertension will have high blood pressure. This patient does have high blood pressure due to the assessments. Her weight-to-height ratio plays a big role in her developing hypertension. Obese patients are at increased risk. Because she is obese, her blood pressure will be indicative of that.

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Cortisol level 35 mcg/dL

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Present weight and height 210 lbs./5'5
2+ pitting edema bilateral lower extremities
Hemoglobin A1C 7.5 %
Fasting blood glucose 132 mg/dL

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Sleep apnea:
3-4 hours of sleep
Present weight and height 210 lbs./5'5

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Muscle aches and pain with movement

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Blood pressure 140/90
Present weight and height 210 lbs./5'5

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Present weight 210 lbs./5'5
Tingling in lower extremities
Fasting blood glucose 132 mg/dL
Hemoglobin A1C 7.5 %
Vision is blurry
ESR of 45 mm/hr

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Blood pressure = 140/90
HR = 92
Present height & weight = 210 lbs./ 5'5

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It is caused by fatty deposits that build up inside the arteries (Lippincott Advisor for Education). Someone who is obese has an excess of fatty tissues. They have higher cholesterol and triglycerides levels which can lead to more fatty plaques being built up in the walls.
Complications: "Diabetes, CAD, CVD, PVT, Renal stasis" (Lippincott Advisor for Education).

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Poorly managed stress can increase someone's risk of obesity. High levels of cortisol in the body due to chronic stress can cause adrenal suppression and lead to imbalances and cause Cushing's disease or syndrome. In turn, Cushing's disease can cause obesity. Also, high levels of glucose in the body can cause micro and macro arterial wall damage.

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"The rise in blood pressure seen with obesity is initially associated with an elevation in cardiac output and a relatively normal systemic vascular resistance" (Appel). A build-up of fat causes plaque to build up in the blood vessels causing restriction and higher blood pressure.
Complications: "Heart failure, MI, Hypertensive crisis, Neurologic deterioration, and Chronic or end-stage kidney failure" (Lippincott Advisor for Education)

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If someone who is obese had a previously sedentary lifestyle, they have an increased risk for osteoporosis. Because of lack of exercise, the bones may demineralized causing osteoporosis. Also, someone who is obese will have their fat compressing against the bone causing bone to be demineralized. Also, the bone mass may decrease.
Complications: "Bone fractures" (Lippincott Advisor for Education)

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Obesity can increase someone's risk of type 2 diabetes. According to Lippincott Advisor for Education, "Overweight or obesity (body mass index equal to or greater than 25 kg/m²)."
Someone who is obese has impaired glucose regulation because of increased insulin resistance and decreased insulin production which can lead to type 2 diabetes.
Complications: "Atherosclerotic cardiovascular and peripheral vascular disease, osteoporosis, damage to macrovascular and microvascular arterial cell walls" (Lippincott Advisor for Education).

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"Fat cells grow larger in response to dietary intake. When the cells can no longer expand, they multiply. With weight loss, the fat cells get smaller but the number of fat cells doesn't change" (Lippincott Advisor for Education)

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Sleep apnea can result in obesity. People who are obese have a higher risk of sleep apnea because the airway can be compressed due to the excess adipose tissue around the neck. Those with a short, thick neck, and possess fatty tissue around the neck can increase the risk of sleep apnea (Lippincott Advisor for Education). Also, people lying on their back can cause compression of the chest cavity due to adipose tissue.
Complications: "Hypertension, increased stroke risk, increased cardio vascular or diabetes risk, increased risk for complications during surgery" (Lippincott Advisor for Education)

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Hyperlipidemia can result from obesity and diabetes. It can result in "increased levels of lipids in the blood, including cholesterol, triglycerides, and phospholipids" (Lippincott Advisor for Education). Someone who is obese has an increased risk due to high levels of fat distributed in his or her body.
Complications: "CAD, Cerebrovascular disease, and Pancreatitis" (Lippincott Advisor for Education).