Introduction
It should be stressed that the individual in the current case study has been a heavy smoker over half of her life. Also, she has been keeping a poor diet and did not exercise enough to keep her health status on a positive level. Due to the patient’s age, weight, malnutrition, and unhealthy habits she is predisposed to developing multiple chronic diseases and complications to health. Despite the increased risk of developing various illnesses, M. K. does not contribute to improving her condition because she does not keep a proper diet, she does not do the essential physical exercises, and she cannot refuse from her harmful lifestyle (Skidmore-Roth, 2014). The only factor that the patient cannot alter is her age. Therefore, deteriorating health is the result of her lifestyle and non-compliance with the recommended course of action to improve her wellbeing because all the other aspects can be changed.
Analysis
As it comes from the case description, the woman has developed several chronic conditions, including:
- type II diabetes;
- hypertension;
- heart failure.
Also, life-long smoking increases the risk of developing chronic bronchitis. Given all these conditions, the patient runs the highest risk of developing COPD. It should be noted that such indicators as PaCO2 52mmHg and PaO2 48mmHg display the presence of this chronic condition. They reveal that she has hypercapnia and hypoxemia (Nici, 2014). These two factors are accompanied by chronic productive cough. Moreover, right-sided heart involvement is a negative indicator as well. It suggests the presence of peripheral edema in the heart. Unfortunately, at this stage, her condition cannot be cured. The only option is to keep control of the current status and eliminate the possible health deterioration. The healthcare objectives should include patient engagement in the process of disease control and relieving the symptoms of her chronic conditions (Nici, 2014). It is essential to avert illness progression and apply preventive practices. The patient should develop tolerance to physical exercises, quit smoking, and keep control of her lifestyle. It also implies reducing the mortality risk as one of the main outcomes of the treatment plan. To ensure the best patient outcomes can be achieved, the plan should be comprehensive. In particular, patient and family education is necessary. The woman should receive nutrition, respiratory, and physical therapy. Importantly, the physician should prescribe particular drug therapy.
Apart from that, the abnormal arterial blood gasses suggest hypercapnia and hypoxemia (Nici, 2014). The evidence the gaseous exchange above the normal levels. The reduced tissue perfusion is another evidence of chronic bronchitis. Further, M. K’s blood pressure is slightly higher than normal, which could have been caused by insufficient lung functioning, medical history, and smoking. However, it can also be the consequence of the body’s reaction to reduced gaseous exchange.
Case Details
Chronic bronchitis is an inflammation of the bronchial mucosa (respiratory tract, which passes the air after inhaling into the lungs and passes it back on exhalation to the external environment). Bronchitis is accompanied by cough with a release of thick mucus. The illness of bronchial mucosa usually develops in connection with the habit of smoking (Nici, 2014). As the membrane grows and becomes more irritated, the productive cough, as well as shortness of breath, can occur. The shortness can increase during physical exercises. Apart from cough, head dizziness and chest tightness are also the indicators of this condition. In terms of the current case, the clinical findings are productive cough with spitting and dizziness caused by the insufficient exchange of oxygen and carbon dioxide.
Recommended Care
The type of treatment recommended for the current patient should be aimed at eliminating the breathing difficulty and relieving the symptoms. In terms of medication, such substances as bronchodilators and steroids in various medication forms can be prescribed (Nici, 2014). They will unblock the airway and allow the woman to breathe without coughing. Oxygen therapy is also advisable to remove breath shortness.
Heart Failure
Presumably, the patient might be experiencing congestive heart failure. The pathogenesis, in this case, is the chronic disease. In this condition, the heart cannot pump such amounts of blood that are essential for sufficient metabolism in tissues. Moreover, it is caused by the weakness of the heart’s contractile function. Congestive heart failure has a negative tendency for worsening. Because the condition has been diagnosed only now, it can be assumed that the patient has been suffering from it for a while. In the initial stage, the heart grows bigger trying to pump more blood (Nici, 2014). However, after that, the heart starts pumping faster. At the same time, the blood vessels decrease their width, and the corpus keeps blood away from the least crucial parts. By doing so, the body ensures that more blood comes to the heart and the brain.
Hypertension
M.K. is experiencing the first stage of hypertension. Its ranges are 140-159 and 90-99 points. The medications prescribed to the patient (Lotensin and Lasix) are diuretics (Skidmore-Roth, 2014). They help her heart to pump the blood better while securing the lungs from the excessive fluid. In terms of the U.S. population, this is one of the widest spread chronic conditions (Muennig & Su, 2013). It adversely influences the health status of people if not monitored and combated promptly.
Other Conditions
Based on the case data, the woman is at risk of developing hyperlipidemia. Moreover, she is suffering from obesity as evidenced by her height and weight. It can be the consequence of type 2 diabetes, and it increases the risks of severe heart conditions. To be more precise, acute heart disease might also result in myocardial infarction. M. K. should be prescribed Atorvastatin, Lovastatin, or nicotinic acid (Nici, 2014).
Body Function
HbA1c test helps to determine diabetes. In particular, hemoglobin A1c indicates the quantity of glucose bound in the person’s blood. Notably, the test displays a blood sugar level during the past three months. Diabetic patients should take the test regularly to check their blood and discuss the medication plan with their healthcare specialist. Also, HbA1c shows how well the patient has been taking care of him or her health during that time (Winterton Edmunds & Mayhew, 2013). M. K.’s test results are not positive. The normal marker for this test is 6%, and the woman’s result is 7.3%, which evidences that she has been paying little attention to her condition.
Conclusion
Thus, it can be concluded that M. K. is predisposed to the development of several chronic diseases along with the diverse conditions she already has. The woman does not keep proper care of her health, and she requires attention from the practitioner. The patient should receive drugs, oxygen, nutrition, and other therapies to be able to maintain the health status on the same level.
References
Muennig, P., & Su, C. (2013). Introducing global health. Hoboken, NJ: John Wiley & Sons.
Nici, L. (2014). Pulmonary rehabilitation. New York, NY: Elsevier.
Skidmore-Roth, L. (2014). Mosby’s drug guide for nursing students. New York, NY: Elsevier.
Winterton Edmunds, M., & Mayhew, M. (2013). Pharmacology for the primary care provider. New York, NY: Elsevier.