SOLVED1162

79 year old Mexican american patient with a history of high cholesterol x 11 years, smoker x 50 pack years (stopped 16 years ago), impaired fasting glucose x 1 year and hypertension x 3 years, stable angina x 2 in past 3 months (seen in ED in So Cal while visiting family) . Todays VS: 157/ 93, p 90, RR 14, T 98.4 orally, O2 sat 98% RA, BMI 29 Last labs: A1c: 6.1, FG: 119, TC 240, LDL 140, HDL 34, TGL 338, CR 55- 6 months ago Current meds: Simvastatin 40mg daily, Metformen 500mg BID x 9 months and HCTZ 25mg daily for 12 months, Nitroglycerin prn CP (new). PE : Cardiac: RRR, pulse 90, PMI displaced to axial. Lungs: CTA Bilaterally Extremities: Pulses decreased, 1 pitting edema. Skin intact, LE extremities cooler than UE. Last visit with you was 6 months ago. You referred her to Cardio, but she never went. 1. What is her ASCVD with the current objective information ? 2. You order an EKG today and the results show Left ventricular hypertrophy with ST-T changes. 3. What is likely going on? 4. What medications changes might you consider to improve BP and decrease cardiac
SCIENCE
HEALTH SCIENCE
NURSING

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