676b week 1 discussion

Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, #3 Anne COPD.

Kathy is a 12-year-old female patient who presents to your clinic with a new diagnosis of iron deficiency anemia. What education regarding diet and supplements should you provide the patient and her parents? What other anticipatory guidance information is necessary for this patient? Discuss your plan for treatment and the clinical guidelines you would use for reference.

 
John is a 72-year-old male with long-standing hypertension, angina, and heart failure. He is aware that his obesity and lack of exercise contribute to his diagnoses. He takes aspirin daily but is starting to have gastric irritation. He asks if there are alternatives. He proudly reports that his cardiologist tells him he has “Class I angina risk.” Explain the rationale for using ASA in this patient. What are the alternatives, if any, to ASA therapy? Help clarify the use of enumerated scales for CV diseases such as angina. Does Class I angina equate to low risk?

 
Anne is a 68-year-old female with chronic obstructive pulmonary disease (COPD). She was recently babysitting her grandkids and reports a 1-week history of worsening productive cough (green sputum) and increased shortness of breath. Current medications are Symbicort (budesonide/formoterol) and lisinopril. Vital signs in office today are 98.7 °F oral, RR 18, HR, 104, BP 135/70 mm Hg, and SaO2 93%. Lung auscultation reveals decreased breath sounds, diffuse inspiratory and expiratory wheezes, and no crackles. What additional medications should be considered for Anne’s COPD exacerbation and why? What can she do to protect herself in the future? Why is it important for Anne to know her vaccination status?

Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.  

In your peer replies, please reply to at least one peer who chose a different topic.