Cardiology and Endocrine Conditions

Patient’s Diagnoses 

The patient's Diagnosis involved both objective and subjective data. The data shows the following diagnoses: 

Urinary Tract Infections 

According to the GU data, the patient frequently urinates and has a strong sense of thirst implying the presence of a UTI. 

Internal Bone and Spine Dysfunctionality 

The MS data depicts chronic bilateral shoulder and the lower backbone dysfunctionality. 

Neuron Problem 

The patient experiences occasional headaches 2-3 times a week. Moreover, the existence of dizziness, numbness, and tingling portray issues with the neurosensory. 

Stress 

Psych data shows depression, which might be caused by the condition of his wife who is pregnant and unable to work. 

Poor Digestion 

The patient constipates, vomits, experiences nausea and pain as recorded by the GI data. More so, the patient has occasional indigestion after meals with presence GERD. 

Respiratory Obstructions 

Even though the patient was not diagnosed with asthma, snoring at night is an implication of blockage in the respiratory system. 

Obesity 

The patient is morbidly obese with a physically examined weight of 294 lbs. as obtained by objective findings. 

Internal Sight and Ear Problems 

According to HEENT data, the patient is detected to be having visual and hearing changes with HA. 

Pathophysiology of Diagnoses 

Headaches 

Even though the pathophysiology of single headaches is unexplained, the symptom is depicted by pain in the forehead, rear part of the head or the neck region. The pain is sharp or throbbing. There are different types of headaches with the common one being the migraine. The causes of headaches include stress, dehydration, noises, variations in sinus issues, colds, and head injuries among other causes. Head treatment is not fixed, but depends on the underlying cause. Mostly, the pain suppressors are the medication for headaches. 

Urinary Tract Infections 

The diagnosis of these diseases shows how the urinary system is infected. The disease displays itself in many forms, for instance, discharges and loose bladder. Notably, the UTI has no specific cause; however, the infections are developed by bacteria, which breed at the productive parts, thus, affecting the urinary system. Treatment is not determined but control and the use of UT insertion and the use of antibiotics to heal the internal infections. 

Internal Bone and Spine Dysfunctionality 

Spine and bone dysfunctionality is a common disease that affects the proper functioning of bones or spinal cord. The leading causes are physical injuries due to strenuous work or sporting may result in fractures. However, lack of exercise and poor diet such as lacking calcium result in bone problems. The symptoms include rigidness of physical parts to function correctly with chronic pain that accompanies it. Treatment is done by exercise, calcium diet, and physical dressing. 

Diabetes Management 

Prescription of sulfonylurea for type two diabetes patients with a disability of achieving glycemic control with metformin. Regular human insulin prescription to type two patients with a disability to achieve control of glycemic with metformin and sulfonylurea. For patients unsuitable to insulin, dipeptidyl peptidase-4 (dpp-4) inhibitor, thiazolidinedione (tzd) or sodium-glucose cotransporter-2 (sglt-2) inhibitor is prescribed. A low-dose of aspirin lowers the chances of heart attack patients and the risk of recurrent myocardial infarction. 

JNC 8 Guidelines for Hypertension Management 

Adults above 60 years with blood pressure of 150/90mm Hg should receive pharmacologic treatment. Patients with both hypertension and diabetes, regardless of their respective ages, should initiate pharmacologic treatment when blood pressure is 140/90 mm Hg or higher. Treatment of antihypertensive should compose a thiazide diuretic (TZD), calcium channel blocker, ACE inhibitor, or ARB in the general nonblack population or a thiazide diuretic or calcium channel blocker in the general black population. In case the target blood pressure fails to be reached within one month after therapy initialization, the initial dosage of medication should be increased, or the addition of the second medication should be done. 

AACE 217 Guidelines for Dyslipidemia Management 

Priority for the screening of dyslipidemia should be given to an individual with diabetes. This group is on a high risk of being affected by the condition. During the screening process, hypercholesterolemia should be assessed in the history of the patients family. The best drugs for the medical condition are fibrates (clofibrate, gemfibrozil, and fenofibrate). This drugs can be used to lower lipids in the body (Ahn & Choi, 2015). The significant benefit that patients stand to gain is that these drugs operate by inhibiting conditions that lead to high cholesterol. They do not have adverse side effects on the patient besides causing gastrointestinal disturbances. The drugs work on the liver, and in this case, they reduce the production of triglyceride and low-density lipoprotein. Besides, the drugs stimulate the metabolism of low-density lipoprotein. The condition hinders cholesterol level in the body hence good health free from Dyslipidemia. 

Non-pharmacological Interventions to Enhance Optimal Health for Jose 

First, Jose should take healthy foods and observe a balanced diet. For instance, he should take foods that have moderate sugar and fats. In the long-run, his condition will become stable. Secondly, he should do regular exercise (Rodakowski et al., 2015). They should not be too strenuous or too light. This will help burn excess calories and fat, which caused a range of diseases leading to poor health. Thirdly, he should attend to regular checkups to ascertain his health condition. This will enable him to make necessary adjustments in diet and lifestyle for optimal health. 

Factors that Elevate the Chances of Being Affected by Cardiovascular Diseases 

First, direct and passive smoking of tobacco elevates chances of one getting cardiovascular diseases. Secondly, living an idle lifestyle with minimal exercises lead to a pileup of fats and calories in the body, hence, causes cardiovascular disease (Hinton et al., 2018). Thirdly, a poor diet can also cause cardiovascular diseases. For instance, foods with high levels of fats lead to high deposition of fats in blood vessels leading to high blood pressure. High blood pressure then leads to cardiovascular diseases. Then also, family history of the diseases can increase the chances of being affected by the same condition. Age people are also higher risk than young people in society. 

Jose’s 10 year atherosclerotic cardiovascular disease (ASCVD) risk using the Framingham and Mesa calculators. 

Risk = (Age × 0.0455) + (Sex × 0.7496) + (Race == 1? 1:0) × -0.2111) + (Diabetes × 0.5168) + (Smoker × 0.4732) + (Total cholesterol × 0.0053) - (HDL cholesterol ×0.0140) + (On lipid-lowering medication × 0.2473) + (On hypertension medication ×0.3381) + (Family history of MI ×0.4522) + (Systolic blood pressure × 0.0085) 

(0.0455 + 0.7496 + 0.2111 + 0.5168 + 0.4732 + 0.0053 - (0.0140 + 0.2473 + 0.0085 + 0.3381 + 0.4522) = 

0.4847- 1.0601= 0.5754 

Consequences of Obesity 

Obesity lead to a range of diseases such as high blood pressure, type 2 diabetes, fatty liver diseases, stress incontinence, and many others. Most of these conditions are associated with the liver. It may be difficult diagnosing the condition due to other medical complication that may be more pronounced. The best diet for Jose should comprise of vegetables and fruits. They contain cholesterol-lowering compounds that enable his lead to a better healthy life. Jose is a suitable candidate for bariatric surgery since he is overweight. His body would not allow effectively take exercises that cut down his weight. The surgery would be of great help to him. 

Multidisciplinary Team Approach 

If medications are costly to him, mindfulness-based cognitive therapy can be used to relieve symptoms associated with the disease. This would be a cheaper option to help him recover from the disease. It is also effective in dealing with stressful medical conditions (David et al., 2018). In this case, medicine and religion would be used concurrently to enhance the power of healing upon him. This would elevate his chances of recovering without spending much the expensive drugs and therapeutic procedures. 

References 

Ahn, C. H., & Choi, S. H. (2015). New drugs for treating dyslipidemia: beyond statins.  Diabetes & metabolism journal ,  39 (2), 87-94. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411552/ 

David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy.  Frontiers in psychiatry ,  9 , 4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/ 

Hinton, W., McGovern, A., Coyle, R., Han, T. S., Sharma, P., Correa, A., Ferreira, F., … de Lusignan, S. (2018). Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC).  BMJ Open ,  8 (8), e020282. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104756/ 

Rodakowski, J., Saghafi, E., Butters, M. A., & Skidmore, E. R. (2015). Non-pharmacological interventions for adults with mild cognitive impairment and early-stage dementia: An updated scoping review. Molecular aspects of medicine ,  43-44 , 38-53. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600436/