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3 pages/β‰ˆ825 words
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Style:
APA
Subject:
Health, Medicine, Nursing
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English (U.S.)
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Topic:

Abdominal Aortic Aneurism

Coursework Instructions:

Please please use up to date and references that are not older than two years. The last case discussion I have received the information was not entirely correct and some information incomplete I had to do a lot of revisions.


Thank you in advance who will be be assisting me. I will attach them rubric and case.

Part I:Mr. Braden is a 54 year old male who comes to the Primary Care Office for a routine history and physical examination.PMH includes early COPD and hypertension, for which he has been prescribed HCTZ in the past. However, he admits that he has not been taking this medication as prescribed. He states that he often “forgets” and that he “feels fine without it”. He admits to smoking 1 ppd since he was a teenager. He does not routinely exercise and is employed in a sedentary job. He reports consuming an “occasional beer when watching the game” and denies illicit drug use.
On ROS he denies headache, lightheadedness/dizziness, blurred vision, diplopia, tinnitus, ear, sinus, or throat pain, chest pain, shortness of breath, palpitations, abdominal pain, constipation, diarrhea, bloody stools, difficulty with urination, and weakness, numbness or tingling of the extremities.
HR 84 BP 158/98 HT 5’ 11 ” WT 220
HEENT: Normocephalic, atraumatic. PERRLA. Fundoscopic exam reveals normal red reflex bil., optic discs yellowish in color with sharp margins, AV nicking noted. TMs WNL.
Pharynx without injection/exudate
Neck: Supple. No bruits. No thyromegaly
CV: Normal SI, S2. No murmurs or rubs. Peripheral pulses 2+.
Bruit noted over aorta.
Pulm: Thorax symmetric, increased AP diameter. Breath sounds distant with delayed expiratory phase. No crackles, wheezes or rhonchi.
Abd: Soft, nontender. No organomegaly.
As you are performing your abdominal assessment, you note a bruit over the aorta. He denies any known history of AAA.
1. What do you do next?
2. What are the immediate concerns?
3. What diagnostic test should the provider order? (Cite the literature that you consulted when developing your treatment plan)
4. What will the diagnostic/treatment plan look like? (Cite the literature that you consulted when developing your treatment plan)
5. What education does he need?
Part II:
The lipid panel reveals the following:
Total cholesterol: 266 mg/dL Triglycerides: 100 mg/dL HDL: 30 mg/dL LDL204 mg/dL

 


Coursework Sample Content Preview:

Case Discussion
Student’s Name
Institutional Affiliation
Case Discussion
What do you do next?
The next action is to do an abdominal ultrasound to check for abdominal aneurism due to aortic bruits.
Issue of concern
There is a range of problems regarding, but the next ones included barrel chests, which suggest advancing chronic obstructive pulmonary diseases such as emphysema, suspected abdominal aortic aneurism, obesity, and hyperlipidemia. The behavioral health concerns exhibited by the patient include smoking, non-adherence to anti-hypertensive medication.
What tests should provider order?
Abdominal aortic aneurism is characterized by dilatation of the abdominal aorta, which has been linked to increased morbidity and mortality. Most patients with aortic abdominal aortic aneurism are asymptomatic, but symptomatic ones more often report what abdominal pain. Besides, symptoms of ischemia will be present if there is an occurrence of thromboembolism.
The appropriate diagnostic tests for abdominal aortic aneurysm include abdominal ultrasound, computerized tomography (CT), magnetic resonance imaging (MRI), and angiography.
The abdominal ultrasound is a substantially accurate way to identify and to measure the size of aneurysms. A Doppler ultrasound can augment the abdominal ultrasound by establishing a boodle flow mechanism along the aorta. The CT scan is highly effective in the determination of the size and extent of the aneurysm. MRI is a more advanced visual imaging test that can provide an overview of significant blood vessels throughout the body by use of contrast medium. Angiography deploys a set of approaches to diagnosis, including the use of x-ray, CT scan, or MRI through a contrasting medium to give a visual overview of vascular vessels and their associated abnormalities, like in the case of an aneurism (Rafailidis et al., 2018). The diagnosis of abdominal aortic aneurism can be established via abdominal ultrasound because it is readily available and convenient (Bath et al.,, 2018). However,  a CT scan can be done to determine if the aneurism has ruptured in symptomatic patients, or is it expanding rapidly without any signs of rupture, and it can also assist in identifying whether the abdominal aortic aneurism symptoms are related to any other abdominal pathology or not.
The patient in this case study also reports a history of chronic obstructive pulmonary disease (COPD). Physical examination reveals increased anteroposterior (AP) diameter of the chest, which is a reflection of pulmonary pathology. It is widely accepted that patients having COPD, tend to depict increased thoracic cage dimensions, with a key focus on anteroposterior (AP) diameter, which leads to a circular chest (Lim et al.,2018). The circular chest appears like a barrel, and this phenomenon occasioned by increased lung volume and hyperinflation.
COPD diagnosis and examination, including ordering spirometry testing to measure the volume of air that can that is exhalable, and this is done after an administration of a short-acting beta-agonist( Price & Williams, 2020). The authors noted that there is an underutilization of spirometry measurements. Spirometry parameters are augmented by chest-X-ray, arterial blood ga...
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