Cure AP3

PATIENT PROFILE CURE ACTION PROJECT 3 Prep Worksheet Patient Demographics In this section, you will be filling out general information regarding your patient. Each detail will help provide a clearer picture of what the present is like for your patient. Include details including (but not limited to) the following: Name: ​John Smith Sex: ​Male Gender: ​Male Age: ​52 Height: ​160 lbs Weight: ​5’10” Medical History: ​He is allergic to shellfish.

Lifestyle Behaviors: ​He exercises less than 75 minutes a week and eats lots of oily foods but eats some vegetables. He is very regular. On average, he gets about 8 hours of sleep a night.

Medical Concerns/Family History:​ Heart disease Purpose of Consultation: ​I will be focusing on heart disease This patient does not want to get heart disease and he knows that his father has had heart disease.

PATIENT PROFILE CURE ACTION PROJECT 3 Patient Risk In this section, you will be describing the likelihood of the patient having a particular disease over a lifetime with two measures. The first is by using the family as a sample to create a simple probability.

The second is to use an assessment performed by a risk calculator (online or otherwise).

Familial Risk: ​For this part, you will create a family tree for the patient. Include as many family members as you can get information on. It is a good idea to ask family members what they know about familial history here.

Draw it out and include an image here:

After you have the family tree, consider the reason for the consult. Of the total number of people in this family tree, how many of them were diagnosed with that ailment? Use this information to create a simple probability.

Give the probability as a reduced fraction as well as a percentage.

1/11 Out of the eleven people 1 person has a chance for it. That is roughly a 9% chance. Santiago’s father has heart disease because he smoked. He later died from it too. Santiago does not smoke any cigarettes.

Risk Assessment: ​The Siteman Cancer Center has a risk assessment for heart disease.

PATIENT PROFILE CURE ACTION PROJECT 3 Treatment/Prevention Suggestions (Pt 1) In this section, you will be making some decisions as to help the patient in their preventative care.

Choose at least two medications, create a nutrition plan, make at least two lifestyle recommendations, and suggest at least two alternative therapies to treat or prevent the medical issue.

Medications:​ Harken back to Cure Unit II and list the medications by name, generic, type, and dosage. Give the indications for the medicine as well as what the intended and side effects are.

Fluvastatin (Lescol) Active Ingredient: fluvastatin sodium Inactive Ingredients in capsules: calcium carbonate, gelatin, magnesium stearate, microcrystalline cellulose, pregelatinized starch (corn), red iron oxide, sodium bicarbonate, talc, titanium dioxide, yellow iron oxide, and other ingredients.

Stop taking fluvastatin and call your doctor at once if you have any of these serious side effects: ● unexplained muscle pain, tenderness, or weakness; ●

confusion, memory problems;

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fever, unusual tiredness, and dark colored urine;

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pain or burning when you urinate;

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swelling, weight gain, urinating less than usual or not at all;

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increased thirst, increased urination.

20 mg to 80 mg/ day.

LESCOL/LESCOL XL can be administered orally as a single dose, with or without food.

Do not break, crush or chew LESCOL XL tablets or open LESCOL capsules prior to administration.

Do not take two LESCOL 40 mg capsules at one time.

Since the maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted according to the patient's response to therapy and established treatment guidelines.

For patients requiring LDL-C reduction to a goal of ≥ 25%, the recommended starting dose is 40 mg as one capsule in the evening, 80 mg as one LESCOL XL tablet administered as a single dose at any time of the day or 80 mg in divided doses of the 40 mg capsule given twice daily. For patients requiring LDL-C reduction to a goal of < 25% a starting dose of 20 mg may be used.

Adult Patients with Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia Adult patients can be started on either LESCOL or LESCOL XL. The recommended starting dose for LESCOL is one 40 mg capsule in the evening, or one LESCOL 40 mg capsule twice daily. Do not take two LESCOL 40 mg capsules at one time.

The recommended starting dose for LESCOL XL is one 80 mg tablet administered as a single dose at any time of the day.

Pediatric Patients (10-16 years of age) with Heterozygous Familial Hypercholesterolemia The recommended starting dose is one 20 mg LESCOL capsule. Dose adjustments, up to a maximum daily dose administered either as LESCOL capsules 40 mg twice daily or one LESCOL XL 80 mg tablet once daily should be made at 6 week intervals. Doses should be individualized according to the goal of therapy

Nutrition Plan:​ In this section, be specific in your recommendations. You can talk about specific foods or types of foods, quantity and frequency of that food, and what specific vitamins or nutritional benefits will be gained, as well as what effect they will have on the patient.

Choose foods low in saturated fat, trans fat, and sodium. As part of a healthy diet, eat plenty of fruits and vegetables, fiber-rich whole grains, fish (preferably oily fish-at least twice per week), nuts, legumes and seeds and try eating some meals without meat. Select lower fat dairy products and poultry (skinless).

Lifestyle Recommendations: What types of activities should the patient be doing or not doing? What changes in their overall lifestyle will lead to treatment or prevention? Consider sleep patterns, exercise, environment, and more when making these recommendations.

You can slowly work up to at least 2½ hours (150 minutes) of moderate-intensity aerobic physical activity (e.g., brisk walking) every week or 1 hour and 15 minutes (75 minutes) of vigorous intensity aerobic physical activity (e.g., jogging, running) or a combination of both every week.

Additionally, on 2 or more days a week you need muscle-strengthening activities that work all major muscle groups (legs, hips, back, abdomen, chest shoulders, and arms). Children should get at least 60 minutes of activity every day.

Alternative Therapies: ​Explore lots of options here - what benefits could the patient reap from aromatherapy, acupuncture, yoga, natural medicine, … the list goes on.

Essential Oils​: There are many natural plant-derived ​essential oils​ that can help heal inflammation and symptoms related to ​heart disease​. Some include lemon oil, lemongrass oil, frankincense oil, helichrysum oil and ginger oil. The active ingredients found in plants are their most potent in this concentrated form.

PATIENT PROFILE CURE ACTION PROJECT 3 Patient Goals For this section, you need to set specifics for the patient - what, when, how, why, and how will we know?

Goals and Timelineâ&#x20AC;&#x2039;: Some goals will be short term, some will be long term, but they all should be SPECIFIC.

PATIENT PROFILE CURE ACTION PROJECT 3 Sources Used in Consultation Include all the sources that you have used in MLA format, organized alphabetically. https://www.rxlist.com/lescol-drug.htm#indications_dosage https://draxe.com/coronary-heart-disease/ http://www.heart.org/HEARTORG/HealthyLiving/How-to-Help-Prevent-Heart-Disease---At-Any-Age_UCM _442925_Article.jsp#.Ww6skGgvzrc https://my.clevelandclinic.org/health/articles/17385-cardiovascular-disease-prevention--reversal/risk-fa ctor-goals