Develop a 1–2-page case study analysis including the genetic principles as they relate to the patient. In your assignment:
• identify genes associated with the disease,
• the effects genetics have on the body of a patient with this chief complaint and diagnosis, and
• note the education you would provide the patient related to CAD/HTN and genetics.
Note that you will use the scenario only to obtain patient information for your analysis; you won’t be submitting the summary for this assignment.
Provide three provider-based scholarly references that are applicable to your case. Utilize APA 7th Edition (2020).
Introduction
This case scenario takes you through a visit with an adult patient who has come to the urgent care clinic with complaints of a chest pain. Use the information provided, along with acquired knowledge from course materials, to complete the case scenario.
Meet Frank Spector, a 58-year-old white male with complaints of chest pain.
Frank Intro Transcript
Nurse Practitioner (NP): Hello, Frank. What brings you here today?
Frank: Hi, I have been having this awful pain in my chest.
NP: Where did the pain start? What were you doing when the pain started?
Frank: It began as a dull pain in my chest and moved down my left arm. I had just finished dinner.
NP: Have you been experiencing any other symptoms?
Frank: Yes. The chest pain seems to make me feel nauseated and a little dizzy.
Frank’s Chart Information
Past medical history
• DM type 2
• HTN
• HLD
Medications
• Metformin
• Lantus
• Lisinopril
• Pravastatin
• ASA
Frank Responds Transcript
Nurse Practitioner (NP): Tell me Frank, have you gained or lost any weight?
Frank: Ah, I ‘ve gained about 10 pounds. I ate a lot of ham during the holidays.
NP: Have you noticed any changes in your vision?
Frank: No, no changes.
NP: Any sore throat or nasal congestion?
Frank: No, no sore throat or nasal congestion.
NP: When did you notice the pressure in your chest?
Frank: For the past two days I have been feeling this pain in my chest, especially when I go up the stairs. That’s when I noticed it first.
NP: Have you been coughing or wheezing?
Frank: No, none of those.
NP: Have you noticed any changes in skin, any swelling?
Frank: Yeah, my ankles feel a little tighter. The skin looks shinier. I think they may be a little more swollen than usual.
Frank’s Physical Exam Information
After completing the review systems, you conduct a physical exam of Frank and note the following results:
• VS: BP 100/68 P 110 R 24 T 98.6
• General: alert, appears in some distress
• HEENT: nose is clear, throat is without edema, thyroid is midline
• Cardio: tachycardic, no murmurs noted, no lifts or heaves. JVD is present
• Respiratory: lungs have some crackles in bilateral bases
• Skin: 3 + pitting edema noted in bilateral ankles
• Neuro: alert and orientated x 3
Frank’s Test Results
After completing your review of his systems and a physical exam, you send Frank to radiology and to the lab for a few tests. You receive these results:
Radiology
• CXR shows left ventricle enlargement
• CXR is normal
Labs
• BNP is elevated at 4200
• Troponin is elevated at 1.2
• D-Dimer is normal
• Liver function tests: all within normal limits
• Bilirubin is normal
Other Pertinent Information
• EKG is normal
• Pain is improved with oxygen and nitroglycerin
Questions
Find at least three applicable scholarly references to answer the remaining questions. The references should be provider-based (such as: NP journals, physician-based journals with a U.S.-based population, or similar).
Answer the following questions in the spaces provided, then select Submit.
1. What evidence do you have from patient complaints and testing that Frank has had a NSTEMI?
2. How do you know that the myocytes have been affected?
3. What steps were taken to reverse further damage to the myocytes?
4. What evidence do you have that Frank has decompensated CHF?
5. What effect would Frank’s low blood pressure have on the renin-angiotensin-aldosterone system?
