Week 10
discussion

Discussion: Diagnosing and Managing Common Cardiovascular
and Neurologic Conditions

Cardiovascular and neurologic conditions are among the
leading causes of death and hospitalization of women in the United States
(Centers for Disease Control and Prevention, 2008a). As an advanced practice
nurse, you must routinely monitor patients at risk of these conditions and
recommend the appropriate health screenings and preventive services. When
assessing patients for these conditions, it is important to keep in mind that
while some female patients might present with typical signs and symptoms,
others might present with atypical signs and symptoms that are unique to women.
For this Discussion, consider signs and symptoms presented by the women in the
following case studies and develop differential diagnoses:

Case Study 1

A 48-year-old overweight African American female is in the
clinic for a wellness visit. A routine fasting lipid panel returned with the
following results:

Total cholesterol: 305 mmol/L

Low-density lipoprotein (LDL): 180 mg/dl

High-density lipoprotein (HDL): 30 mg/dl

Triglycerides: 165 mg/dl

Case Study 2

You are seeing a 63-year-old African American female for a
two-week history of intermittent chest pain. The pain varies in intensity and
resolves with rest. She does not believe it has increased over time. She is a
nonsmoker with a history of hypertension treated with Lisinopril 10 mg once
daily. She had an exercise stress test one year ago that was within normal
limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22,
O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical
pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to
palpation that reproduces her complaint of pain. Extremities include no
clubbing, cyanosis, or edema. The remainder of the exam is within normal
limits.

Case Study 3

A 32-year-old Asian American female is in the clinic for a
history of recurrent headaches for the past year, occurring monthly, lasting up
to 12–18 hours. The headaches are sometimes associated with photophobia,
nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief
that is not always successful. She uses Ortho Tricyclin for birth control. Her
physical exam is within normal limits.

To prepare:

Review Chapter 8 of the Tharpe et al. text and the McSweeney
et al. article in this week’s Learning Resources.

Review and select one of the three provided case studies.
Analyze the patient information.

Consider a differential diagnosis for the patient in the
case study you selected. Think about the most likely diagnosis for the patient.

Reflect on the appropriate clinical guidelines. Think about
a treatment and management plan for the patient. Be sure to consider
appropriate dosages for any recommended pharmacologic and/or nonpharmacologic
treatments.

Consider strategies for educating patients on the treatment
and management of the disorder you identified as your primary diagnosis.