After Studying Module 6 Lecture Materials And Resources Read

After studying Module 6 Lecture Materials Resources Read The Case S

After studying Module 6 Lecture Materials & Resources, read the case study scenarios and answer the questions in paragraph form for each: Scenario 1: Lenora is a 57-year-old Jamaican American female who works as a desk clerk. Her job requires her to sit all day from 9 a.m. to 5 p.m., then she drives for one hour to go home. She lives alone in a studio apartment. By the time she gets home, she is tired and barely has time to pick up some fast food. She was recently diagnosed with hypertension and diabetes type 2.

She is 5’5” tall and weighs 180 pounds with a BMI of 30.1, which classifies her as obese according to the BMI categories outlined in Appendix J of the textbook. Her blood pressure was 150/105 mm Hg, indicating hypertension, and her HbA1C was 7.5%, signifying poor glycemic control. The healthcare team prescribed her atenolol (Tenormin) for her hypertension and metformin (Glucophage) for her diabetes.

Two significant risk factors contributing to Lenora’s development of hypertension are her obesity and sedentary lifestyle. Obesity increases the workload on the heart and causes structural changes in blood vessels, leading to elevated blood pressure (Centers for Disease Control and Prevention, 2023). Her sedentary job further exacerbates this risk by reducing physical activity, which is essential for maintaining healthy blood pressure levels. The combination of excess weight and inactivity creates a cumulative effect that predisposes her to hypertension.

Regarding her diabetes management, HbA1C, or glycated hemoglobin, reflects the average blood glucose levels over the past two to three months (Kumar & Clark, 2017). It is a critical marker used to monitor long-term glycemic control, guiding healthcare providers in adjusting treatment plans. In Lenora’s case, an HbA1C of 7.5% indicates her blood sugar has been higher than the target range (

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Hypertension and type 2 diabetes are chronic conditions that often coexist, especially in populations with certain risk factors such as obesity and sedentary lifestyles. In Lenora’s scenario, her obesity, as indicated by a BMI of 30.1, significantly contributes to her risk of developing hypertension. Obesity leads to increased blood volume and cardiac output, which raise blood pressure levels. Furthermore, adipose tissue secretes cytokines and hormones that can cause inflammation and vascular resistance, perpetuating hypertension (Chobanian et al., 2003). Her sedentary occupational behavior further compounds this risk by reducing physical activity, which is known to improve vascular health and lower blood pressure (Cornelissen & Fagard, 2005). Addressing these risk factors through weight management strategies and increased physical activity could significantly mitigate her hypertensive risk.

HbA1C is a glycemic marker that measures the percentage of hemoglobin molecules in the blood affected by glycation, reflecting an individual's average blood glucose levels over approximately three months (Kumar & Clark, 2017). Unlike daily blood glucose monitoring, which shows current levels, HbA1C offers insight into long-term glucose control. For diabetes management, maintaining an HbA1C below 7% is generally recommended for most adults to reduce the risk of microvascular and macrovascular complications, including neuropathy, nephropathy, and cardiovascular disease (American Diabetes Association, 2023). In Lenora’s case, her current HbA1C of 7.5% suggests her blood glucose levels have been poorly controlled, necessitating lifestyle changes such as diet and exercise, along with potential medication adjustments. Regular monitoring of HbA1C allows clinicians to track the effectiveness of treatment regimens and make informed decisions to prevent adverse outcomes related to diabetic complications.

References

• American Diabetes Association. (2023). Standards of medical care in diabetes—2023. Diabetes Care, 46(Supplement 1), S1–S144.
• Chobanian, A. V., Bakris, G. L., Black, H. R., et al. (2003). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA, 289(19), 2560–2572.
• Cornelissen, V. A., & Fagard, R. H. (2005). Effects of exercise training on blood pressure: A meta-analysis of randomized, controlled trials. Journal of Hypertension, 23(2), 251-258.
• Kumar, P., & Clark, M. (2017). Clinical Medicine (9th ed.). Elsevier.
• Centers for Disease Control and Prevention. (2023). About chronic diseases. https://www.cdc.gov/chronicdisease/about.htm