[Solved]: D

D. D. is a 73-year-old male who has presented to the Veteran Administration (VA) emergency department complaining that “I don’t feel like myself and haven’t for a while.” As you perform your assessment, he says that he has not felt well for the last six months. There has not been any weight loss. Medical history is of hypertension, hyperlipidemia, a previous TIA, and he had a hip fracture three years ago. He continues to smoke 10 cigarettes a day and states that he drinks “4 to 5” beers per day. Current medications are Docusate sodium 100 mg po BID, hydrochlorothiazide (HTCT) 12.5 mg po OD, Pravastatin 40 mg, po HS, Warfarin 5 mg po QD. Client is not short of breath, there is no complaints of headache, no peripheral edema, chest pain, anorexia, sore mouth/tongue, lightheadedness, pain with swallowing, muscle/abdominal pain, and diarrhea. No bruising or bleeding or paresthesia. VS BP 145/85 (sitting right arm), HR 110, RR 18, T 97.8 deg F, O2 sat 95.5. Skin is cool to touch and there is obvious pallor. The skin does have normal turgor. Heart sounds were tachycardia with normal sinus rhythm. No other abnormal findings. Laboratory findings are: LabResultNa137 mEq/LK4.6 mEq/LCl104 mEq/LHCO322 mEq/LBUN20 mEq/LCr1.1 mg/dLCa9.5 mg/dLMg2.4 mg/dLGlu, fasting185 mg/dLHb8.8 g/dLHct0.197RBC3.0 x 106/mm3Plt139 x 103/mm3WBC4.4 x 103/mm3MCV103 fLMCHC33.5 g/dLFe67 pg/dLFerritin124 ng/mLVitamin B12230 pg/mLFolate1.7 ng/mLAST17 IU/LALT49 IU/LAlk Phos126 IU/LBilirubin1.2 mg/dLAlbumin3.5 g/dLCholesterol194 mg/dLLDL99 mg/dLHDL30 mg/dLINR2.5 What are the abnormalities in the client’s physical findings and laboratory findings? Matching the medications, laboratory findings, and physical assessments findings with the disease category. Discuss whether the diseases are being well managed. Is the client on the expected 2020 ACC/AHA guidelines to treat hypertension? If not, what would be the current treatment standards? Based on the physical findings and the laboratory results, what type of anemia do you anticipate the client being diagnosed with. What physical findings support a medical diagnosis of anemia? What orders do you anticipate to address the anemia in the client? What risk factors does the client have to develop the anemia? Provide two teaching points to this client as you provide discharge orders and prescriptions.