Student name

Capella University

4015

Professor’s Name

Submission Date

Introduction

It’s too tough, so if the patient is having number of risk factors so from holistic patient care perspective at least head to toe assessment should be required. This one is a complete biography of Mrs. Aiyana Tahamata, the complainant: she has numb feet if she stands around for too long; she graduated from at least junior high school and probably did not get any further than that; this appears to be in New Zealand. The evaluation included a neurological examination and cardiovascular status; assessment of depressive and anxiety symptoms, obesity, comorbid conditions, including hypertension or hyperlipidemia in addition to possible peripheral neuropathy.

Comprehensive Nursing Assessment

Aiyana was alert and oriented and not acutely distressed. She noted primarily tingling in the bilateral feet, consistent with peripheral neuropathy. Blood pressure was under control and other vital signs were stable. Auscultation revealed a systolic murmur consistent with tricuspid regurgitation at 4th left intercostal space. Peripheral pulses were intact, and no edema was palpable on examination. Physical examination was significant for a symmetric, non-tender abdomen with bowel sounds within normal limits and an unremarkable respiratory exam.

Even, the ophthalmologic examination that could have been preventable as HEENT(Head, ears, eyes & neck) but were generally normal findings but the patient with such an complain usually require spectacles to correct his vision. Examination suspected early peripheral nerve injury compatible with chronic inflammatory demyelinating polyneuropathy (ie, decreased sensation and reflexes in the lower extremities). Musculoskeletal examination was notable for full range of motion and normal strength in all muscle groups. Skin and capillary refill were normal.

Pathophysiology and Pharmacology Considerations

Peripheral neuropathy may be due to chronic hypertension, hyperlipidemia or undiagnosed type 2 diabetes. What happens is that the tiny blood vessels that are responsible for feeding those nerves get damaged or break down so they’re not getting the oxygen and nutrients they need to function, which manifests as tingling, numbness or burning of the extremities (Busui et al., 2022). Management Blood pressure and cholesterol control; blood glucose monitoring; Medication (gabapentin or pregabalin) for Neuropathic pain

Hypertension and hyperlipidemia were controlled with metoprolol and atorvastatin not only for cardiovascular protection but also to reduce potential vascular insult from nerves. Other lifestyle modifications support these steps; a heart-healthy diet and foot care are also crucial to staving off progression of neuropathy or the other manifestations of metabolism.

Care Planning and Patient Education

Aiyana of James: Increase education around the focus on routine blood glucose and HbA1c monitoring; adherence to medications; foot care; and early identification of neuropathic symptoms. Transthoracic echocardiography was preferred to assess the tricuspid murmur. A more detailed description of the components of such a comprehensive care plan (4), incorporating diet and lifestyle modification, with pharmacologic therapy as needed, along with regular follow-up specifically directed towards cardiovascular, neurologic and metabolic health is beyond the scope of this article.

Capella Flex Path and DNP Programs Integration

Your doctorate here will also serve to imbue critical thinking, clinical reasoning, and a holistic approach to your patient assessment that you can offer in DNP programs or Capella FlexPath classes. They learn to integrate knowledge of pathophysiology, pharmacology, and physical assessment into patient- centered plans most conducive to effective outcomes while providing patients with enhanced capacity to self-manage their health.

Conclusion

Assessment of Aiyana Tahamata: Early nursing and routine full examination. The nurse’s prevention and evidence-based best-practice care implementation assesses cardiovascular, metabolic & neurological health to prevent complications & increase quality of life. DNP curricula, e.g., Capella Flex Path to DNP also prepare nurses who possess such assessment skills with antenatal preparation as part of their clinical expertise within a holistic framework.

References

American Diabetes Association. (2020). 11. Microvascular complications and foot care: Standards of medical care in diabetes−2020. Diabetes Care, 43(1), 135–151. https://doi.org/10.2337/dc20-s011 

Busui, P. R., Ang, L., Boulton, A., Feldman, E., Marcus, R., Mizokami-Stout, K., Singleton, J. R., & Ziegler, D. (2022). Diagnosis and treatment of painful diabetic peripheral neuropathy. American Diabetes Association Clinical Compendia, 2022(1), 1–32. https://doi.org/10.2337/db2022-01 

Chakraborty, S. P., Verma, A., Garg, R., Singh, J., & Verma, H. (2023). Cardiometabolic risk factors associated with type 2 diabetes mellitus: A mechanistic insight. Clinical Medicine Insights: Endocrinology and Diabetes, 16. https://doi.org/10.1177/11795514231220780 

Joseph, J. J., Deedwania, P., Acharya, T., Aguilar, D., Bhatt, D. L., Chyun, D. A., Di Palo, K. E., Golden, S. H., & Sperling, L. S. (2022). Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: A scientific statement from the American Heart Association. Circulation, 145(9). https://doi.org/10.1161/cir.0000000000001040 

Kaminski, M. R., Golledge, J., Lasschuit, J. W. J., Schott, K.-H., Charles, J., Cheney, J., & Raspovic, A. (2022). Australian guideline on prevention of foot ulceration: Part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease. Journal of Foot and Ankle Research, 15(1). https://doi.org/10.1186/s13047-022-00534-7 

Kaminsky, L. A., German, C., Imboden, M., Ozemek, C., Peterman, J. E., & Brubaker, P. H. (2021). The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease. Progress in Cardiovascular Diseases, 70, 8–15. https://doi.org/10.1016/j.pcad.2021.12.001 

Kristiansen, O., Vethe, N. T., Peersen, K., Wang Fagerland, M., Sverre, E., Prunés Jensen, E., Lindberg, M., Gjertsen, E., Gullestad, L., Perk, J., Dammen, T., Bergan, S., Husebye, E., Otterstad, J. E., & Munkhaugen, J. (2020). Effect of atorvastatin on muscle symptoms in coronary heart disease patients with self-perceived statin muscle side effects: A randomized, double-blinded crossover trial. European Heart Journal – Cardiovascular Pharmacotherapy. https://doi.org/10.1093/ehjcvp/pvaa076 

Li, Y., Liu, Y., Liu, S., Gao, M., Wang, W., Chen, K., Huang, L., & Liu, Y. (2023). Diabetic vascular diseases: Molecular mechanisms and therapeutic strategies. Signal Transduction and Targeted Therapy, 8(1), 1–29. https://doi.org/10.1038/s41392-023-01400-z 

Pepe, M., Lanzotti, P., & Mazza, M. (2021). Hypnotics: Course and duration of therapy, side effects, contraindications, interactions, withdrawal syndromes, and resistance to therapy. NeuroPsychopharmacotherapy, 1–28. https://doi.org/10.1007/978-3-319-56015-1_455-1 

Soyoye, D. O., Abiodun, O. O., Ikem, R. T., Kolawole, B. A., & Akintomide, A. O. (2021). Diabetes and peripheral artery disease: A review. World Journal of Diabetes, 12(6), 827–838. https://doi.org/10.4239/wjd.v12.i6.827 

Vieira, I. H., Barros, L. M., Baptista, C. F., Rodrigues, D. M., & Paiva, I. M. (2021). Recommendations for practical use of metformin, a central pharmacological therapy in type 2 diabetes. Clinical Diabetes, 40(1). https://doi.org/10.2337/cd21-0043 

Zaino, B., Goel, R., Devaragudi, S., Prakash, A., Vaghamashi, Y., Sethi, Y., Patel, N., & Kaka, N. (2023). Diabetic neuropathy: Pathogenesis and evolving principles of management. Disease-a-Month: DM, 69(9). https://doi.org/10.1016/j.disamonth.2023.101582