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 reveals 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 symmetric, non-tender abdomen with bowel sounds within normal limits and 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 on the lower extremities). Musculoskeletal examination was notable for full range of motion and normal strength in all muscle groups. Skin and capillary refill 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 also are 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 pathophsyiology, pharmacology and physical assessment into patient- centered plans most conducive to effective outcomes while providing patients with enhanced capacity to self managetheir 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 prepares nurses who possess such assessments 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
FAQs
Q1: Head to toe assessment nursing is a complete assessment of the patient that starts with head down to toes.
A head-to-toe, an assessment of a patient’s physical, neurological and psychologis health — you want to know not only what’s there but what could be.
Q2: How does peripheral neuropathy develop?
In contrast, peripheral nerves may be injured in isolation or in patchy fashion, but its preferential involvement occurs during chronic pathologies like diabetes(more), hypertension and/or hyperlipidaemia where there is paraesthesia alone and/or numbness/pain of the limbs.
Q3: Most Prescribed Agents in Neuropathic Pain?
The two drugs more commonly used to alleviate neuropathic pain and curtail hyperactivity in nerve fibers are Neurontin or Lyrica.
Q4: It is such lifestyle changes that are paramount and how they help to prevent complications for those susceptible?
Aside from foot caretobacco cessationtand best optimization of cardiac risk factors (for vasculonervous health) which can prevent neuropathy or cardiovascular diseasesd30 lifestyle modification including exercise and nutrition management helpd31-d34.
Q5: Data and Information: Keep Learning?
While these programs implement pathophysiological, pharmacologic analysis as physical assessment skills into the nurse’s education who can provide evidence based patient centered care with multiple health issues of patients to ensure them the maximum possible outcome.