case study 5

  Mrs. Jones, a 40-year-old changeable patient, is presenting for a history and physical. The assistant gathers a ancestors history from the patient. She shares that her mother died at 70 years of age of colon blight and had developed access diabetes controlled with articulate agents, hypercholesterolemia, and hypertension. She had a achievement afore casual away. Her ancestor died at 67 years of age from a stroke. He had a continued history of alcoholism and smoked two packs per day of cigarettes for 50 years. He had hypertension, hypercholesterolemia, and two affection attacks; the aboriginal affection advance was at 30 years of age and the additional at 52 years of age. He had developed access diabetes controlled with articulate agents back 50 years of age. He had renal binding that was abominably advised with a renal angioplasty and he developed end-stage renal abortion acute hemodialysis. Mrs. Jones has two brothers. One brother developed hypertension, hypercholesterolemia, and developed access diabetes controlled with articulate agents at 50 years of age. The additional brother has no bloom problems. The affectionate grandmother died at 88 years of age of a achievement and had hypertension. The affectionate grandfathering died at 70 years of age of a massive affection advance and had a history of hypertension. The benevolent grandmother died at 80 years of age of a affection attack. The benevolent grandfathering died at 50 years of age from bleeding esophageal varices accompanying to abiding alcoholism. The accommodating shares that her mother’s aboriginal cousin, George, died at 52 years of age of Hodgkin lymphoma. She has addition aboriginal accessory Mabel, 72 years of age, who is animate but has had blight of the colon and had a contempo stroke, and has a history of hypertension, hypercholesterolemia, and developed access diabetes controlled with diet. Her mother’s sister, who is 68 years of age, is animate and has a history of hypertension and hypercholesterolemia. Her mother’s brother died at 68 years of age of renal blight and had a history of hypertension, hypercholesterolemia, and developed access diabetes controlled with articulate agents. He additionally had a affection advance at 45 years of age and a coronary avenue bypass affix operation of three argosy at 55 years of age. He smoked cigarettes for 50 years. The patient’s ancestor was an alone adolescent and her father’s ancestors all lived to be over 80 years of age. What genetic-related diseases do the patient’s first-order ancestors have? What genetic-related diseases do the patient’s second-order ancestors have? Optional: Draw a genogram of the patient’s family’s bloom history application the archetype in the arbiter (see Fig. 5-2) as a guide. 2. The registered assistant prepares to conduct a comestible appraisal on Mrs. Varner, a 52-year-old Caucasian changeable who describes herself as “overweight best of my developed life.” The applicant states that her bloom is good. She works allotment time as a agent and volunteers about 10 hours per anniversary in her church. The assistant obtains Mrs. Varner’s acme as 64 inches and her weight as 165 pounds.  What is the account for accretion anatomy accumulation index? What is Mrs. Varner’s BMI? Calculate her ideal anatomy weight. What is your appraisal of her BMI and weight? Based on Mrs. Varner’s BMI and weight, the assistant measures her waist circumference. Describe the able action for this assessment. Mrs. Varner’s waist ambit is 38 inches. What is your assessment? What class ethics would the assistant analysis to appraise Mrs. Varner’s protein levels?

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