Get Answer: Case Scenario Year Question Guide
This question focuses on applying theory to practical scenarios.
What This Question Is About
This question relates to case scenario year and requires a structured academic response.
How to Approach This Question
Focus on explaining concepts clearly and supporting them with examples.
Key Explanation
This topic involves case scenario year. A strong answer should include explanation, application, and examples.
Original Question
Case Scenario: Ms. AB, a 48-year-old Caucasian woman, has been directed to the pharmacist clinician for an evaluation of her pharmacotherapy and diabetes management. She carries a medical history marked by various conditions, including the diagnosis of type 2 diabetes in 1993, hypertension, hyperlipidemia, asthma, coronary artery disease, persistent peripheral edema, and chronic musculoskeletal pain resulting from a motor vehicle accident. Additionally, her medical background includes atrial fibrillation with cardioversion, anemia, knee replacement, and several emergency room admissions for asthma. At present, Ms. AB manages her diabetes with a premixed insulin lispro protamine suspension and insulin lispro preparation (Humalog 75/25), administering 33 units before breakfast and 23 units before supper. While she occasionally adjusts her insulin based on elevated blood glucose readings, she has not received guidance on utilizing an insulin adjustment algorithm. Alongside her diabetes medication, she takes a range of regular medications, including fluticasone metered dose inhaler (Flovent MDI), salmeterol MDI (Serevent MDI), naproxen (Naprosyn), enteric-coated aspirin, rosiglitazone (Avandia), furosemide (Lasix), diltiazem (Cardizem CD), lanoxin (Digoxin), potassium chloride, and fluvastatin (Lescol). Additionally, she has “as needed” medications such as sublingual nitroglycerin, additional furosemide, and albuterol MDI (Proventil, Ventolin). Ms. AB’s primary concern currently centers around worsening asthma exacerbations and the need for prednisone tapers. During her last prednisone therapy, her blood glucose levels spiked to 300-400 mg/dl despite significant reductions in carbohydrate intake. Due to financial constraints, she has been unable to obtain fluticasone and salmeterol, relying solely on prednisone and albuterol for acute asthma exacerbations. She adheres to a three-meal-a-day routine with an evening snack, carefully monitoring her carbohydrate intake. Unfortunately, she encounters difficulties in maintaining a regular exercise routine due to adverse weather conditions and her asthma. The blood glucose meter records from the past 30 days indicate 53 tests with an average blood glucose level of 241 mg/dl (SD 74). With a target premeal glucose range of 70-140 mg/dl, none of the readings fell within the target range; 8% were within target, and 91% were above target. In comparison, her results from the same month a year ago averaged 112 mg/dl, with a high of 146 mg/dl and a low of 78 mg/dl. Physical Exam Ms. AB is well-appearing but obese and is in no acute distress. A limited physical exam reveals: . Weight: 302 1b; height 5’1″
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