Case presentation on Coronary artery disease and diabetes

Case Presentation on Coronary Artery Diseases and Diabetes Student Name Program Name or Degree Name (e.g., Master of Science in Nursing), Walden University COURSE XX: Title of Course Instructor Name Month XX, 202X Case Presentation on Coronary Artery Disease and Diabetes The case presentation entails information about a patient named KJ, for anonymity purposes, with coronary artery disease and diabetes. This essay analyzes the alterations of coronary artery disease and diabetes and how they impact each other. The narrative explains the pharmacodynamics and the pharmacokinetics of the drugs KJ can use to treat the ailments. The essay analyzes the abnormal findings the laboratory tests will indicate to inform the assessment process. The case presentation guides nurses on specific nursing advocacy strategies and the education tools to recommend to KJ. Therefore, this case presentation proposes the optimal treatment intervention for the comorbidities and offers recommendations to other patients with similar conditions. Alteration of the Disorders The pathophysiology of coronary artery disease (CAD) entails the development of atherosclerotic plaque. The heart will form lipid-laden macrophages, which will deposit in the heart. The macrophages consume oxidized low-density lipoproteins, which then leads to an increase in the number of foam cells. Research argues that diabetes causes risk factors such as myocardial infarction (Nakamura et al., 2022). In KJ’s case, the alteration of the comorbidities could lead to risk factors such as inflammation, hypertension, hyperglycemia, and dyslipidemia. Glucose and oxidized lipids affect the lipids at the epigenetic level. The end metabolic defects in diabetes impact lip metabolism, stimulating postprandial in the body. Research argues that the link between CAD and diabetes leads to glucose toxicity due to insulin resistance, artery failure, and vascular endothelial dysfunction (Nakamura et al., 2022). Diabetes leads to chronic inflammation due to the nucleotide-binding and the thioredoxin interaction. In KJ’s case, diabetes will lead to abnormalities in controlling the heart rate due to hyperglycemia (Park, 2021). Moreover, sodium retention will decrease because of the inflammatory cells in the vascular wall. Diabetes increases complications of CAD due to the commencing of atherothrombosis and atherosclerosis. Additionally, diabetes is a hypercoagulable state that increases the thrombin generation. Diabetes impacts CAD due to epigenetic changes and endothelial dysfunction in the heart (Gupta et al., 2022). Diabetes also leads to intracellular metabolic changes due to impairing fibrinolysis, increasing circulatory levels of fibrinogen and interleukin-6, and the tissue factor. The presence of diabetes increases coronary atherosclerosis by accelerating the progression to unstable plaques (Gupta et al., 2022). Pharmacotherapeutic Agents KJ will use beta-adrenoreceptor antagonists or beta-blockers as a form of pharmacotherapy to treat the disease. Jovin et al. (2023) argue that beta-blockers reduce the amount of oxygen in the heart and decrease the heart rate in a patient. They are made up of an aromatic ring lined with oxygen atoms. The mechanism of action involves beta-blockers decreasing the sympathetic nervous system. The drug increases the coronary filing time, resulting in bradycardia and reducing oxygen requirement (Diaconu et al., 2019). KJ will use sodium-glucose transport protein 2 (SDLT2) to treat diabetes since it improves blood sugar control by reducing the reabsorption of absorbed glucose. The drug is an antihyperglycemic agent containing canagliflozin, empagliflozin, and dapagliflozin. The drug is well absorbed from the gastrointestinal tract, reduces postprandial plasma glucose, and undergoes biotransformation. The interactions between SDLT2 and beta-blockers promote a reduction in cardiovascular death by impeding the stereogenic activation of the heart (Packer, 2020). Sdlt2 reduces oxidative stress and regulates upregulation to reduce adverse renal events in the cardiovascular system. Therefore, the medication interaction justifies the selection because the interaction decreases diastolic blood pressure, reducing heart failure. Abnormal Findings A blood test indicates the amount of lipoproteins, levels of cholesterol, and proteins, which are signs of inflammation for a patient with CAD. KJ will undergo a blood test to assess whether the findings prove he has CAD. Abnormal findings will range from a cholesterol level of above 200. The readings for the lipoproteins will fluctuate between 50 mg/dL or 75 nmol/L. The high levels ...