Cj is a 53 year old african american female presenting to pharmacy for first-time certification and cmr so that she may start getting her medications at no cost. cj states that her main concern about her health is her diabetes.
pmh: t2dm, htn, hyperlipidemia
sh: denies tobacco and illicit drug use, occasional alcohol use (1-2 drinks/month)
fh: unknown
allergies: penicillin (unknown reaction; had reaction when young).
medications: lisinopril 5 mg daily aspirin 81 mg daily simvastatin 20 mg daily wt 231 lbs (105 kg), ht 5’6”, bmi 37.3 (obese), ibw 59.3 kg, bp 145/80, hr 98, random blood glucose 395, a1c 11.2%, estimated 10-year ascvd risk 9.5%
drug-related problems:
1. uncontrolled t2dm
2. uncontrolled htn
3. suboptimal statin intensity
1) identify two pieces of objective data included in this case:
2) what kind of monitoring needs performed for the new prescription for this patient?
3) based on your case how would you counsel the patient on the new prescription medication? provide examples of specific aspects you would include in your patient education.
4) review your patient case. identify any medications that do not have a corresponding disease state.
5) review your patient case. identify any disease states are not treated by current medications.
6) what otc (over the counter) product would you recommend for this patient (based on the patient request for an otc product? include dose, frequency of administration, route of administration, and critical counseling points.

Mr smith a 52 year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. the patient has a history of smoking two packs of cigarettes for 35 years, and he drinks a six pack of beer on weekend nights, but does not drink the rest of the week. he is the sole financial support for his family. he is a consultant for a company and is out of town during the week days. mr smith has gained 20 pounds. he is 5 foot, 6 inches, weighing 200 pounds. his diet consists mostly of fast foods. he rarely exercise. his wife care for their three teenage children. the eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. mr smith developed chest pains and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. the wife is in the waiting room while the nurses settle mr smith into his room. the youngest son, 13 years of age, is at a friends house. the teenage daughter is staying at the bedside of the criticall i’ll eldest son. the wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son i’ll. a. what maladaptive response to stress may have contributed to mr smith’s development of an illness b. based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family. c. what nursing interventions should be used to promote effective coping for the patient and his family?