After reading the article listed below, address the following questions in the blackboard discussion. Elkins, C., Fruh, S., Jones, L., & Bydalek, K. (2019). Clinical Practice Recommendations f
After reading the article listed below, address the following questions in the blackboard discussion.
Elkins, C., Fruh, S., Jones, L., & Bydalek, K. (2019). Clinical Practice Recommendations for Pediatric Dyslipidemia. Journal of Pediatric Health Care, 33(4); 494-504. https://www.jpedhc.org/article/S0891-5245(18)30408-5/pdf
Define Familial Hypercholesterolemia. Discuss the types, populations at risk, symptoms, and diagnostic findings.
What information obtained during the history and physical examination would lead you to consider secondary dyslipidemia?
Discuss the difference between target screening and universal screening and the benefits of each.
At what ages should a child be universally screened for dyslipidemia? What is the disadvantage of screening a child between 12 and 16 years old?
The nurse practitioner develops a treatment plan for a child with a LDL-C level of 140 mg/dL. What non-pharmacologic measures should be addressed prior to instituting pharmacologic treatment?
When is pharmacological management for hypercholesterolemia indicated?
Oscar is an 11 year old male seen in the office for a well-child examination. The nurse reports his weight to be 180 pounds and height 60 inches. You calculated his BMI to be 35.2, which is the 99th percentile for his age. The vital signs are recorded as, T 98.2 P82 R20 BP 122/84. Family history is positive for a father with hypercholesterolemia and a paternal grandfather who died at 65 years old from a myocardial infarction. Oscar’s 24 hour food recall includes two bowls of cheerios with whole milk and a bagel with cream cheese for breakfast. Chicken nuggets, French fries and a coke for lunch and a Big Mac and Large fried with a large chocolate shake from McDonalds for dinner. In the evening when he watches Netflix Oscar eats half of a box of Oreo cookies with a glass of whole milk. The mother reports that she has been trying to convince Oscar to join a sports team at school, but he is not interested. Instead he prefers to play video games. When the nurse practitioner reviewed the lab results from the previous well child exam, it was noted that Oscar had a total cholesterol 240 mg/dL, HDL 35 mg/dl and LDL 150 mg/dL, blood glucose 140 mg/dL. The nurse has a discussion with the family regarding the findings and a treatment plan.
A. What questions should the nurse practitioner ask in order to ascertain a complete history for this child?
B. List the differential diagnoses?
C. What laboratory tests should be ordered?
D. What education topics should the nurse practitioner discuss?
E. Is this child a candidate for pharmacologic treatment? What should be done prior to initiation of pharmacologic therapy?
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