A Client with Coronary Artery Disease

The client diagnosed with coronary artery disease is prescribed atorvastatin (Lipitor), an HMG-CoA reductase inhibitor. Which statement by the client would warrant the nurse notifying the health-care provider  

I really haven t changed my diet, but I am taking my medication every day.  

I am feeling pretty good except I am having muscle pain all over my body.  

I am swimming at the local pool about three times a week for 30 minutes.  

I am taking this medication first thing in the morning with a bowl of oatmeal.  

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Some patients will be seen for multiple reasons therefore, the pharmacist may need to record more than one ICD-9-CM code to fully describe the patient visit. For example, if a client with coronary artery disease (CAD) is referred to a pharmacist, it may not be uncommon that the physician requests education on lowering cholesterol through both diet and medications and education on weight loss and smoking cessation. All three conditions (CAD, obesity, and tobacco use) can be coded to represent the health conditions discussed. Example ICD-9 codes for these conditions include 414.01 (native-vessel disease), 272.2 (mixed hyperlipidemia), and 305.1 (tobacco-use disorder) (Buck and Lockyear, 2007). The specific ICD-9 code used on the claim form should be the same code used by the physician to decrease the risk of claim rejection owing to mismatched codes. Therefore, the ICD-9 code should be requested on the referral form from the physician (Snella et ah, 2004). 

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