A 50-year-old male presents to the community clinic. He has just relocated to the area and has no primary provider. He is a long distance truck driver and requires a physical examination as per his employer.
Physical examination demonstrates a BMI of 33, blood pressure of 180/90 mm Hg, diminished femoral pulses and bilateral varicose veins with 1+ pitting edema in both ankles. He has a 30 year history of smoking two packs of cigarettes per day.
Using the information provided, identify the risk factors for cardiovascular problems for that need to be modified for this patient. As the RN in the community clinic, describe a patient centered approach that you will implement to determine which of these risk factors needs to be addressed first with this patient.