Patient Profile R.L. is a 45-year-old African American man with no…
Patient Profile R.L. is a 45-year-old African American man with no… Patient ProfileR.L. is a 45-year-old African American man with no previous history of hypertension. At a screening clinic 2 months ago, his BP was found to be 150/95 mm Hg. His primary care provider has followed him for the past month. During this time he has been taking hydrochlorothiazide 12.5 mg/day. He is here today for a follow-up visit. Subjective DataFather died of stroke at age 60Mother is alive but has hypertension and a history of MIStates that he feels fine and is not a “hyper” personSmokes one pack of cigarettes daily for the past 28 yrDrinks 1-2 six-packs of beer on most Friday and Saturday nightsHas heard that BP drugs “make you impotent” Objective DataMild retinopathy (retinal arteriolar narrowing on ophthalmoscopic examination)BP: 166/108 mm Hg (average of two readings, 1 min apart)Sustained apical impulse palpable in the fourth intercostal space just lateral to the midclavicular line Diagnostic StudiesECG: mild left ventricular hypertrophyUrinalysis: protein 30 mg/dL (0.3 g/L)Serum creatinine level: 1.6 mg/dL (141 mmol/L) Collaborative CareLow-sodium, DASH dietHydrochlorothiazide 25 mg/day PO (dosage increase)Nicardipine (Cardene) sustained release 30 mg PO bid (second drug added)Discussion sWhat modifiable and non-modifiable risk factors for essential hypertension does R.L. have?What evidence of target organ disease is present?What misconceptions about hypertension should be corrected Health Science Science Nursing MED SURGE NUR102 Share EmailCopy link Comments (0)
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