You have just accepted a new position as an office nurse for a busy… You have just accep

You have just accepted a new position as an office nurse for a busy… You have just accepted a new position as an office nurse for a busy internal medicine physician. During your interviews with her, she told you that patient education was very important to her but she has found that she never has enough time to give adequate teaching. Part of your new job is to help her with patient management and education in her already-established hypertension clinic.On your first day at the hypertension clinic, you meet M. P., a 78-year old woman who was told about 6 months ago that her blood pressure was elevated. You take her blood pressure using the recent American Heart Association guidelines and get 160/102. She tells you that the physician told her she has hypertension and that she should take a pill everyday. She seems confused and asks you, “What is hypertension, anyway?”1. How would you explain hypertension to M. P.? M. P. goes on to say that she feels just fine and doesn’t think she needs this pill anyway. She shows you a prescription for enalapril (Vasotec) 2.5 mg daily and states, “The doctor gave this to me but I don’t think I’ll get it filled. Right now I feel fine.”2. What is your next nursing intervention? M. P. thanks you for explaining everything to her and reports she will get her prescription filled today on the way home from the doctor’s office. She goes on to ask if there is anything else she should do to treat her HTN.3. What non-pharmacologic measures might help someone like M. P., control her blood pressure? M. P. leaves your office a much more informed health care consumer and says she will see you in a month at her follow-up appointment. M. P. returns to the office 4 weeks later. She sits down to get her blood pressure taken and tells you she has been doing everything you taught her and has no questions about your previous teaching.4. You are getting ready to take M. P.’s blood pressure. What are important factors to keep in mind to guarantee an accurate reading of M. P.’s blood pressure?You escort M. P. to the exam room. While you are walking with her she tells you that she has a cough that has been bothering her for the past 3 weeks. She reports it is so bad that she can’t even sleep. She tells you she is going to ask the doctor “for an antibiotic to get rid of this cough.”5. Knowing what you do about M. P.’s treatment plan, what is the most likely cause of her cough? M. P. sees the physician and tells you that the doctor stopped her medication to see if her cough got better. She has submitted metoprolol (Lopressor) 50 mg b.i.d. M. P. is curious what side effects this new medication will have.6. List 4 things you would include in teaching M. P. about her new medication.  M. P. calls you 3 weeks later and states she is feeling fine and does not have any side effects from her new medication. She has had her blood pressure checked twice at the senior citizens’ center, and those readings were 138/78 and 142/82.7. M. P. asks if these blood pressure readings are OK. What do you tell her?  M. P. comes in for routine follow-up 1 year later. She continues to do well on her metoprolol 50 mg daily with average BP readings of 132/78. She participates in a routing walking program and eats a low-fat, no added salt diet. She tells you she recently was at a luncheon with her garden club and that most of those ladies take different blood pressure pills than she does. She is curious if she would be better off on a different medication.8. How can you best respond to M. P.’s statement? Health Science Science Nursing NURSING VN114 Share QuestionEmailCopy link Comments (0)

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