Assignment: Hypertension Case Study
D. G. is a 54-year-old African American male who comes into the clinic for a "blood pressure check". He states that his previous physician told him that his blood pressure was high and too loose weight. He was supposed to follow up in four weeks but did not return to the clinic. His current blood pressure is 172/92. D.G. states that he feels fine and does not have time to exercise.
PMH
-hyperlipidemia
-hypertension
-surgical repair for broken ankle (7 years ago)
FH
Father died of heart disease at age 80, but his first MI was at 44; mother died at age 68 and had HTN and diabetes; brother (age 50) has HTN and high cholesterol; younger sister (age 42) has diabetes and HTN.
SH
He has been married for 30 years and has 1 daughter and 1 son who are healthy. He is a current smoker 1 ppd for 20 years. He occasionally drinks alcohol (1-2 drinks per week). His diet consists mainly of fast food and starchy carbohydrates. D. G. likes to drink regular soda pop
Meds
-Simvastatin 20 mg every evening
-Acetaminophen 500 mg as needed for pain
ALL
-NKDA
VS
BP 172/92, HR 80, wt 250 lbs., 6" ft. 5"
Questions: Read all of the questions before answering. Your references should be from the textbook, clinical or evidenced based guidelines, or peer reviewed journals. Points will be deducted for references that are not from the above sources.
1. Define the patient's problem.Refer to chapter 3 Rationale for prescribing
2. What is the therapeutic objective for treating this patient?
3. The patient has already been diagnosed with hypertension. What are his risk factors (modifiable and non-modifiable for cardiovascular disease)?
4. List the goals of treatment for this patient. This is different from question 2
5. What nonpharmacologic therapies are necessary for this patient to achieve and maintain adequate blood pressure reduction?
6. What reasonable pharmacotherapeutic options are available for controlling this patient's blood pressure?
7. Outline a specific and appropriate pharmacotherapeutic regimen for this patient, including:
a. Drug name, dose & dosage, form, route, regimen, duration and purpose.
b. Identify the medication classification
c. Mechanism of action
d. Major adverse effects and side effects
e. Contraindications
f. Safety alerts and precautions
g. Determination of clinical efficacy 15pts
8. What clinical guideline/standard of practice guidelines support your medication selection?
State the specific clinical guideline used.
How do these guidelines relate to your patient?
Include dosage, patient variables, follow up, diagnostic tests, and maintenance regimens.
9. Outline specific lifestyle modifications for this patient.
10. Based on your recommendations, provide appropriate education to this patient. Include how you would assess the patient's level of understanding.
Clinical Course
DG two month follow up appointment, he states that he has been walking 2 miles a day, and has been adherent to his medications as prescribed He states that he is having difficulty with healthy eating. His average blood pressure is 140/82.
11. What instructions should you give the patient at this point in his therapy.
12. What changes in therapy would you recommend if the patient now complains of intolerable adverse effects due to the current antihypertensive drug therapy. Outline an appropriate change to his current therapy. Include rationale and clinical guideline used to support the change.
13. What changes in therapy would you recommend if the patient is tolerating the current drug therapy but had not achieved the desire BP control (average BP162/88)? Outline an appropriate change to her current therapy. Include rationale and clinical guideline used to support the change.
Format your assignment according to the following formatting requirements:
1. The answer should be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.
2. The response also include a cover page containing the title of the assignment, the student's name, the professor's name, the course title, and the date. The cover page is not included in the required page length.
3. Also Include a reference page. The Citations and references should follow APA format. The reference page is not included in the required page length.
Attachment:- Hypertension.rar