, a 65-year-old African-American man, was referred to the APRN-NP in the hypertension clinic for evaluation of high BP noted on an initial screening....

Question R. S., a 65-year-old African-American man, was referred to the APRN-NPin the hypertension clinic for evaluation of high BP noted on an initial screening. He reports having headaches and nocturia. He states that he has gained 8 pounds over the last year. Past medical history: Appendectomy 30 years ago, Peptic ulcer disease 10 years ago, Type 2 diabetes mellitus for 10 years; Family history: Father had hypertension; died of myocardial infarction at age 55, Mother had diabetes mellitus and hypertension; died of cerebrovascular accident at age 60; Physical examination: Height 69 in, weight 108 kg; BP: 140/89 mm Hg (left arm), 138/82 mm Hg (right arm); Pulse: 84 beats/min, regular; Funduscopic examination: mild arterial narrowing, sharp discs, no exudates or hemorrhages; Laboratory findings: Blood urea nitrogen: 24 mg/dL, Serum creatinine: 1.5 mg/dL, Glucose: 95 mg/dL, Potassium: 4.0 mEq/L, Total cholesterol: 201 mg/dL, High-density lipoprotein cholesterol: 30 mg/dL, Triglycerides: 167 mg/dL, Urinalysis: 1+ proteinuria; Electrocardiogram and chest radiograph: mild left ventricular hypertrophy; Social history: Tobacco: 35 pack years, Alcohol: pint of vodka/week, Coffee: 2 cups/dayIn this discussion forum: -Discuss the patient’s diagnosis of hypertension, including the stage, comorbidities, and family history. -Discuss specific goals for pharmacotherapy for treating R. S.’s hypertension and cholesterol -Discuss what you would consider to be first-line pharmacotherapy for R. S., and why. -Discuss the parameters for monitoring the success of the therapy. -Discuss health promotion recommendations you would consider for R. S. -Does the presence of Diabetes Mellitus impact your treatment selection? Health Science Science Nursing NURS N521 Share QuestionEmailCopy link Comments (0)