Hypertension Case Study

Hypertension Case Study

C.D is a 55-year-old African American male who presents to his primary care provider with a 2-day history of a headache and chest pressure.

PMH

Allergic Rhinitis

Depression

Hypothyroidism

Family History

Father died at age 49 from AMI: had HTN

Mother has DM and HTN

Brother died at age 20 from complications of CF

Two younger sisters are A&W

Social History

The patient has been married for 25 years and lives with his wife and two children. The patient is an air traffic controller at the local airport. He has smoked a pack of cigarettes a day for the past 15 years. He drinks several beers every evening after work to relax. He does not pay particular attention to sodium, fat, or carbohydrates in the foods he eats. He admits to “salting almost everything he eats, sometimes even before tasting it.” He denies ever having dieted or exercised.

Medications

Zyrtec 10 mg daily

Allergies

Penicillin

ROS

States that his overall health has been fair to good during the past year.

Weight has increased by approximately 30 pounds in the last 12 months.

States he has been having some occasional chest pressure and headaches for the past 2 days. Shortness of breath at rest, headaches, nocturia, nosebleeds, and hemoptysis.

Reports some shortness of breath with activity, especially when climbing stairs and that breathing difficulties are getting worse.

Denies any nausea, vomiting, diarrhea, or blood in stool.

Self treats for occasional right knee pain with OTC Ibuprofen.

Denies any genitourinary symptoms.

Vital Signs

B/P 190/120, HR 73, RR 18, T. 98.8 F., Ht 6’1”, Wt 240 lbs.

HEENT

TMs intact and clear throughout

No nasal drainage

No exudates or erythema in oropharynx

PERRLA

Funduscopy reveals mild arteriolar narrowing without nicking, hemorrhages, exudates, or papilledema

Neck

Supple without masses or bruits

Thyroid normal

No lymphadenopathy

Lungs

Mild basilar crackles bilaterally

No wheezes

Heart

RRR

No murmurs or rubs

Abdomen

Soft and non-distended

No masses, bruits, or organomegaly

Normal bowel sounds

Ext

Moves all extremities well

Neuro

No sensory or motor abnormalities

CN’s II-XII intack

DTR’s = 2+

Muscle tone=5/5 throughout

What you should do:

  • Develop an evidence-based management plan.
  • Include any pertinent diagnostics.
  • Describe the patient education plan.
  • Include cultural and lifespan considerations.
  • Provide information on health promotion or health care maintenance needs.
  • Describe the follow-up and referral for this patient.
  • Prepare a 3–5-page paper (not including the title page or reference page).

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric to make sure you have included everything necessary; and
  • utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition format as outlined in the APA Progression Ladder.

Expert Solution Preview

Introduction: Hypertension is a chronic condition that affects a significant portion of the population. As a medical professor, it is essential to equip our students with the skills and knowledge required to manage hypertension successfully. In this case study, we will develop an evidence-based management plan, including pertinent diagnostics, patient education plan, cultural and lifespan considerations, health promotion or health care maintenance needs, and follow-up and referrals.

1. Develop an evidence-based management plan:

The patient’s blood pressure of 190/120 mmHg indicates stage 2 hypertension requiring immediate intervention. The management plan includes both non-pharmacological and pharmacological interventions.

Non-pharmacological interventions include weight loss through a healthy diet and exercise, reducing salt intake, moderating alcohol consumption, smoking cessation, and stress management.

Pharmacological interventions include initiating antihypertensive medication using Angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) as first-line therapies because of comorbidities such as depression, hypothyroidism, and allergic rhinitis. The medication will be adjusted until the patient’s blood pressure is controlled.

2. Pertinent diagnostics:

The patient requires a complete metabolic panel, urinalysis, electrocardiogram (ECG), and lipid panel. The tests will help identify any underlying comorbidities such as hyperlipidemia, diabetes, and renal function.

3. Patient education plan:

Patient education will focus on lifestyle modifications such as a heart-healthy, low-sodium diet, regular physical activity, quitting smoking, limiting alcohol consumption, and stress reduction techniques. The patient should adhere to medication schedules and monitor blood pressure regularly.

4. Cultural and lifespan considerations:

The patient is an African American male, and hypertension is more prevalent in this population, making culturally sensitive treatment important. Health literacy is also a consideration, and the patient’s education plan should be tailored to their learning needs.

5. Health promotion or health care maintenance needs:

The patient should receive regular blood pressure monitoring, routine medical assessments, and screenings for comorbidities such as diabetes, hyperlipidemia, and renal function.

6. Follow-up and referrals:

The patient should follow up with their primary care provider within four weeks after initiating antihypertensive medication and then regularly thereafter. Referral to specialists may be necessary if necessary, such as cardiologists or endocrinologists.

Conclusion:

Hypertension is a prevalent chronic condition that requires a multifaceted approach to management. This case study highlights the importance of developing evidence-based management plans, including pertinent diagnostics, patient education plans, cultural and lifespan considerations, health promotion or health care maintenance needs, and follow-up and referrals. Educating medical students on effective hypertension management is essential in promoting and maintaining good patient outcomes.

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