Nr508 Week 3: Discussion
Nr508 Week 3: Discussion. Mr. Russell is a 73-year-old male who presents to your clinic with complaints heart palpitations and light headedness on and off for the past 3 months. He has a history of hypertension and is currently prescribed HCTZ. He also is complaining of heartburn and belching after a large meal.
Vital Signs: B/P 159/95, Irregular HR 88, Resp. 22, Weight 99 kilograms
Lower extremities with moderate 3+edema noted in left leg, 2 + edema in right leg, ABD + BS, Neuro AOX3,
Labs: NA 143mEq/L, CL 99 mmol/L BUN 18mg/dL, Hbg 15, TC 234 mg/dL, LDL 137 mg/dL, HDL 35 mg/dL, triglycerides 241mg/dL,
What are your treatment goals for Mr. Russell today?
What is your pharmacologic plan; please state your rationale for your plan?
What are five key patient education points based on your plan?
How would your plan change if your patient is African American?
Nr508 Week 3: Discussion Answer
Treatment Goals for Mr. Russell:
Considering Mr. Russell’s blood pressure of 159/95, the primary treatment goal is to reduce it to a normal or acceptable range, adhering to the American Heart Association’s guidelines (2018) of less than 120 mm Hg for systolic and less than 80 mm Hg for diastolic.
Achieving a normal blood pressure range is crucial not only for blood pressure management but also to alleviate symptoms such as heart palpitations and lightheadedness. Furthermore, Mr. Russell will be educated on lifestyle modifications, including an exercise program and a healthy diet, aimed at managing his weight. Additionally, addressing the cholesterol level, currently at 234, to bring it within the normal range around 200 is another treatment goal.
Pharmacologic Plan and Rationale:
The proposed pharmacologic plan involves the use of Amiloride in combination with HCTZ. Amiloride, recognized as a potassium-sparing diuretic, aids in salt absorption while maintaining appropriate potassium levels (Roush & Sica, 2016). Simultaneously, Hydrochlorothiazide (HCTZ), a diuretic, facilitates the elimination of excess salt and water. This combination is selected to address Mr. Russell’s elevated blood pressure, targeting sodium and water retention to contribute to blood pressure reduction and manage edema effectively.
References:
American Heart Association. (2018). Understanding Blood Pressure Readings. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings
Roush, G. C., & Sica, D. A. (2016). Diuretics for hypertension: a review and update. American Journal of Hypertension, 29(10), 1130-1137.
