PATHOPHYS/ADV/PRAC – 2021-2022 WinterA 74-year-old Caucasian female patient presents in the clinic with chief complaints of fatigue and headache. On physical exam, she was found to have BP of 190/105 mmHg. Other V/S are as follows: HR 91, RR 20, Temp 98.0 F, Weight 190lbs, Height 5’2″. The patient states that she was on lisinopril for the past two years, but she stopped taking the medication six months ago because of severe persistent cough, which she attributes to lisinopril. PMH includes Type II DM x 3 years; Hyperlipidemia x 3 years. No history of MI or stroke. Her meds include metformin 500 mg BID, glyburide 5 mg in AM, Lipitor 20 mg daily. 1. How would you treat this patient? Please use the assigned reading on D2L to support your answers. 2. Discuss the underlying pathophysiology of hypertension and coronary disease. 3. What are the complications of uncontrolled HTN? 4. What is your plan of care for this patient? What is your goal of treatment? Return to the clinic schedule for a follow-up? When do you change/add more anti-hypertensive drugs? Referral to a specialist? 5. What is a J-CURVE effect in HTN? What are its implications for the management of HTN in older adults? Health Science Science NursingNSG 428
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