R. S Hypertension Case Studies

Patient R.S. is a 65-year-old African American male diagnosed with stage 1 hypertension. He complains of headache, nocturia, and an 8-pound weight gain over the past year. His past surgical history consists of an appendectomy. He has peptic ulcer disease and type II diabetes. His father had hypertension and died at age 55 of myocardial infarction, and his mother had diabetes mellitus and hypertension and died of CVA at age 55. R.S. is 5’9” and weighs 237.6 pounds.
Specific goals for managing R.S. are minimizing the use of pharmacotherapies while gaining control of his hypertension. Most important, the provider should assess R.L.’s current medication regimen to avoid potential interactions and/or duplications. The CNP must be aware of medications that may aggravate R.S.’s PUD, DMII, nocturia, and headaches.
According to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), the first-line treatment for hypertension is lifestyle modifications (Edmunds & Mayhew, 2014). In R.S.’s case, …show more content…
R.S. will need to be monitored closely upon initiation of pharmacotherapy to titrate dosing and monitor side effects till the desired effect is achieved. In the case of diuretic therapy, electrolytes, renal function, and volume status must be monitored carefully (Edmunds & Mayhew, 2014). Status should be monitored prior to initiation of therapy, approximately seven days after initiation, and at one month. The patient should also be monitored with dose changes and periodically thereafter (Edmunds & Mayhew, 2014). With ARB therapy also monitor electrolytes and kidney function. It is suggested the practitioner monitor for leukopenia occasionally as well (Edmunds & Mayhew, 2014). CCB therapy should be monitored with occasional kidney and liver function blood tests (Edmunds & Mayhew,