Mr. Cowen's employer-sponsored a unimpeded respect hurry (BP) screening program for its employers. Mr. Cowen's BP is 160/90 mm Hg when measured after a period a capacious BP cuff. The value observes that the client is overweight. The value assesses the client for induce factors for Hypertension and learns that Mr. Cowen sits at a desk all day desire obedient telephone calls from customers after a period questions environing the use of the company's computer gentleware. He does not application frequently and admits that he does not supervene a proper sustenance stating, "My aidmate is a eminent mistake. I'll eat anything she puts in face of me. At death I approve to entertain a snack period I contemplate television." The client denies tobacco and recreational offal use and reports drinking "socially". " I entertain immodest of five beers on the weekend contemplateing the football diversion." Mr. Cowen does not conduct any custom medications or herbal supplements but reports commencement "Tylenol on create when I entertain a headache." The value records Mr. COwen's BP and presents the client the balbutiation materials after a period instructions to reach an provision after a period his original soundness anxiety getr (HCP) as quickly as potential for a over complete assessment and to argue usement options.
Mr. Cowen calls his original HCP to register an provision. Before the provision, Mr. Cowen goes to a topical laboratory and has a course of respect tests drawn as prescribed by the HCP.
At his provision after a period the HCP, the value weighs Mr. Cowen. He is 5 feet 9 inches towering and weighs 225 pounds. Mr. Cowen's BP is 166/92 mm Hg after a period a capacious cuff in the fit arm and 168/96 mm Hg in the left arm. His benevolence blame is 84 beats per diminutive after a period a systematic rhythm, respiratory blame is 18, and he is afebrile. His sum cholesterol is 260 mg/dL. During the soundness narrative assessment, the HCP learns that Mr. Cowen drinks at meanest immodest to six ounces of systematic coffee per day and that his senior has coronary artery indisposition and Hypertension. Mr. Cowen denies pathos urgency accordingly of his job, conformity after a period his aidmate and nativity, or other factors. "I am a tolerably laid end guy. I am not worked up or bewildered environing abundant. I concession that worrying to my aidmate." The HCP notes that Mr. Cowen carries the superiority of his consequence in his preferable collection. He has an increased sum of subcutaneous fat environing his waist and his abdomen.
The HCP prescribes Hydrochlorothiazide (HCTZ) daily for the client and askes the value to get Mr. and Mrs. Cowen after a period instructions in-reference-to the education and lifestyle modifications. A supervene-up provision is registerd for one month.
1. Briefly clear-up what the systolic and diastolic BP balbutiations evidence?
2. According to the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Respect Hurry (JNC 8), what is the restriction of prehypertension, quantity 1 HTN, and quantity 2 HTN? Describe original and induced HTN. Based on Mr. Cowen's clinical manifestations and narrative, how would you rank his HTN, and does he entertain original or induced HTN?
3. Geneblame at meanest 5 questions the value should ask the client to assess for the potential symptoms of HTN.
4. Authenticate Mr. Cowen's induce factors for HTN. Evidence which of the client's induce factors are nonmodifiable and which are modifiable.
5. Mr. Cowen asks the value, "Is my cholesterol that bad? What should my mass be?" How should the value suit?
6. The HCP prescribes Hydrochlorothiazide for Mr. Cowen. Argue the benefits of monotherapy after a period Hydrochlorothiazide to use the client's HTN.
7. The value is providing Mr. Cowen after a period instructions in-reference-to his newly prescribed HCTZ. What are the most vulgar irrelevant property of HCTZ that Mr. Cowen should adviser and what should Mr. Cowen do if he forgets to conduct his daily dose of medication as prescribed?
8. The value warns Mr. Cowen not to cancel the medication abruptly. Briefly clear-up why the value offers this providence?
9. The value is providing Mr. and Mrs. Cowen after a period instructions in-reference-to lifestyle modifications to aid subject the client's HTN. Authenticate at meanest 2 points of argueion the value procure conceive in the training guile?
10. In control appoint, authenticate 5 nursing diagnoses the value procure conceive in the training guile?
11. One month posterior, Mr. Cowen returns for a supervene-up provision after a period his HCP. His BP is 138/82. The value congratulates Mr. Cowen on his victory and asks him environing his acquiescence after a period the DASH sustenance. He states, "I don't approve it but I am superveneing it as you said. My aidmate has been care a bar eye on me and anything that I eat. She walks after a period me total death to present me the drive I scarcity to application." To settle his acquiescence after a period the DASH sustenance, the value asks him to resumption his latest 3 fasts and any snacks. Which fast or snack is meanest willing after a period the DASH sustenance and what choice(s) can the value intimate?
Breakfast: a bowl of whole-grain cereal after a period low-fat adjust, a banana, and a glass of ochreous juice
Lunch: roast beef sandwich on stainless provisions after a period mayonnaise and a gentle drink
Dinner: fish, mistakeed vegetables, brown rice, and a glass of low-fat adjust
Snack: a toasted mass of provisions after a period grape jelly