Nursing

According to the CDC, 32.5% of people in the United States have hypertension, and 3.7 million patients have a diagnosis of essential hypertension (CDC/National Center for Health Statistics: http://www.cdc.gov/nchs/fastats/hypertension.htm [accessed March 26, 2016]). Hypertension is frequently managed in primary care, and its sequelae can be life altering for patients. Patients with hypertension may have other comorbid conditions, including diabetes, hyperlipidemia, and obesity. For this assignment, you must choose from one of the following patients and develop a treatment plan that addresses your chosen individual’s issue in total, which will help to optimize her or his health. Case #1: A 46-year-old African American female with long-standing blood pressure of 180/110, treated intermittently because of insurance issues. The patient also has type 2 diabetes and a BMI of 27. She currently is employed and has a PPO. Her last blood pressure medication was HCTZ and she tolerated it well, but her blood pressure has never been lower than 170/80. Case #2: A 69-year-old Caucasian female with history of MI 20 years ago, currently on metoprolol and Norvasc. Her blood pressure readings on her last several visits have been 155–170/70–90 with a heart rate of 70–90. She has no chest pain. Her other medications are ASA 325mg, Prilosec 20mg, Lipitor 20mg, and Tylenol prn. She has a history of high cholesterol, and her lipid profile has been normal for the past 2 years. Case #3: A 59-year-old Hispanic male with type 2 diabetes on metformin 1000mg, Amaryl 4mg, Lipitor 40mg, lisinopril/Hctz 40/25, and Tricor. His last A1C was 12, and his current blood pressure is 170/88. Office urine microalbumin 100ug/mg. Case #4: A 39-year-old Hispanic female with headaches for the past two weeks. She is new to you, but she has been to the office 3 times in the past 4 weeks. Your partner put her on HCTZ for a blood pressure of 188/90. Today, her blood pressure is 180/74, and her heart rate is 90. She continues to have headaches. Her lab work had the following abnormalities: Her lipid profile shows total cholesterol of 325, HDL of 30, LDL of 78, and triglycerides 322, A1C 8, and BMI of 33. To prepare: Review the chapter that discusses rational drug selection, diabetes mellitus, hyperlipidemia, and hypertension in the text (Woo & Robinson). Consider the medications that are used for patients with diseases outlined in the patient problems listed above, taking into consideration age, gender, and culture. Think about the pathophysiology of comorbid diseases. To complete: Write a minimum 4-page paper in APA format (excluding cover page and references) that addresses the following: Briefly describe the disease processes of your chosen patient. Describe the approach to the pharmacological treatment plan for the patient that should optimize this patient’s health. Describe your optimal goal for your chosen patient and discuss the national guidelines that support your goals. Describe the potential pharmacological interactions of your chosen plan and the education necessary for the patient in regards to these potential interactions. Describe the interdisciplinary team that might be involved in the care of the patient and how working collaboratively as a team affects patient outcomes. Discuss the nonpharmacological educational needs for this patient. Discuss the health maintenance needs for this patient to maintain optimized health. Include four or more appropriate scholarly sources from the last five years throughout the paper.