Question

An 83 year-old male presents to your clinic for his 3 month check. He is well known to your clinic. His medical history includes hypertension, myocardial infarction followed by quadruple bypass at 60 years-old, atrial fibrillation, hypercholesterolemia, and early Parkinsonism. His medications include metoprolol, Sinemet, clopidogrel, and atorvastatin. He told the medical assistant that he recently moved into a retirement center after he lost his wife. Vital signs: T 97.7F; P 78; R 20; BP 180/96; height 68 inches; weight 135, BMI 20.5. The provider notes that his blood pressure is 180/96 and that he has lost 10 pounds since his last visit. The provider’s physical assessment is normal for his age and health status. When the provider states that his blood pressure is high, the man states that he has been forgetting to take his medication. The provider then stresses the need to take his medication regularly, provides him with prescriptions for all his medications, and requests that he come back in 3 months.

What would you have done differently and why?

What is your number one priority in this scenario and why?

Answer 1

The things which could have been differently are

• Supporting him psychologically because the elevated blood pressure ,loss of weight can be related to the loss of his wife affecting him most emotionally
• Encouraging him to participate in the social activities, spirituality services,online support services to share the feelings and get interacted with the society of same and different characters of people
• Encourage him to do meditation, yoga, mild exercises regularly to feel relaxed and active
• Encourage him to have his food on time without skipping

2.The number one priority in this scenario is to control his high blood pressure because a diastolic blood pressure of 96 can be dangerous which can affect the circulation and impair blood supply to vital organs like brain and causing stroke.