Question

Hypertension Case Study: Rex Ryan, 86 year-old male, is diagnosed with CHF and hypertension. He is experiencing a significant headache. You are caring for him and are responsible for interpreting his medication orders and subsequent nursing implications. Here is Rex's current vitals and medications Vitals: HR: 58 BP: 200/95 RR: 18 SpO2: 94% Room Air Temp: 98.2 degrees F Medications: Lopressor (Metoprolol) 25 mg PO BID Hydrochlorothiazide 25 mg PO daily Lisinopril 20mg PO BID Lasix 40mg PO Daily What should your detailed nursing assessment consist of at this time? 1. 2. What laboratory results will you look for? Why? 3. List 3 adverse effects for each of the ordered medications. What would you educate the patient about with the above medications? Why? 5. List beside each medication whether it affects just blood pressure or both blood pressure and 4. heart rate. 6. What dietary education should be provided with use of Lasix and Hydrochlorothiazide? 8. What will you report to the physician? Why? 9. What route of administration would be best at this time to lower blood pressure? Why? 10. Would you hold any of the above medications? Why? What diet should the patient be on? 7.

Answer 1

Ans) Around 80% of the heart failure patients are with the age 65 or more.The identification and controlling of heart failure in the older individuals are always demanding or challenging.With the help of good clinical expertise and practice, the older individuals heart failure can be clearly identified and controlled.

-- The heart failure is a cardiac syndrome with complicated and quickly developing pathogenesis and medical care.Anyway the heart failure is eventually a syndrome,as nearly all heart failure clients are controlled by generalist doctors and it is also a important reason for hospitalization between older individuals.

-- The identification and controlling of heart failure in the older individuals can be complex by numerous co-morbidities and poly pharmacy.The controlling of heart failure in the older individuals in the age more than 75 with usual left ventricular emission fraction can be complex by reduced proof to lead therapy and comorbidities like the diabetes,hypertension,kidney disorders and poly pharmacy related to this situation.

-- In the older adults like Rex Ryan, they commonly experiences Orthopnea and Paroxysmal nocturnal dyspnea as the symptoms of heart failure. Orthopnea commonly happens very easily after lying down and is also able to happen by sitting.Paroxysmal nocturnal dyspnea happens 2-3 hours succeeding after the starting of sleep and makes patients to break their sleep with the dyspnea, which can be come behind the cough.Most of the older peoples with the heart failure commonly sleeps in the chair to prevent the orthopnea.

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