Question

Scenario 1 RR is a 58 year old man who has had been diagnosed with hypertension of 178/92 and hyperlipidemia. Over the course of 1 year he has had several blood pressure checks and medications have been added. Currently his blood pressure is running 128/66 He is currently prescribed metoprololopressor), lisinopril (zestril), and hydrochlorothiazide for the hypertension and pravastatin (pravachol). 1. When he asks the nurse why he has so many medications now that his blood pressure is low - what teaching needs to be completed? Scenario 2 MG is a 78 year old woman who has previously been diagnosed with atherosclerosis and now with atrial fibrillation. She has previously been on nitroglycerin for intermittent chest pain. She has been prescribed warfarin (coumadin). 1. Please explain how this warfarin (coumadin) works for her. 2. What teaching would the RN need to provide? Six months later, M G falls. She stated she was light-headed. Her cardiologist performs a cardioversion and prescribes amiodarone (cordarone). 3. Please provide patient teaching for her new medication. What needs to included in the teaching?

Answer 1

1.

R R is a 58-year-old man who had been diagnosed with hypertension of 178/92 1 year before. Now his blood pressure is 128/66 with medication.

Answer - The nurse should teach RR is

- Your blood pressure is in normal range due to the effects of medications.

- you are taking combine drug therapy, which includes beta-blockers (Metoprolol), ACE inhibitor (Lisinopril) and Diuretics (Hydrochlorothiazide) for effective control of blood pressure because you have chronic hypertension.

- These 3 drugs are antihypertensive but they do not work in the same way, Beta-blocker reducing your blood pressure by reducing heart rate and contractibility, ACE inhibitor reduces your blood pressure by relaxing your blood vessels and Diuretics excrete extra fluid from body which also reduces your blood pressure.

- You are taking Pravastatin which is maintaining your cholesterol level because an increase in cholesterol level can worsen your high blood pressure and makes you prone to cardiovascular diseases.

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