Question

undamentalS of Nursing II Case Study – Hypertension/Heart Failure Greg George, a 72-year-old African-American patient, has heart failure and diabetes. His vital signs are blood pressure 176/94, pulse 92, and respirations 30. His medications include hydrochlorothiazide 50mg/day, atenolol 50mg/day and digoxin 0,25mg/day. 1. Why was the hydrochlorothiazide prescribed for Mr. George? Explain the effects of hydrochlorothiazide on the blood pressure. 2. Abnormal electrolytes and other laboratory test results may occur when taking hydrochlorothiazide. Would the following serum electrolytes and laboratory values be expected to increase or decrease? Explain your answer. a. Sodium. b. Potassium c. Calcium d. Magnesium e. Glucose f. Uric Acid 3. Why should Mr. George's blood glucose be monitored while taking hydrochlorothiazide? What effect may result when Mr. George takes digoxin and hydrochlorothiazide together? Explain your answer. 4. 5. Atenolol is what type of an antihypertensive? Would atenolol by effective in lowering Mr. George's blood pressure if given as the only antihypertensive drug? Explain your answer. How effective is the combination of hydrochlorothiazide and atenolol for controlling Mr. George's blood pressure? Explain your answer. 6. When using a combination of drug therapy to correct hypertension, would the dosage for each drug be the same? Explain your answer. 7. 8. When abruptly discontinuing beta blockers for hypertension without the patient taking another antihypertensive, what might occur? Explain how these adverse effects can be avoided.

Answer 1

1. hydrochlorthiazide prescribed for increased blood pressure. It will help to lower down blood pressure by producing more urine output and decreasing fluid overload will decrease blood pressure.

2. Hydrochlorthiazide causes hyponatremia, hypokalemia, hypercalcemia, hypomagnesemia as there is increased excretion of sodium, potassium, and magnesium. hyperglycemia as it increases the production of glucose from liver, hyperuricemia because it decreases fluid inside the body so uric acid level increases as a result.

3. Yes blood pressure should be monitored to check the effectiveness of medication in lowering bp.

4. Yes these medicines can be taken together but levels of digoxin, potassium and magnesium need to be monitored. There may be visual problems, decrease in appetite, tiredness, nausea, muscle cramps.