Question

PN 200 Fundamentals 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? 4. What effect may result when Mr. George takes digoxin and hydrochlorothiazide together? Explain your answer. 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. 6. How effective is the combination of hydrochlorothiazide and atenolol for controlling Mr. George's blood pressure? Explain your answer. 7. When using a combination of drug therapy to correct hypertension, would the dosage for each drug be the same? Explain your answer. 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- hydrochlorothiazide- is a diuretic

Increase water loss through urine and decrease bp and afterload of heart

2- sodium - decrease

Potassium- decrease

Calcium- increase

Magnesium- decrease

Glucose- increase

Uric acid- increase

3- because hydrochlorothiazide increase blood glucose level

4- thiazaide decrease afterload on heart and digoxin improve heart function capacity, digoxin decrease oxygen consumption by heart muscle and increase work capacity

5- atenolol is a beta blocker

Atenolol block beta 1 receptor on blood veseel and produce vesodilation