Question

Phil, 44yo has been diagnosed with primary hypertension. His medical history includes type 1 diabetes mellitus, with early signs of nephropathy. He has been taking metoprolol succinate 25mg and losartan 100mg. His blood pressure today is 138/98 mm Hg, which is consistent with the readings on his last three visits. His health care provider has added amlodipine 10 mg to his treatment regimen.

1. Phil states that he does not understand why he needs an additional medication considering his blood pressure is below 140 mm Hg systolic. How should the nurse respond?
2. What are the reasons Phil is on an ARB?.
3. Based on the current medication regime, what lab studies should the nurse be monitoring in this person?
4. What adverse effects and things to report should the nurse include in teaching Phil regarding the lisinopril, metoprolol and amlodipine ?

Answer 1

Nurse inform that after consuming losatran and metoprolol succinate , your diastolic pressure still high. So you need to start amlodipine along with your other medicines

ARB helps to reduce high blood pressure, prevent kidney failure for patient with diabetes. It may prevent diabetes and reduce the risk of stroke also.

Based on current medication regimen need to monitor kidney function test, lipid profile, serum potassium,sodium and calsium, urine analysis, HbA1c.

Talk to Mr Phil regarding the adverse effect of those hypertensive medicines such as Dizziness, cough, skin rashes, light headedness, ankle swelling, flushing, tired ness, diarrhoea or constipation.