For the scenarios below, Answer the questions below using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.
Sara is a 45-year-old female presenting for her annual exam. Her blood pressure
today is 160/90 HR 84 RR 16. Her height is 64 inches and her weight is 195. Her
last visit to the clinic 3 months ago shows a BP of 156/92. She is currently taking
ibuprofen 600 mg tid for back pain. She has no known allergies. What is the goal
for her blood pressure? What medication would you prescribe to treat her blood
pressure? What education would you prescribe?
Title: Managing Hypertension in a Middle-Aged Female
Introduction
Hypertension, or high blood pressure, is a common medical condition that affects a significant portion of the population. In this scenario, Sara, a 45-year-old female, presents with elevated blood pressure readings during her annual exam. This essay aims to address the problem of uncontrolled hypertension in Sara, discussing the goal blood pressure levels, appropriate medication therapy, and necessary patient education.
Problem Explanation
Sara's blood pressure readings of 160/90 mmHg indicate stage 2 hypertension, a condition that requires prompt management to reduce the risk of cardiovascular complications. With a history of consistently elevated blood pressure measurements, it is crucial to establish treatment goals and initiate appropriate therapy to bring her blood pressure within the recommended range.
Addressing the Problem
Goal Blood Pressure:
The goal blood pressure for Sara, as per clinical practice guidelines, should be less than 130/80 mmHg for individuals with hypertension and additional risk factors like diabetes or chronic kidney disease.
Medication Therapy:
Considering Sara's presentation and the need for pharmacological intervention to manage her blood pressure effectively, prescribing an antihypertensive medication is warranted. In this case, initiating treatment with an ACE inhibitor such as Lisinopril 10 mg once daily would be a suitable choice. ACE inhibitors are recommended as first-line agents in the management of hypertension due to their proven efficacy and cardiovascular benefits.
Complete Medication Order:
- Medication: Lisinopril
- Strength: 10 mg
- Dosage: One tablet
- Route: Oral
- Frequency: Once daily
Patient Education:
In addition to pharmacological therapy, patient education plays a crucial role in managing hypertension. For Sara, it is essential to provide education on lifestyle modifications that can help improve her blood pressure control. This includes recommendations on dietary changes (such as reducing sodium intake), increasing physical activity, weight management, stress reduction techniques, and the importance of medication adherence.
Conclusion
In conclusion,
managing hypertension in middle-aged individuals like Sara requires a comprehensive approach that combines pharmacological therapy with lifestyle modifications and patient education. By setting appropriate treatment goals, prescribing evidence-based medications like Lisinopril, and empowering patients with the necessary knowledge to manage their condition, healthcare providers can effectively address hypertension and reduce the associated risks of cardiovascular disease.
References:
1. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. Clinical guideline [CG127]. 2011.
2. American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. J Am Coll Cardiol. 2018;71(19):e127-e248.
3. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):1269-1324.