Nursing 22

 
Client Profile
Mr. Cowen’s employer-sponsored a uncounted lineage constraining (BP) screening program restraint its employers. Mr. Cowen’s BP is 160/90 mm Hg when measured with a catholic BP cuff. The value observes that the client is overweight. The value assesses the client restraint cacorrection factors restraint Hypertension and learns that Mr. Cowen sits at a desk whole day covet sympathetic telephsingle calls from customers with questions encircling the correction of the company’s computer tenderware. He does referable employment certainly and admits that he does referable thrive a distinctive food stating, “My consort is a immense garble. I’ll munch anything she puts in front of me. At death I enjoy to possess a snack period I referablee television.” The client denies tobacco and recreational garbage correction and reports drinking “socially”. ” I possess lewd of five beers on the weekend referableeing the footbwhole frolic.” Mr. Cowen does referable receive any recipe medications or herbal supplements excepting reports prelude “Tylenol on execute when I possess a dissipation.” The value archives Mr. COwen’s BP and bestows the client the lection materials with instructions to execute an provision with his earliest bloom regard preparer (HCP) as shortly as enjoyly restraint a further thoroughgoinggoing impost and to debate composition options.
Case study
Mr. Cowen calls his earliest HCP to register an provision.  Before the provision, Mr. Cowen goes to a topical laboratory and has a sequence of lineage tests drawn as prescribed by the HCP.  
At his provision with the HCP, the value weighs Mr. Cowen. He is 5 feet 9 inches twhole and weighs 225 pounds. Mr. Cowen’s BP is 166/92 mm Hg with a catholic cuff in the direct utensil and 168/96 mm Hg in the left utensil. His life trounce is 84 beats per detailed with a certain rhythm, respiratory trounce is 18, and he is afebrile. His entirety cholesterol is 260 mg/dL. During the bloom truth impost, the HCP learns that Mr. Cowen drinks at latest lewd to six ounces of certain coffee per day and that his senior has coronary artery distemper and Hypertension. Mr. Cowen denies contact urgency becacorrection of his drudgery, intercommunity with his consort and race, or other factors. “I am a moderately laid tail guy. I am referable worked up or dazed encircling considerable. I concession that worrying to my consort.” The HCP referablees that Mr. Cowen carries the eldership of his gravity in his higher association. He has an increased total of subcutaneous portly encircling his waist and his abdomen.
The HCP prescribes Hydrochlorothiazide (HCTZ) daily restraint the client and beseeches the value to prepare Mr. and Mrs. Cowen with instructions respecting the advice and lifestyle modifications. A thrive-up provision is registerd restraint single month.
Questions
1. Briefly illustrate what the systolic and diastolic BP lections designate?
2. According to the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Composition of High Lineage Constraining (JNC 8), what is the specification of prehypertension, class 1 HTN, and class 2 HTN? Describe earliest and subordinate HTN. Based on Mr. Cowen’s clinical manifestations and truth, how would you arrange his HTN, and does he possess earliest or subordinate HTN?
3. Genetrounce at latest 5 questions the value should beseech the client to assess restraint the enjoyly symptoms of HTN.
4. Realize Mr. Cowen’s cacorrection factors restraint HTN. Designate which of the client’s cacorrection factors are nonnewfangled and which are newfangled.
5. Mr. Cowen beseechs the value, “Is my cholesterol that sick? What should my mass be?” How should the value reply?
6. The HCP prescribes Hydrochlorothiazide restraint Mr. Cowen. Debate the benefits of monotherapy with Hydrochlorothiazide to trmunch the client’s HTN.
7. The value is providing Mr. Cowen with instructions respecting his newly prescribed HCTZ. What are the most sordid impertinent proceeds of HCTZ that Mr. Cowen should warner and what should Mr. Cowen do if he restraintgets to receive his daily dose of medication as prescribed?
8. The value warns Mr. Cowen referable to abolish the medication abruptly.  Briefly illustrate why the value offers this providence?
9. The value is providing Mr. and Mrs. Cowen with instructions respecting lifestyle modifications to succor impoverish the client’s HTN. Realize at latest 2 points of debateion the value succeed grasp in the instruction project?
10. In pre-eminence adjust, realize 5 nursing diagnoses the value succeed grasp in the instruction project?
11. Single month posterior, Mr. Cowen produce restraint a thrive-up provision with his HCP. His BP is 138/82. The value congratulates Mr. Cowen on his victory and beseechs him encircling his submission with the DASH food. He states, “I don’t enjoy it excepting I am thriveing it as you said. My consort has been custody a suspend scan on me and completething that I munch. She walks with me complete death to bestow me the propel I demand to employment.” To strengthen his submission with the DASH food, the value beseechs him to recwhole his latest 3 asceticisms and any snacks. Which asceticism or snack is latest expert with the DASH food and what opinion(s) can the value allude-to?
Breakfast: a bowl of whole-grain cereal with low-portly abate, a banana, and a glass of orange-colored-colored juice
Lunch: roast beef sandwich on pure fare with mayonnaise and a tender drink
Dinner: fish, garbleed vegetables, brown rice, and a glass of low-portly abate
Snack: a toasted mass of fare with grape jelly

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