NU636 Advanced Pharmacology: Treating Hypertensive Urgencies – Unit 2 Discussion Solution

DQ1 Treating Hypertensive Urgencies

You have a 57 year old mixed race male (black and Asian) who comes into your office for a screening to participate in a study to evaluate the effectiveness of a home cervical traction device on neck pain and intervertebral disc space.  He has a history of neck pain and was diagnosed six years ago with spinal stenosis at the C5-C6 level.

During the screening the gentleman is found to have a BP of 217/109.  When you question him about this BP measurement he reports to you that he knows that his blood pressure has been in that range for about the last decade.  He reports he has not seen a health care professional about his elevated blood pressure and does not have a health care professional that he sees on a routine basis.  He is a healthcare professional at the provider level.

Based on the blood pressure measurement he does not meet the inclusion criterion for the cervical traction device research study.

Please develop a discussion that responds to each of the following prompts.  Where appropriate your discussion needs to be supported by scholarly resources.  Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.

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DQ2 Treating Hyperlipidemia

You are seeing a 62 year old white female for her annual visit.  Presented below are some pertinent subjective and objective data that you elicited during your comprehensive assessment session with the patient (note – this is not the entire subjective and objective data set for this office visit).

PMH:  HTN, Hyperlipidemia

Social History:  divorced, employed full time as a graduate nursing program professor, no smoking history, reports on a rare occasion she may have a 2 – 3 ounces of wine when dining out [less than 6 times a year]

Health Maintenance Activities: 1 ½ to 2 hours of exercise every morning [45 – 60 minutes of yoga, 45 – 60 minutes of step aerobics]; low glycemic Pescatarian; has not engaged with recommended colonoscopy, does not have screening mammograms, does not get a flu shot and has not had any other recommended adult immunizations

Review of Systems-Treating Hypertensive Urgencies

Cardiovascular: reports hypertension diagnosed at 27 years of age, controlled on 5mg Lisinopril daily; reports elevated total cholesterol level for the last decade or so with no pharmacologic treatment; denies chest pains, palpitations, lower extremity edema.

Physical Exam
Constitutional – Ht. 64 inches, Wt. 127 pounds [BMI 21.8], BP 112/60, P 68, T 97.9 temporal, R 16, SpO2 99%
Integument – pink, warm and dry to touch

Eyes – no arcus senilis

Cardiovascular – heart regular rate and rhythm, S1 and S2; no S3 or S4, murmur or gallop; no carotid bruits; radial pulses palpable and pedal pulses 2+; no lower extremity edema; capillary refill < 3 seconds bilateral
Lipid panel – Total cholesterol 302, HDL 117, Triglycerides 45

Please develop a discussion that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly literature. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.