Nursing Case Study Essay

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Christine is a 45-year-old female here today with concerns for elevated blood pressures. HPI The patient tells me she has been checking her blood pressures recently. Last week, she checked her blood pressures with the nurse at school that she sometimes substitutes at, and more recently has checked them with the Rite-Aid machine and they are ranging in the 147 to 158 systolic/97 to 99 diastolic. She reports her diastolic has not been lower than 97. Here today in the office, on her check, she was 158/88. She is not having chest pain, shortness of breath, dyspnea on exertion, or lower extremity swelling, but is feeling an occasional palpitation in the chest, and just an overall sense of tightness everywhere. She is exercising, though has…show more content…
She recently had a dose adjustment for the Levoxyl. Her TSH was done on September 24th showing an elevation at 6.5. I did elect to increase her medication to 0.0175 from 0.015 mg. She tells me the palpitations were present prior to that change. She is feeling relatively good at that standpoint, but does admit to fatigue, which she says she has had her whole…show more content…
We did discuss this at length today. We reviewed the risks associated with uncontrolled elevated blood pressures and talked about her options, including lifestyle changes versus medication therapy, and she is really doing the best she can right now with lifestyle. She wanted to move forward with medications. We did discuss options I elected to place her on hydrochlorothiazide 25 mg #30 with no refills. She will take a half tablet for the first week or so and then increase to a full tablet, if her blood pressures need that and if she is not having any side effects. I did review typical use and side effects with her. She was given a lab slip for a basic panel to check in approximately three to four weeks before her next evaluation. She plans on buying a blood pressure cuff. I have asked her to bring that in to her next visit, so we can ensure that she is getting accurate results. I have encouraged her to really work on those lifestyle choices in the meantime, and certainly if able down the road consideration for decreasing or stopping the medication can be done. Any problems or concerns with this, she will update

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