NR 508 grand grounds presentation

HYPERTENSION Chamberlain College of Nursing NR 508 Rachel Avisrur June 10th 2018 Case Study • David a 54 yo Caucasian male went to his primary care providers office for his yearly physical. The nurse came in and took Davids vitals. His blood pressure was 150/92, HR 75, RR 16, 98 kg. His blood pressure was repeated 2 times five minutes apart and the systolic pressure remained <150 and diastolic <90. While discussing the elevated blood pressure, David mentioned to the practitioner that he has been having dizzy spells and headaches off and on for the past 5 months. David works three jobs to support his family. He is a non smoker but admits to having other bad habits like eating fast food on a daily basis and avoiding the gym. Upon assessment the provider notices bilateral lower extremity +1 pitting edema. Davids routine lab work (CBC, CMP, urinalysis) shows all values are within normal limits. There is no past medical history and Davids surgical history includes a tonsillectomy at the age of 4. Hypertension JNC 8 Clinical Guidelines • In the general population <60 years, initiate pharmacologic treatment to lower BP at SBP ≥140 mm Hg and treat to a goal SBP <140 mm Hg. (James et al., 2014)