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Mrs. Lyons is a 57-year-old African American female who recently developed headaches and had an elevated blood pressure reading at her work health fair. Her blood pressure was taken at the health fair, and the reading was 168/99. She has returned to the drugstore three times to take her blood pressure. The readings have been: 145/90, 150/89, 140/88. At the health fair, she was told her BMI is elevated. Her cholesterol levels were also done at the health fair, and the results were: total cholesterol level of 250, LDL 138, HDL 48, and Triglycerides 170.  

 

She has not been to see a primary care provider in over 5 years. At her last office visit, which was 5 years ago, her blood pressure was (135/95). Her LDL and triglycerides were also elevated at that time. The patient was supposed to monitor her blood pressure at home and trial diet and lifestyle changes. She was supposed to return for a follow-up with her blood pressure log and for a recheck of her labs. She, unfortunately, did not do this. 

Today in the clinic, her vital signs are: 

BP 146/92, HR 90, Temp 98.4, RR 12, O2 98%, Height 5’5, Weight 220 lbs, BMI 36.6 

She is not currently taking any medications. She has NKDA. Family history: her brother and sister both have been diagnosed with hypertension and DM. Diagnoses for the patient are HTN, Obesity, and Hyperlipidemia. 

 

 

1. Please briefly discuss the first-line treatment recommendations from JNC8, and the AHA/ACC for a patient with no other major comorbidities. 

2.  What are the recommended medications to start this specific patient on? Please provide the drug class, generic & trade name, and initial starting dose. 

SCIENCE
HEALTH SCIENCE
NURSING
MSN – FNP 571

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