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Case Study:

NT is a 64-year-old African American male who is transferring to your practice. He complained of occasional headaches and lightheadedness when getting up too quickly over the past month. He admits to minimal exercise and states, “I don’t add salt to my food”. His last visit to his PCP was 9 months ago.

Medical history includes HTN, Type II Diabetes, and COPD. Social history includes; occasional alcohol, 2-3 cups tea daily, smokes socially when going out.
Current meds: Hydrochlorothiazide 25 mg daily; Insulin glargine 20U daily hs; Metformin 1000 mg BID, tiotropium (Spiriva) 1 capsule inhaled daily.
VS: 162/90 (sitting), HR 76, RR 16. Ht. 70″ Weight 190 lbs. pulse ox 96%

Questions:

Would you change any of NT’s antihypertensive medications? If so, what would you change?
Discuss why you would or would not choose to add an Ace Inhibitor, Calcium Channel Blocker or a Beta Blocker in this patient.
Provide the rationale using an evidenced base source for your choice.
List five things you would teach this patient.
SCIENCE
HEALTH SCIENCE
NURSING
NR 552C

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