CASE STUDY Patient is a 55-year-old African American college…
CASE STUDY
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Patient is a 55-year-old African American college professor seen in the emergency clinic. He complains of generalized malaise, dyspnea on exertion, and puffy ankles. He has hypertension that is difficult to control. He states his cholesterol is elevated and had started on medication.
Additional History
Has gained 10 pounds in the past month and feels this is due to physical inactivity
Medications: Calcium channel blocker for hypertension, a statin for hyperlipidemia
In the past year, three episodes of urinary tract infections with pyelonephritis, the most recent were two weeks ago
No known allergies
States he smoker and has been unable to quit; rarely consumes alcohol
Family History
His father died of a heart attack at age 60
Mother died of diabetes complications at age 69
Older brother has hypertension
Lab and Diagnostic Results
Routine blood chemistry reveals a potassium level of 5.2 mEq/L
Sodium is slightly low; BUN is 36 and creatinine is 1.6
Serum cholesterol is 248 mg/dl
Vital signs: Temperature 36.8 °C, P 96 (regular), R 24, BP 162/90
You notice mild jugular vein distention when the patient is sitting upright
Medication Class
He is ordered Lasix 40 mg IV, a loop diuretic, now.
Upon discharge, he will be prescribed a thiazide diuretic.
Questions:( Provide at least two credible reference sources)
- Why was the patient in the case study prescribed a “now” order for a loop diuretic?
- Explain, findings of the physical assessment and how the Lasix works to present the desired outcomes. Review the patient’s habits and current condition.
- Explain the pharmaceutics of thiazide.
- How can this medication improve the patient’s over condition (heart, blood pressure, renal function)?
- What patient teaching is essential to optimal outcomes?
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