Module 6 Clinical discussion reply to Anna Kassandra.

Dear writer i need a discussion reply to a fellow fnp student clinical week experience. Please do not critique their paper but rather expand on her original week experience.

Student clinical week post to reply to:

In this week’s clinical experience, I encountered a challenging case of a 65-year-old man who visited due to his evaluate blood pressure. During the consultation, he failed to remember his last screening or history with the disease, which limited our awareness on his issue while also raised a concern about his mental wellness (Jabeen, Adnan, Summaiya, & Maham, 2018). His medical records revealed that he was prescribed Benazepril (Lotensin) and denied taking any other medication. However, the data proved there was some prior progress on his condition before a notable change of his treatment, thus the need to explore alternatives relying on different strategies. Our analysis demonstrates that he missed six doses, which can lead to irregular blood pressure and a heart attack. Further interrogations also show that the man lived by himself and lacked an effective support system in managing hypertension.

The major signs of high blood pressure include severe headaches, difficulty in breathing, and irregular heartbeat, among others (Dunphy, Winland-Brown, Porter, & Thomas, 2015). This patient exhibited mild symptoms of irregular heartbeat, chest pains, and headaches. For diagnosis, we conducted two blood pressure tests using pressure cuffs and recorded the results on his medical record (Dunphy et al., 2015). For precision, we ensured that he was comfortably seated for at least five minutes to increase the blood flow into the arms (Aronow, 2020). Apart from that, the pressure cuffs were fitted onto his arm tightly to reduce the variance between the outcomes (Ioannidis, 2018). After taking two readings, the average result was 143 mm Hg, a diagnostic for stage 2 hypertension (Dunphy et al., 2015).

At this stage, the care plan requires a combination of diet and medication, but his case also demanded a refinement of treatment as the current procedure was ineffective. Based on his evaluation, we recommended beta-blockers, which reduce the heartbeat by inhibiting hormonal production rather than tightening the blood vessels (Singharaj, Pisarski, & Martirosyan, 2017), a change expected to reduce the frequency of headaches and, consequently, the memory lapses. For the diet plan, we proposed a healthy balanced nutritional plan mostly comprising fruits and whole grains, fewer animal products, more vegetables, and increased amounts of calcium to boost the red blood cells’ capacity to carry oxygen (Aronow, 2020). Furthermore, we designed with a manageable exercise scheme that would increase the body activity, reduce cholesterol, and increase blood flow (Singharaj, Pisarski, & Martirosyan, 2017). To solve his medication management issues, we reached out to a social worker to work on his case. The patient was cooperative and expressed the desire to take the medication, exercise, and adapt a healthy diet. In this stage, other possible diagnoses would be swelling of the lower extremities and chronic failures of organs such as the kidney and the heart (Ioannidis, 2018).

This experience has taught me the importance of a patient’s support system in managing chronic conditions such as hypertension. Therefore, advanced practice nurses need to be informed about the respective support system, such as family members, to whom they can be accountable while managing their conditions at home. Where such a system is not in place, the nurse practitioner should recommend programs that offer similar services, among them nursing homes or outpatient services.

References

Aronow, W. S. (2020). Managing the elderly patient with hypertension: current strategies, challenges, and considerations. Expert Review of Cardiovascular Therapy, 18(2), 117-125.

Dunphy, L. M., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing. FA Davis.

Ioannidis, J. P. (2018). Diagnosis and treatment of hypertension in the 2017 ACC/AHA guidelines and in the real world. Jama, 319(2), 115-116.

Jabeen, M., Adnan, A., Summaiya, I., & Maham, R. (2018). An assessment of difference in manifestations of mixed and isolated hypertension in terms of their signs and symptoms in hypertensive patients. Palliat Med Care, 5(1), 1-6.

Singharaj, B., Pisarski, K., & Martirosyan, D. M. (2017). Managing hypertension: Relevant biomarkers and combating bioactive compounds. Functional Foods in Health and Disease, 7(6), 442-461.