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Case Study In Ineffective Pharmacological Management

4998 words - 20 pages

Running Head: CASE STUDY IN INEFFECTIVE PHARMACOLOGICAL MANAGEMENT

Case Study in Ineffective Pharmacological Management
Southern University A&M College
Graduate Nursing 652
Dr. Blair
April 23rd, 2015

Introduction
In the case study of Mr. J; he has been exhibiting dyspnea upon exertion and fatigue. His blood pressure was 170/95 mmHg. After reviewing his labs; his LDL level was 200 mg/dl. Upon physical examination, he was found to have peripheral edema and jugular vein distention. A chest X-ray revealed cardiomegaly and pleural effusion. An echogram has also been scheduled. Based on his signs and symptoms, the physician ...view middle of the document...

Overview of Mr. J’s medical conditions
Mr. J has been diagnosed with Hypertension. Hypertension is a chronic medical condition; in which the blood pressures in the arteries are elevated. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum, respectively, in the arterial system. The systolic occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction. Normal blood pressure at rest is within the range of 100-140 mmHg systolic (top reading) and 60-90 mmHg diastolic (bottom reading). Hypertension is present if it is persistently at or above 140/90 millimeters mercury (mmHg) for adults; different criteria applies to children. The symptoms of Hypertension is rarely accompanied by any symptoms, and its identification is usually through screening, or when asking healthcare for an unrelated problem. A proportion of people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes. The diagnosis of Hypertension is on the basis of a persistent high blood pressure. Traditionally, the National Institute of Clinical Excellence recommends three separate sphygmomanometer measurements on monthly intervals. The American Heart Association recommends at least three measurements on at least two separate health care visits. An exception to this is those with very high blood pressure readings especially when there is poor organ function. Initial assessment of the hypertensive people should include a complete history and physical examination. With the availability of 24-hour ambulatory blood pressure monitors and home blood pressure machines, the importance of not wrongly diagnosing those with white coat hypertension has led to a change in protocols. The first line of treatment for Hypertension is identical to the recommended preventive lifestyle changes and includes dietary changes, physical exercise and weight loss. Several classes of medications, collectively referred to as antihypertensive medications, are available for treating hypertension. Use should take into account the person’s cardiovascular risk (including risk of myocardial infarction and stroke) as well as blood pressure readings, in order to gain a more accurate picture of the person’s risk. Benefit of medications is related to a person’s cardiac disease risk.
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis-a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected (approximately 50% of cases). It may also present as tophi, kidney stones, or urate nephropathy. It is caused by elevated levels of uric acid in the blood. The uric acid crystallizes, and the crystals...

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