Hypertension Draft: Checkpoint 2

Case Study

Angela, a 30-year-old white female presented with complaints about frequent headaches, frequent nose bleeding, blood in the urine, fatigue, and confusion. The patient reported that she has been experiencing symptoms daily for the past days. The patient has a history of hypertension and kidney stones with hematuria. The patient further reported the headache last the entire day and the counter medications do not relieve the headache, and the pain score is 7/10. The nose bleeding occurs at least daily with difficulty stopping the bleeding while the confusion is intermittent daily for the last five days. The patient reported that she holds a demanding VP position in a large corporation that is very stressful. The current blood pressure reading for the patient is 164/102 mmHg while sitting in a chair at rest. The family history includes hypertension and kidney failure where the father has hypertension and kidney failure.Hypertension Draft Essay Example

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Physiological Measurements

The recommended physiological measurements include urinalysis, ECG, and blood tests. A blood test for the patient will examine the level of certain proteins, sugars, fats, and minerals within the blood. The blood test will show if Angela has elevated cholesterol levels or other health problems such as diabetes or kidney condition. elevated sugars may be an indication of diabetes for the patient while elevated proteins may indicate a problem with the kidney (Yaxley & Thambar, 2015). Similarly, an abnormality with minerals may indicate that the patient is having a kidney problem. Urinalysis would be performed to screen for protein in the blood. The presence of protein in the urine may indicate a kidney problem while the presence of blood in the urine may also indicate a problem with the kidney for Angela (Yaxley & Thambar, 2015). Angela has a family history of kidney disease and a personal history of hypertension and kidney stones with hematuria; all these are risk factors for kidney disease. An ECG is also appropriate for Angela to identify if hypertension has caused any damage in the heart or the blood vessels and if the patient’s heart is working well. It is important to examine the patient’s heart condition because hypertension is a major risk factor for cardiovascular problems (Yaxley & Thambar, 2015).

Alternative and Complementary Treatments

The concern of alternative treatments is that they may hinder the mainstream treatment for the patient and this can allow hypertension to deteriorate and affect other body organs. Moreover, the complementary and alternative treatments may cause serious problems and toxicity to the patient (Ibrahim et al., 2016).

Treatment Plan

The first drug choice in the treatment of blood pressure level higher than 130/80 mmHg and in patients with or suspected of kidney disease include angiotensin-converting enzyme (ACE) inhibitors. Angela has a BP value of 164/102 mmHg and possible kidney disease and thus ACE inhibitors will be the treatment choice for this patient. Angiotensin II helps in contracting the muscles surrounding the blood vessels and thus narrows blood vessels, which reduced the pressure of the blood (Messerli et al., 2018). Moreover, ACE inhibitors not only lower the blood pressure but also assists in slowing kidney damage.  Moreover, Angela will be advised to do lifestyle modifications that include losing weight, eating vegetables and fruits, limiting her sodium intake, exercising for at least 30 minutes daily, avoiding excessive alcohol and caffeine intakes, and avoid smoking (Pugh et al., 2019).

References

Ibrahim, I. R., Hassali, M. A., Saleem, F., & Al Tukmagi, H. F. (2016). A qualitative insight on complementary and alternative medicines used by hypertensive patients. Journal of pharmacy & bioallied sciences, 8(4), 284–288. https://doi.org/10.4103/0975-7406.199349.

Messerli, F. H., Bangalore, S., Bavishi, C., & Rimoldi, S. F. (2018). Angiotensin-converting enzyme inhibitors in hypertension: to use or not to use? Journal of the American College of Cardiology, 71(13), 1474-1482.

Pugh, D., Gallacher, P. J., & Dhaun, N. (2019). Management of Hypertension in Chronic Kidney Disease. Drugs, 79(4), 365–379. https://doi.org/10.1007/s40265-019-1064-1.

Yaxley, J. P., & Thambar, S. V. (2015). Resistant hypertension: an approach to management in primary care. Journal of family medicine and primary care, 4(2), 193–199. https://doi.org/10.4103/2249-4863.154630. Hypertension Draft Essay Example