Regis NU664B Week 6 Discussion Latest 2022 October

NU664B Primary Care of Family I

Week 6 Discussion

Patient with Hypertension

Imagine that you are a primary care provider in the middle of your busy Thursday. Your 10:30 a.m. telehealth appointment is as follows:

HPI: A 50-y-old Spanish-speaking female who is bilingual returns to your office for a follow-up BP check. She is a schoolteacher and has been your patient for many years. She arrives 45 min late for her appointment. At her previous visit 4 weeks ago, her BP was 160/90 mm Hg on atenolol 50 mg QD (Tenormin, beta-blocker, max dose 100 mg QD), and you increased the atenolol to 75 mg QD at that time.

Today she feels well, and her BP is 140/85 mm Hg on 2 measurements and her HR is 50 bpm.

Labs: CBC (WNL), Creatinine 2.0 mg/dl (normal range 0.5–1.3 mg/dl), potassium 3.8 MEQ/L (nml range 3.5–5 MEQ/L), and a 24 h urine protein of 1.3 g (normal <150 mg/d), similar to her previous lab results 6 month ago.

Allergies: NKDA

Family History: Father (deceased 85 y/o CVA); Mother (deceased 91 y/o MI)

Physical Exam

Vitals: BP 140/85, HR 50, RR 18, Wt 132 lbs, Ht 5’1”

HEENT: PERRL, Funduscopic exam notes cotton wool spots present.

Respiratory: Lungs were clear bilaterally with good aeration.

Cardiac: RRR, S1/S2 auscultated. 2+ pitting edema bilaterally.

Abdominal: Unremarkable

Integumentary: Intact.

Vascular: Capillary refill +3

Complete the following:

Initial Post by Wednesday (Day 3) at 11:59 p.m.

List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.

Initial Post by Wednesday (Day 3) at 11:59 pm

Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:

Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.

You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.