Instruct patient to have a blood test drawn that includes CBC, kidney, liver ,lipid, and electrolyte test so baseline on patients overall status is established before initial treatment.
Ms. Smith needs to follow-up with the clinic two weeks after initial dose of lisinopril/hctz dose to determine if dosage titration is needed. The patient needs to monitor and record blood pressure for 2 weeks and bring the records to the clinic for revaluation. Advice the patient to change the position slowly to avoid orthostatic hypotension. Instruct patient to weigh themselves daily and to monitor weight gain or extreme weight loss that can be harmful. Inform patient that coughing is a side effect of lisinopril and should be reported so medication can be change.
Instruct patient to continue
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Healthy lifestyle that includes a heart-healthy diet, regular physical activity and limit alcohol intake can enhance the effectiveness of Lipitor to lower cholesterol level and lowers body’s BMI. According to 2013 AHA/ACC/TPS guidelines, Ms. Smith can have daily caloric intake of 1200-1500 kcal /day and to avoid eating food that is high in carb, low fiber or high fat food in order to loose weight.
Lifestyle changes that include home BP monitoring and compliance in medication regimen, weight loss, sodium restriction, DASH (rich in fruits, vegetables, low fat dairy, whole grain, fish, nuts, low in sweets, red meat and saturated fat) diet, limiting alcohol consumption, increase physical activity can be highly effective in lowering BP.
Educate the patient regarding the disease , management of sign and symptoms and recognition of COPD exacerbation. Refer patient to a pulmonary rehab program that will help reduce symptoms, improve life style and decrease social isolation by providing exercise training, nutrition and psychological counseling, breathing and energy conserving
Louise C. Cope et al, investigated the impact of non-medical prescribing. Non-medical prescribing could be evaluated through the NMP, or other health practitioner such as GP, and patients. Currently there is limited information on how NMP has impacted other professions, such as radiographer, optometrists and physiotherapists. Personally, I think this is due to how recent these professions gained the right to prescribe. Most of the findings have been extremely positive, with limited disadvantages. Within this evaluation of NMP “students who are becoming NMPs felt that the programme provided them with adequate knowledge to prescribe with some stating that the period of learning in practice was ‘the most valuable part of the course’”
This exacerbation of her COPD revealed the need for inhaler re-education. This education holds more importance due to her exacerbation that possibly could have been prevented with proper inhaler use. An education plan should be developed to assess her readiness to learn and to map out a schedule of sessions. Several sessions over an extended period of time with continuous re-evaluations is essential. Research has shown that this approach has better long term outcomes (M., Duerden & D., Price, 2001).
This paper discusses pharmacology and terminology related to “Pharmacology” which is the branch of medicine concerned with the uses, effects, and modes of action of drugs“ pharmacology. 2015. In Merriam-Webster.com. The study of different classes of drugs, routes of absorption, and drugs have effects on those consuming them. There are drugs that are necessary for illnesses and healing but, there are medicines that cause concern regarding interaction and harming the body.
In some studies, CAM approaches have shown potential for controlling hypertension, but more research needs to be done to show the safety and effectiveness. Some herbs and supplements show evidence of lowering blood pressure. Omega-3 fatty acids are found in fish, some nuts and vegetables, and supplements. Research shows that they can decrease triglycerides (the major form of fat stored in the body), slow the buildup of fatty deposits inside arteries, decrease the risk of abnormal heartbeats, and lower blood pressure slightly (Hirsch). Coenzyme-Q10 is produced by the body and is also available in supplements, there is good scientific evidence that coenzyme Q-10 does lower blood pressure (Hirsch). Furthermore, Garlic contains sulfur that has a positive effect on cholesterol levels, which could lower blood pressure levels. Cocoa products and dark chocolate are rich in antioxidants. A study shows that when people with high blood pressure consumed cocoa twice daily for two weeks, it improved the ability of artery walls to relax but did not lower blood pressure significantly (Hirsch). A patient who is taking alternative medicines needs to let their physician know because some herbs and supplements will interact with other medication. Relaxation techniques help relax the body and reduce stress, which could help with blood pressure.
Mrs. Andrews hypertension is mild at 146/96 which leads to the recommendation of lifestyle modification opposed to pharmacological treatment. In a study led by the American Heart Association, “lifestyle interventions received class I recommendations (Mosca et al., 2004, p. 675)” to prevent major cardiovascular issues in women. There are several useful tools and programs available to assist patients making lifestyle changes. A couple of examples of programs are the WISEWOMAN and Therapeutic Lifestyle Changes (TLC). WISEWOMAN is a “program funded by the CDC that provides low income uninsured women (40-64) with chronic disease risk factor screening, lifestyle modification interventions, and referral services to prevent CAD (Schroetter & Peck, 2008, p. 109).” TLC is “an effective lifestyle therapy recommended by the American Diabetes Association, the American Heart Association, and the Obesity Society ("Can TLC ...
To effectively manage COPD it is essential for patients to monitor themselves by writing a list of dates and times when experiencing symptoms and reactions to treatments. (Lung Chicago Managing COPD, 2016). Understanding a patient’s personal disease characteristics will help in determining treatment to prevent exacerbations. To maintain stable condition of the disease, COPD patients need to understand and reduce risk factors. Counseling programs such as smoking cessations need to be available for COPD patients as part of their treatment. Pharmacotherapy for the disease is also used to reduce its symptoms and difficulties on
Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).
Your doctor may advise you to increase your blood pressure by making these simple changes. Eat a diet with higher salt content. Drink lots of non-alcoholic fluids, a minimum of eight glasses per day. day (preferably water or sports drinks that are high in sodium and. potassium.
Observe, record, and report to physician patient's condition, treatment provided, and reactions to drugs and treatment
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
Long range BMI target/goal is less than 25. If lifestyle changes are not enough, than drugs that help lower cholesterol levels, high blood pressure and blood sugar can be used such as statins, fibrates or nicotinic acid. 4Other things that can be done include trying to fight the insulin resistance by starting thiazolidinedione. Also, treating the different risk factors like elevated blood pressure, prothrombotic and proinflammatory state independently. Our patient has 4 of the 5 risk factors: low HDL, high triglycerides, high fasting blood glucose, and central obesity.
The symptoms may worsen with lying down in the night, and the patient may be Cyanosed in chronic bronchitis (Rice, 2012). The symptoms may be similar to those of other conditions, and the severity may depend on upon the amount of damage that has been caused to the lungs. There may be other symptoms in severe COPD such as swelling in the ankles, feet or legs with lower muscle endurance. After the doctor has explored the symptoms in a patient and diagnosed it as COPD, several treatment procedures are available depending on the severity of the condition. There are medications, surgeries and other therapies that are available for treatment of the management of the condition where I as the nurse would be involved in choosing the best of option together with the
The Complete Blood Count (CBC) with Differential test involves a blood draw by a qualified lab technician. Tests usually part of a CBC include:
The first thing to do if you smoke, it's best to stop to slow the progression. Other than quitting smoking the treatment that a pulmonologist would suggest depending on the severity of the disease include medication, breathing retraining, and surgery. “Bronchodilators, can help by relaxing constricted airways. Corticosteroid drugs reduce inflammation and may help relieve shortness of breath. If you have a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate. A pulmonary rehabilitation program can teach you breathing exercises and techniques. Supplemental oxygen can help If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery. Lung volume reduction surgery, In this procedure, surgeons remove small wedges of damaged lung tissue. Lung transplantation is an option if you have severe lung damage and other options have failed.” (Mayo Clinic, 2017). When you are diagnosed with this disease since it’s a systemic disease that causes wasting of the muscles and bones certain physical exercises can help improve quality of life. When you are exercising you don't have to go vigorously with the exercise because it's hard to get a
The test is used to acquire the measurements of red blood cells, white blood cells, haemoglobin, haematocrit and platelets. A complete blood count reveals any abnormal increases or decreases in cell counts, which calls for further evaluation as it may indicate a hidden medical condition. The test is carried out by collecting the blood in a test tube which contains an anticoagulant to prevent the blood from clotting. In the laboratory the blood is placed into an analyser, which analyses the different elements in the blood. Within this test the numbers and types of different cells present in the blood are counted. The results are then either printed out or sent to a computer for examination. The reason a complete blood count is carried out for various reasons such as to review a patient’s overall health, to diagnose a medical condition, to monitor a medical condition and to monitor a