Case study Hypertension Discussion
Answer the following 6 questions in the case study. Be sure to use rationales and support from the text-book to support your work
Mrs. Smith, a 52-year old African American female presents to the ED complaining of the worst headache of her life. The client reports it started about 3 hours ago. She reports taking 1,000 mg of Acetaminophen with no relief. Upon further questioning, Mrs. Smith also reports blurry vision. She denies any past medical history.
Question 1: What initial nursing assessments (list at least 5) need to performed for Mrs. Smith? Use your text to support your rationales
Upon further assessment, Mrs. Smiths’ lungs are clear, pulses are 2+bilaterally in radial and pedal pulses, S1/S2 are present with no extra sounds. Her vital were as follows:
- Height: 162 cm
- Weight 107 kg
- Blood pressure: 210/105 mm Hg
- Heart rate 92 beats per minute
- RR: 20 bpm
- SpO2 96% on Room air
- Temp: 36.9 Celsius
Question 2: What are your top 3 concerns for Mrs. Smith and Why? Elaborate with information from your text regarding the hypertensive client.
Question 3: What medications do you anticipate the provider ordering for Mrs. Smith?
The ED provider orders the following:
- Blood -CBC, BMP, BNP
- Diagnostics – CT head, CXR
- Interventions -Insert 2 large bore IV’s
- Nasal Cannula keep SpO2 > 92 %
Medication Administration:
- Metoprolol 5 mg push x 1 dose stat
- Hydralazine 10mg IV push, PRN q1hr for SBP >200 mm Hg
Question 4: Which order would you implement first and why?
Question 5: What risk factors can you identity that can put Mrs. Smith at risk for hypertensive crisis?
Question 6: What education topics would you want to provide to the client before discharge? Provide rationales and use support from the text: