free blood pressure (BP) screening program for its employers
free blood pressure (BP) screening program for its employers
Client Profile
Mr. Cowen’s employer-sponsored a free blood pressure (BP) screening program for its employers. Mr. Cowen’s BP is 160/90 mm Hg when measured with a large BP cuff. The nurse observes that the client is overweight. The nurse assesses the client for risk factors for Hypertension and learns that Mr. Cowen sits at a desk all day long answering telephone calls from customers with questions about the use of the company’s computer software. He does not exercise regularly and admits that he does not follow a special diet stating, “My wife is a great cook. I’ll eat anything she puts in front of me. At night I like to have a snack while I watch television.” The client denies tobacco and recreational drug use and reports drinking “socially”. ” I have four of five beers on the weekend watching the football game.” Mr. Cowen does not take any prescription medications or herbal supplements but reports taking “Tylenol on occasion when I have a headache.” The nurse records Mr. COwen’s BP and gives the client the reading materials with instructions to make an appointment with his primary health care provider (HCP) as soon as possible for a more thorough assessment and to discuss treatment options.
Case study
Mr. Cowen calls his primary HCP to schedule an appointment. Before the appointment, Mr. Cowen goes to a local laboratory and has a series of blood tests drawn as prescribed by the HCP.
At his appointment with the HCP, the nurse weighs Mr. Cowen. He is 5 feet 9 inches tall and weighs 225 pounds. Mr. Cowen’s BP is 166/92 mm Hg with a large cuff in the right arm and 168/96 mm Hg in the left arm. His heart rate is 84 beats per minute with a regular rhythm, respiratory rate is 18, and he is afebrile. His total cholesterol is 260 mg/dL. During the health history assessment, the HCP learns that Mr. Cowen drinks at least four to six ounces of regular coffee per day and that his father has coronary artery disease and Hypertension. Mr. Cowen denies feeling stress because of his job, relationship with his wife and family, or other factors. “I am a pretty laid back guy. I am not worked up or excited about much. I leave that worrying to my wife.” The HCP notes that Mr. Cowen carries the majority of his weight in his upper body. He has an increased amount of subcutaneous fat around his waist and his abdomen.
The HCP prescribes Hydrochlorothiazide (HCTZ) daily for the client and askes the nurse to provide Mr. and Mrs. Cowen with instructions regarding the education and lifestyle modifications. A follow-up appointment is scheduled for one month.
Questions
