Reference no: EM133911621

Questions

Ronald Sanford, age 37 years is diagnosed with essential hypertension. His blood pressure has been ranging between 148 and 176 mm Hg systolic and 90 and 110 mm Hg diastolic. His average blood pressure is 160/94 mm Hg.

There's a strong family history of hypertension and stroke on both sides of the family. Mr Sanford is married, with two school-age children. He works full time as a loading dock supervisor for a long-distance trucking company. His elevated blood pressure was found during a routine physical examination. He reports no other manifestations. At this time, there is no evidence of renal insufficiency or retinopathy.

Mr Sanford is to begin taking lisinopril, 10mg daily, and hydrochlorothiazide, 50mg daily

1. Lisinopril is an angiotensin converting enzyme inhibitor (ACEI). How will this type of drug contribute to the control of Mr. Sanford's blood pressure?

2. Describe the antihypertensive action of hydrochlorothiazide.

3. What does Mr. Sanford need to know about taking his medications and avoiding adverse effects?

4. In addition to drug therapy, what non-pharmacologic measures should you teach Mr. Sanford to help lower his blood pressure?

5. Over the next 2 years, Mr. Sanford experiences a gradual increase in his blood pressure. Dosage adjustments in the Lisinopril and hydrochlorothiazide fail to lower his blood pressure effectively. Atenolol, 25 mg two times daily, is added to his treatment program. How does atenolol lower blood pressure

6. What does Mr. Sanford need to know about taking atenolol to achieve maximum therapeutic benefit?

7. After 6 months on this drug therapy, Mr. Sanford's blood pressure is maintained at 124 to 138 mm Hg systolic and 78 to 88 mm Hg diastolic. However, he complains that he doesn't seem to have the energy he used to have and that he is having some decrease in sexual activity. What should you tell Mr. Sanford about these concerns and their relationship to the addition of Atenolol to his medication regimen?