Medical Analysis of Hypertensive Renal Disease

Doppler pulses for her lower right leg are very weak and absent in her right foot. Doppler pulses for her left leg are present (no mention of strength) and weak in her left foot. Pathology results, either from admission to prior too, show Mrs Jones has a serum creatinine level of 221mmol (potentially indicating renal failure (…) )and a blood glucose level of 29.8mmol. Elevated levels of creatininne indicate a lower glomerular filtration rate (the flow rate at which fluid is filtered through the kidneys) and as a result a decreased capability of the kidneys to excrete waste products. Mrs Jones morning finger-prick blood sugar level was

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

K.H. is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and stethoscope with her in the hope of learning to take her husband’s blood pressure at home.

Hypertension, also known as high blood pressure, has become a major risk factor for several types of heart disease across the globe. In the United States alone, nearly 70 million adults have been diagnosed with this condition [1]. Hypertension is a condition in which arterial walls experience extreme force from blood flowing through; long-term force against artery walls will lead to more serious health problems such as stroke, renal failure, and other cardiovascular diseases [2]. If the proper steps to treat hypertension are not taken, patients have a high risk of developing atherosclerosis, a condition that causes arteries to harden significantly. Smoking, obesity, lack of physical activity, high alcohol consumption, and high sodium intake are factors that may cause an individual to be diagnosed with hypertension [3] Detection of hypertension is crucial in order to reduce the incidence of death by cardiovascular disease [1].

The concern on whether anti-hypertensive’s should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure.

Elevated urine microalbumin/creatinine ratio. His last labs in January did show a mild increase. I will recheck that along with a basic metabolic panel and inform him of those results. A copy of them will be sent to Dr. Dourdoufis, as

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

According to JNC 8 guidelines, close monitoring is essential when patients start on new hypertensive medication. Therefore, Mr. Hightower will require frequent visits to the clinic to ensure improvement in his health condition. His blood pressure will be monitored at each visit and blood work will be done to monitor his kidney and liver functions and to determine his adherence to treatment. In case of noncompliance, a third category of antihypertensive must be added to improve hypertension outcomes and prevent cardiovascular disease.

The patient is a 75-year-old female who did see a new pulmonologist (Daniel Kim, DO) as Elvira Aguila, MD left this area. She did have a CT scan done of her lungs. She was told to hold her metformin and had blood work done because of IV contrast. Her creatinine did go up to a high of 1.5, but then on repeat came back to 1.37 with a BUN of 14. I did have her decrease her dose of metformin from 1000 mg b.i.d. to 500 mg b.i.d. She did have a BUN and creatinine done in December of 2014, which showed creatinine of 1.46, BUN of 35. Repeat in March of 2015 showed creatinine of 1.1 with a BUN of 49. The patient has also been found to have proteinuria with a urine microalbuminuria/creatinine

A 79-year-old female present with her daughter for ongoing fatigue also noted to have lost 5 pounds over past 6 months. No night sweats or fevers. Pertinent past medical history includes severe, generalized osteoarthritis, hypertension, type 2 diabetes mellitus and depression. She is taking the following medications: acetaminophen 650mg every eight hours, Lyrica 75 mg twice daily; alendronate 70 mg once weekly, valsartan 320 mg once daily, fluoxetine 40mg once daily and insulin glargine 20 units once daily. Your exam reveals slight pale conjunctivae, a 2/6 systolic ejection murmur and generalized arthritic joints in her extremities. A point of care test results in a hemoglobin of 10.2 g/dL. Complete blood cell count is done; results

The patient is an 86-year-old female who was brought to the emergency room because of bilateral leg swelling. She was recently discharged from the Arbor Glen Reha and she's developed increasing bilateral leg edema. Her medical history is significant for hypothyroidism, chronic kidney disease stage II, anemia which is a chronic, ulcer in the sacral ulcer stage III and she denies any other symptoms. Review of the lab work does show a bump in her creatinine from 1.27 baseline in February of 18 to 1.54 on this admission with an increase in her BUN. She also demonstrates a mild anemia of 10 with a MCV of 90. Her edema is described as massive by the attending physician. PT examination reveals she needs significant assistance to moneuver her

Elevated blood pressure, blood pressures at home, however, have been excellent. She has had side effects on both atenolol as well as losartan. Given that her blood pressures are so well controlled at home and it is good today, we will hold on starting her on any blood pressure medications. She will continue to monitor her blood pressure.

This is an 82-year-old gentleman, who was referred from Dr. Gretchen Marsh’s office because the patient’s BUN and creatinine were high, as he has acute kidney injury. The patient went to Dr. Marsh’s office yesterday and was having generalized weakness. He does not have any vomiting. No diarrhea. No fever. No cough with expectoration. No sharpness. No wheezing. No headache. No dizziness. No passing out. No rectal bleeding. No hematemesis. No abdominal pain. No sore throat. No stuffy nose. No cough with expectoration. No burning, frequency, or

The patient is a 78-year-old female who had a recent fall. She fell on the left side. She has a very large left medial thigh hematoma. She continued to feel weak and unable to care for herself at home and presented to the ED. She is known to have hypertension, insulin dependent diabetes mellitus, a TIA in 1998 with some minimal left-sided weakness and she has had nephrolithiasis. In the ED she was found that her creatinine has gone from 1.2-1.82. Sodium on admission was 130 with a glucose of 360 which suggests that she has some hyponatremia not as profoundas the 130 would suggest. The patient has a complained of pain all over her body, her neck, her arms and her back. She is evaluated by physical therapy who feels that she is unsafe

Mr. Armstrong has a history of renal insufficiency and uncontrolled hypertension, along with symptoms of fatigue, pedal edema, and occasional shortness of breath. He does not have a history of trauma or obstruction to his kidneys, but his creatinine and BUN levels are currently at 3.5 mg/dl and 40 mg/dl. Normal creatinine concentration values are 0.7 to 1.2 mg/dl and normal BUN values are 10 to 20 mg/dl; this reveals that Mr. Armstrong’s kidneys are not removing wastes properly (McCance, Huether, Brashers, & Rote, 2014).  Mr. Armstrong’s history of renal insufficiency and uncontrolled hypertension is commonly found in patients diagnosed with intrarenal (intrinsic) acute renal failure. Intrarenal acute renal failure can be categorized as