S. M.: A Case Study

S.D. is a 45-year-old woman who comes to the ED complaining of sudden onset of palpitations and shortness of breath. Standard protocol requires you to obtain a 12-lead ECG and attach S.D. to the cardiac monitor for continuous monitoring. A 12-lead ECG recording for S.D is ordered while you print out a rhythm strip from the cardiac monitor.

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 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).

At 1212 hours, this writer spoke with Ms. Natayla Walker, (242) 470-5425 the mother of M-1. She told this writer M-1 was with her. This writer met M-1 and his mother inside of the Discount Mart located at 401 Eastern Avenue, Capital Heights, Maryland 20743at 1234 hours. Ms. Walker advised this writer this is her weekend to have her son. (Referring to M-1).

Consider J.M. J. M. a 43-year-old Hispanic female with type 2 diabetes, with lipid abnormalities and hypertension. LDL 174, HDL 52 and Triglycerides 32, A1C 9.3, microalbumin 32, and fasting blood glucose of 216 with average glucose variance of 200mg/dl, blood pressure 145/89, morbidly obese at 262 pounds. She has been diabetic for 10 years and has not seen an educator since her diagnosis. She previously danced for exercise, but has not done so in a while to work and family obligations. She has three children age 16, 14 and 10. She is married and the primary source of income for the family, which presents significant stress. J.M. presents with numerous comorbidities that contribute to the development of cardiovascular disease. Current medications

Four different people, four different lifestyles, all with at least one thing in common—their races (or so we have yet to discover). I began my interviews wanting to show the similarities and differences in eating habits and traditions with the African American perspective in mind. Although race is used as the combining factor in this situation, each individual’s lifestyle, cultural behavior, and even eating habits are all very unique. My interviewees consisted of four Americans, as mentioned before all of same race, with similar yet very distinct backgrounds. They range from a black Jew, to a “Jamerican,” to what I would call a “traditional southerner”, right on down to a modern day Muslim.

MEDICAL UPDATE: Client continues to report arthritis in her left leg and hand, high blood pressure. She also reports she will need surgery but she is waiting to be housed.

is the middle child of two other sisters. Both have a history of hypertension, with the oldest having severe allergies. Their father passed away from cirrhosis of the liver at the age of 72; while their mother alive and has a history of colitis, migraines, and asthma. Currently, R.P. husband is 78 and is healthy, with the same for their children age 38 and 41 years old. She is an active mother and wife. While spending majority of her time traveling and attending golf tournaments with her spouse. When she is not doing so, she is out spending time with her friends and family. R.P. involves her husband in every aspect of her care and decision making. She does not partake in any drugs or tobacco, with some occasional alcohol. She is very family

The following section is broken into six subsections that will assess how each topic relates to JNC 6, 7, and 8. The subsections are organized into the following: algorithms, classification of hypertension, lifestyle modifications, pharmacological treatment, and management of care. It is important to note that JNC 6 and 7 have a greater correlation in format and the types of recommendations presented to clinicians. Contrastingly JNC 8 varies in format, as well as the type of recommendations presented to clinicians, therefore each of the subsections may not contain information on JNC 8.

I would argue that Company and Battalion senior warrant officers, not only should be, but already are, part of the command team. Whether they have command authority, or

A.M is a 31-year-old African-American female present today complaints of grayish white vaginal discharge and itching that started five days ago. On the assessment, foul-smelling fishy vaginal odor, and grayish white discharge notice. However, she denies pain or any burning during urination. She reports recently having a new sexual partner and she believed that he may be the cause of all these. She said she was so miserable that she used over the counter cleansing agent (douching) to get relief from the itching but it has been worsening since then. A.M also reported that she was very healthy before these symptoms stated that her under control hyperlipidemia, depression, and hypertension.

Machado et al. did not address the scope of the problem or consequences of the problem in the problem statement. However, these items were identified in the introduction leading up to the problem statement as complications of uncontrolled HTN with low rates of adherence to treatment associated with advanced age and disparaging public health factors (Machado et al., 2017). The problem is identified as systemic arterial hypertension (SAH) requiring treatment changes that might be difficult to institute or maintain for the elderly population due to various factors (Machado et al., 2017). Machado et al. briefly address the background and knowledge gaps as aspects related to culture, the health environment and individual capacities (2017). A proposed solution is introduced in the problem statement to build a relationship with the HTN patient to with the patient in corroborating on a plan of care that the patient is able understand and will follow through with (Machado et al.,

She reported last week her blood pressure was high and she purchased an over the counter blood pressure machine. Client continues to report hypertension, Dyslipidemia, diabetes, coronary artery disease, paralysis of the dominant side as sequela of CVA, Asthmas and Psoriasis, Client reported she is going for physical therapy her lower back twice a week at 380 Grove St. Brooklyn, New York. She reported no changes in her medications and she is seen by Dr. Alice V Coghill/PCP.

R.M. is a 74-year-old Caucasian male with a history of stage IV neuroendocrine tumor with metastasis who was admitted from the ER with a fever of unknown cause and sudden onset of bilateral lower extremity weakness. Brain cancer due to metastasis will first be discussed along with etiology, signs, symptoms, diagnosis, and treatment methods. The patient’s comorbidity of chronic anemia will then be discussed and related to the diagnosis of cancer. The suspected diagnosis of cauda equina syndrome will then be related to the patient's sudden onset of weakness and diagnosis of brain cancer. Finally, the patient’s admitting diagnosis of fever will be discussed, along with the suspected diagnosis of urinary tract infection (UTI).

The two major types of hypertension are primary and secondary. Primary hypertension accounts for more than 90% of all cases and has no known cause, although it is hypothesized that genetic factors, hormonal changes, and the altercations in sympathetic tone all may play a role in its development. Secondary hypertension develops as a consequence of an underlying disease or condition. The prevention and treatment of hypertension is a major public health issue. When blood pressure is controlled, cardiovascular, renal disease, and stroke may be prevented. The JCN, reported more than 122 million individuals in American are overweight or obese, consume large amounts of dietary sodium and alcohol, and do not eat adequate amounts of fruits and vegetables; less than 20% exercise regularly. Both modifiable and non-modifiable factors play a role in the development of hypertension