A 70-year-old J.M. man who has been coming to the clinic forseveral years for management of coronary artery disease (CAD),hypertension (HTN), and hyperlipemia (HLD). A cardiaccatheterization done a year ago showed 50% stenosis to one of hiscoronary arteries.
For the past 6 months, he has had episodes of dizziness,orthostatic hypotension, and decreased exercise tolerance.
On his last clinic visit 3 weeks ago, a chest x-ray (CXR)showed cardiomegaly. Results of chemistries (blood studies) drawnat this time were as follows: Na 136 mmol/L, K 4.2 mmol/L, BUN 15mg/dl, creatinine 1.6 mg/dl, glucose 93 mg/dl, Complete Blood Count(CBC): WBC 4.4, Hgb 9.5 g/dl, Hct 29.4%, and platelets 229
This morning his son brought him to the clinic because he hashad increased fatigue, significant swelling of his ankles, andshortness of breath (SOB) for the past 2 days. His vital signs (VS)are Blood pressure (BP) of 142/83, Heart rate (HR) of 105,Respiratory rate (RR) of 24, and Temperature of 97.9° F.
1) describe the correlations between HTN and HF in Mr. J.Mcase study.
2) Other than a history of hypertension, give one pathologywhy Mr. J.M’s BP is 142/83 (elevated).
3) Explain why Mr. J.M is experiencing increased fatigue,ankle swelling, and shortness of breath(wirh a respiratory rate of24).
4) The Health Care Provider concluded that MR. J.M isexperiencing symptoms of Heart Failure (HF). What classes of drugsmight the Health Care Provider prescribe? And how might they workto help J.M’s condition. (Hint: there are up to 4 drug classes forconsideration).
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