JoAnne Saba

09/08/2015
Case Study I
1. M.P.'s blood pressure is classified as Stage I hypertension.
2. M.P. could be taking the thiazide diuretic too late in the day which causes her to have nocturia.
3. The risk factors M.P. has that increase her risk for cardiovascular disease include the
following: hypertension, diabetes mellitus, physical inactivity, and being of African descent.
4. Calcium channel blockers, angitensin-converting enzyme inhibitors, or angiotensin receptor
blockers should be recommended to M.P. at this time according to the JNC 8 national guidelines.
5. According to M.P.'s height and weight, she is not considered overweight. Her BMI is 18.9,
which puts her within the values for normal weight.
6. i. Regular exercise. Exercising helps to strengthen the heart so that it can do more work for
less effort resulting in a decrease of force on the arteries.
ii. Decreasing sodium intake. A healthy diet that is low sodium helps to reduce blood pressure.
High sodium will cause blood vessels to take in more fluid resulting in an increase of pressure.
By reducing sodium, cells can expel the extra sodium and it can properly be excreted from the
body.
7. Reducing the dose of HCTZ will decrease risk of side of effects, such as electrolyte imbalance
and kidney/liver functioning, from occurring when using it in a combination therapy with
benazepril.
8. Common side effects of benazepril include headache, cough, shortness of breath, constipation,
and dizziness. (all answers A thru E)
9. i. Set an alarm or watch to remind you to take your medication.
ii. Take the medication as part of your self-care ritual. (e.g. take it during your morning routine as
you are getting ready for the day)
10. Answer C: "Its okay to skip a few doses if I am feeling bad as long as it's just for a few days."
11. I would expect to monitor BUN, creatinine, serum electrolytes (particularly sodium and
potassium), and blood glucose levels while someone is taking HCTZ and an ACE inhibitor.
12. The patient's glucose is slightly elevated. However, none of her lab results prove to be a
concern at this time.
13. I would base my response on her history and observable success of her current medication
regimen. Though she does not have the ideal 120/80 blood pressure, it is significantly lower than

it had been on recent visits. With help of medication, her blood pressure is currently at a
controllable level.
14. i. Remind M.P. to continue to take her medications even though her blood pressure has
lowered.
ii. Encourage M.P. to continue to get her blood pressure checked at the senior center at least once
a week.
iii. Refer M.P. to senior exercise classes so that she will partake in physical activity and will not
have to do it alone.
15. Pills come in different shapes and colors so that the pharmacists can decipher between all the
different medication in the pharmacy. This ensures that the pharmacists gives you the correct
medication that was prescribed and not anything else.
16. Hypertension can damage the small capillaries that are behind the eyes resulting in vision
loss. Since the capillaries behind the eye are most easily assessed in the body, it can also be a
determinant of how the capillaries in other parts of your body have responded to the stress of
your high blood pressure.