CASE STUDY - HYPERTENSION Rachelle Wagner, 42-year-old African American. Complete Case Study

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CASE STUDY - HYPERTENSION Rachelle Wagner Patient Assignment R.W. is a 42-year-old African American executive assistant who comes to the outpatient clinic for a routine physical. During the intake... interview, R.W. reveals that she is experiencing considerable job stress, has two young teenagers at home, and is providing care for her elderly grandparents with the help of her husband. Initial Assessment 1730 VS: T 37.5° C (98.6° F), BP 158/88, P 84 and regular, R 20 and unlabored. R.W. denies any pain and has an O2 saturation of 98% on RA. Height: 172.7 cm (68 in), weight: 88.5 kg (195 lb) with a BMI of 29.6. R.W. is A&O×4, PERRLA, apical pulse is 84, lung sounds are clear throughout all lobes, abdomen is soft and large, no distention, bowel sounds present in all four quadrants. Pedal pulses 2+ bilaterally. R.W. states that she tends to eat more when she is under stress and has gained several pounds in the last few months. She denies any urinary or bowel problems. 1. As the clinic nurse, you know that R.W. is hypertensive based on what initial physical assessment finding? ● BP: 158/88 ● Diet & Lifestyle. R.W. is probably experiencing primary hypertension due to poor diet, lack of exercise and stress from job and at home 2. What is the scale for determining if an adult patient is hypertensive? What is R.W.’s hypertension stage? ● Using the blood pressure scale will help determine if a patient is hypertensvie. Prehypertension is 120-139/ 80-89 mmHg, Hypertension stage 1: 140-159/ 90-99 mmHg, Hypertension stage 2 greater than or equal to 160 / 100 mmHG. ● R.W is experiencing isolated systolic hypertension because SBP > 140 mmHG but DBP is < 90 mmHG. According to the BP scale chart, R.W has hypertension stage 1 [Show More]

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