Case study Hypertension
Mrs. Smith, a 52-year old African American female presents to the ED complaining of the worst headache of her life. The client reports it started about 3 hours ago. She reports taking 1,000 mg of Acetaminophen with no relief. Upon further questioning, Mrs. Smith also reports blurry vision. She denies any past medical history.
Question 1: What initial nursing assessments (list at least 5) need to performed for Mrs. Smith? Use your text to support your rationales
Upon further assessment, Mrs. Smiths’ lungs are clear, pulses are 2+bilaterally in radial and pedal pulses, S1/S2 are present with no extra sounds. Her vital were as follows:
Height: 162 cm
Weight 107 kg
Blood pressure: 210/105 mm Hg
Heart rate 92 beats per minute
RR: 20 bpm
SpO2 96% on Room air
Temp: 36.9 Celsius
Question 2: What are your top 3 concerns for Mrs. Smith and Why? Elaborate with information from your text regarding the hypertensive client.
Question 3: What medications do you anticipate the provider ordering for Mrs. Smith?
The ED provider orders the following:
Blood -CBC, BMP, BNP
Diagnostics – CT head, CXR
Interventions -Insert 2 large bore IV’s
Nasal Cannula keep SpO2 > 92 %
· Metoprolol 5 mg push x 1 dose stat
· Hydralazine 10mg IV push, PRN q1hr for SBP >200 mm Hg
Question 4: Which order would you implement first and why?
Question 5: What risk factors can you identity that can put Mrs. Smith at risk for hypertensive crisis?
Question 6: What education topics would you want to provide to the client before discharge? Provide rationales and use support from the text: