Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
The different case study: CASE STUDY 4: EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She brings in her medication bottles and she has some medication bottles from the previous year full of medications. She is missing one medication she had been prescribed and says she may have forgotten it at home. Her BP in clinic today is 182/99 with HR of 84.
Note: Create a reply (that corresponds to the instructions above) for the two posts, 1 page each for both, with 2 or more references not less than 5years each, thanks
POST 1 (from Classmate F.J)
CASE STUDY 4: EB is a 68-year-old black female who comes in for follow-up of hypertension.
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
EB could be a religious or spiritual woman who believes that God or Allah will fix this. She may believe that the foods she eats have nothing to do with her present health. She may believe that her parent(s) had high blood pressure and they lived to be a certain age, they were okay. What are her beliefs about high blood pressure (Buckley et al., 2016)?
How does she cope with her disease (Galanti, 2016)? EB is probably very independent and does not believe in being a burden to anyone, so she will not ask for help. She needs to be convinced that she needs assistance with at least the preparation of her medications for each week. What are her concerns regarding her blood pressure (Galanti, 2016)? Why is she on so many?
Does the prescribing provider know that she has not been taking them? Why has she not been taking them? Do they make her feel some kind of way? Is her forgetfulness the start of dementia (Ball et al., 2019)? What types of food does she eat at home? Does she have potassium in her diet? Does she consume a reduced sodium diet (Muntner et al., 2017)?
What does she believe is wrong with her? Has she fallen while on any of the medications? Does she feel light-headed after taking them?
Does EB have insurance? How is her medication being paid for?
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
I would ask EB does the patient have any children or family that could help her out. Is her family involved in EB’s life? Do they visit?
We do not know her relationship with her family, so we need to ask open ended questions to see if she will allow them to help her. If she does not allow them to help, will she accept help from a visiting nurse daily or once a week? She needs to be educated on the fact that her vision is worsening because of her uncontrolled blood pressure.
She is not taking her medications this could lead to a stroke, myocardial infarction, kidney disease (which will eventually lead to dialysis). Does she know anyone who has had a stroke or is on dialysis? What is her view on it?
Assess her mental status by using the Montreal Cognitive Assessment tool (MoCA) (Ball et al., 2019). She may get offended by me wanting to test her mental status, but I would reassure her that the information will not be given to anyone.
What are her beliefs about the medical system? Does she feel they have her best interest in mind? Does she feel as if the medical system is against people?
Since her vision has decline, can she or will she exercise at home? Depending on the facility I am employed, I can get her resistance bands and show her some exercises (make sure she can teach back the exercises). With each follow-up visit have EB show me what she has been doing, and maybe add an additional exercise.
Is she cooking her own meals? Is she able to obtain low sodium/high potassium meals?
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
1.How have you been, EB? Anything else going on you would like to speak on besides your blood pressure?
2.Any chest pains? Shortness of breath? Any headaches? Rate your pain on a scale of zero to ten with zero being none and ten the worse you have ever felt. Have you ever had any numbness, tingling on one side of your body?
3.Does she have a blood pressure machine at home? Would she be willing to do telehealth visit to monitor her blood pressure or a visiting nurse?
4.Do you smoke? Do you have high blood sugar? Drink alcohol?
5.Why have you not been taking your blood pressure medications? What can I do to help you to take your medications? Do you know you should take you medicine even if you feel good? Are you taking anything else besides medications to help with your blood pressure? Herbal medications (Buckley et al., 2016)? So, what is our next step, EB?
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach. Elsevier Mosby.
Buckley, L., Labonville, S. and Barr, J. (2016). A systematic review of beliefs about hypertension and its treatment among African Americans. Current Hypertension Reports. 18 (7). 1-9. https://doi:10.1007/s11906-016-0662-5
