E.M. recently started coming to your clinic.

E.M. recently started coming to your clinic. Today, he has an appointment for a follow-up visit for treatment of hypertension and dyslipidemia. HPI E.M. is a 67-year-old man with high blood pressure that has been difficult to control. During his most recent visit, he was noted to have a BP of 180/86 mm Hg with a heart rate of 76 bpm. A fasting lipid profile, complete chemistry profile, and TSH were obtained. Past Medical History Hypertension (HTN), diagnosed 2005 Hypothyroidism, diagnosed 1997 Shoulder pain x 2 months History of low back pain (LBP) with intermittent flare-ups Benign Prostatic Hypertrophy (BPH) Family History His father, who is deceased, experienced an MI at 54 years of age, an uncle experienced a stroke at 55 years of age, and his grandfather died suddenly at 59 years of age. His 87-year-old mother, who has systolic hypertension and mild cognitive impairment, is in an assisted living facility. E.M. was an only child; he and his deceased wife had no children. Social History Patient was recently widowed and lives alone on a restricted income in a small New England town. His diet is high in saturated fats, cholesterol, refined foods, canned soups, and vegetables. He has been a smoker for 50 years and is currently smoking about 1 ppd. He drinks about 3 to 4 beers daily. Patient states that his physical activity is minimal. Patient is retired; he worked in construction for over 40 years. Meds Hydrochlorothiazide, 25 mg po daily Lisinopril, 20mg po daily Levothyroxine, 0.1 mg po daily Ibuprofen, 400 mg po PRN shoulder pain Tamsulosin, 0.4 mg daily for BPH Allergies or Adverse Drug Reactions (ADRs) No Known Drug Allergies (NKDA) (per patient recollection) Here are the items to address : 1. E.M. has a long way to go to reach his healthcare goals. Please list 3 healthcare goals for the patient. What pharmacological methods would you use to help reach these goals? 2. What non-pharmacological interventions should be considered? Please use technology, motivational interviewing, and other methods to help this patient reach his goal. Here is the booklet from the VA that the provider could use to help create these goals: Setting Health Care Goals. 3. How will the Nurse Practitioner evaluate the progress on each goal? Please include a guideline you are following to evaluate the improvem SCIENCE HEALTH SCIENCE NURSING NURS MISC

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