Case Scenario No. 1 Bruno a male

Case Scenario No. 1 Bruno a male business executive, was seen for a routine insurance physical. His examination was normal except for a blood pressure reading of 164/102 mm Hg. He also was approximately 20 pounds overweight. Urinalysis and blood work results were all within normal limits. He was given a 1,200-calorie-per-day diet to follow and was encouraged to reduce his salt and alcohol intake, start exercising, and stop smoking. He was asked to return in 3 weeks for a follow-up appointment (step 1). Three weeks later, Bruno returned with a 7-pound weight loss and an average blood pressure reading (of three readings) of 145/92 mmHg. Discussion was held about starting Bruno on a diuretic (step 2) in addition to the lifestyle changes that B.R. was undertaking. Bruno was reluctant to take a diuretic and, after much discussion, was prescribed a calcium channel blocker, amlodipine 5mg/tab, po, OD. Bruno asked for a couple more weeks to try to bring his blood pressure down with lifestyle changes before starting the drug. 1. What nursing interventions should be done at this point? (Consider the risk factors that Bruno has for hypertension and the damages that hypertension can cause) 2. What are the chances that Bruno can bring his blood pressure within notmal range with lifestyle changes alone? 3. What additional teaching points should be covered with Bruno before a treatment decision is made? SCIENCE HEALTH SCIENCE NURSING NURSING 279

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