Chapter 21 Physical Examination 463 Proper body mechanics include which
Risk Factors for Hypertension Mr. L has several risk factors for hypertension: Age and Ethnicity: Being 48 years old and of Aboriginal descent increases his risk. Family History: His father died of a stroke, and his mother has Type 2 Diabetes. Lifestyle Factors: He smokes one pack of cigarettes daily and consumes a six-pack of beer on weekends. Medical History: He has a history of hypertension and Type 2 Diabetes, and he is non-compliant with his medications. Obesity: He is moderately obese, which is a significant risk factor for hypertension. Evidence of Target-Organ Damage The following evidence indicates target-organ damage: Left Ventricular Hypertrophy (LVH): The ECG results show LVH, which is a common consequence of prolonged hypertension. Kidney Damage: Elevated serum creatinine levels (141 mmol/L) and proteinuria (0.3g/L) suggest renal impairment. Significance of Laboratory/Diagnostic Test Results Blood Pressure (BP): A BP of 180/120 mmHg is significantly elevated, indicating severe hypertension. ECG: The presence of LVH indicates that the heart is working harder to pump blood, a common result of chronic hypertension. Serum Creatinine: Elevated levels suggest impaired kidney function, which can be both a cause and a consequence of hypertension. Urinalysis: Proteinuria indicates kidney damage, which is often associated with hypertension and diabetes. Collaborative Problems Medication Compliance: Mr. L’s non-compliance with his diabetes and hypertension medications needs to be addressed through patient education and possibly a simplified medication regimen. Lifestyle Modifications: Smoking cessation, reduction in alcohol intake, and weight management are crucial. Collaboration with a dietitian and a smoking cessation program may be beneficial. Monitoring and Follow-Up: Regular monitoring of BP, kidney function, and heart health is essential. Coordination with a primary care physician, cardiologist, and nephrologist may be required. References American Heart Association. (2023). Understanding Blood Pressure Readings. Retrieved from https://www.heart.org National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Diabetes, Heart Disease, and Stroke. Retrieved from https://www.niddk.nih.gov This analysis highlights the importance of a comprehensive approach to managing Mr. L’s hypertension, addressing both medical and lifestyle factors to reduce his risk of further complications.
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