Rusell Case Study
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Hypertension is one of the common cardiovascular diseases that affect many people in America. Statistics indicate that in every three adults, one is having hypertension that is either diagnosed or not. Hypertension is usually asymptomatic in its mild and moderate stages but can result in severe health complications with it reaches its advanced stages Cooper-Dehoff, R., & Johnson, J.A. (2016). It is also good to note that hypertension can be managed successfully with the use of medication and lifestyle modification.


For the above-mentioned patient, there is symptomatic hypertension, which is under pharmacological therapy. It is evident from the vital signs and the lab diagnostics that the condition is not well managed hence the need to develop a new plan of care to complement the current treatment strategies.

Treatment Goals for Mr. Rusell

The goal of treatment or management of Mr. Russel is to eliminate symptoms, prevent complications, and promote quality life. This will be achieved through the management of the underlying cause of the observed symptoms. Heart palpitations and lightheadedness are significant symptoms of hypertension that require immediate intervention. Therefore, to eliminate these alterations, there is a need to effectively treat hypertension. He has elevated blood pressure despite being on HCTZ 25mg daily; hence he is diagnosed with secondary hypertension. Treatment will, therefore, aim at introducing drugs that will lower blood pressure to the normal ranges and also do away with the edema of the legs, crackles in the lungs, and palpitations. It is also important to review the laboratory results by comparing the past and the present results with the standard levels of the electrolytes and nutrients such as lipoproteins. Antihypertensive drugs such as HCTZ have significant effects on electrolytes level; hence the patient should have regular electrolyte profile tests. The majority of these test result is borderline hence the need to monitor them. Lastly, the management of this patient will also aim at educating the patient on the proper lifestyle behaviors to promote recovery and prevent complications.

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Pharmacological Plan for Mr. Rusell

Currently, the patient is on HCTZ 25mg daily, yet there are still symptoms of hypertension, meaning that drug therapy is not effective. There are two reasons for this phenomenon. One is that either she is not taking the drug as prescribed or the drug is not effective in reducing the blood pressure. There is a need to review the medication behaviors of the patient before making any other decision. Based on the symptoms, there is a need to add another drug to complement the roles of HCTZ. The appropriate drug of choice for the patient will be an ACE inhibitor. Lisinopril 10mg daily is the drug of choice, which works to reduce peripheral vascular resistance to blood flow (Parekh et al,. 2017). Combining this drug with HCTZ will result in better outcomes. The patient should be examined after a month to evaluate the effectiveness of drug therapy.

Health Education for the Patient.

Following the addition of a new drug, there are several health messages that the patient has to take home. First is that he need to learn the importance of adhering to drug therapy while it home. This is essential in ensuring that complications are prevented and promote quality life. Secondly, the patient has to learn how to monitor blood pressure regularly. He has to learn on the levels that require healthcare interventions (Cooper-Dehoff, & Johnson, 2016). Thirdly, the patient needs to learn on the side effects of the new drug and such as dry cough, headaches, and dizziness. He has to know when to seek healthcare interventions when symptoms persist. The fourthThe fourth health message necessary for the patient is the importance of proper nutritional practices and regular physical activity in the management of hypertension. He has to take diets without much sugars or lipids. Finally, the patient should quit smoke and alcohol consumption if he has such behaviors (American College of Cardiology, 2017).

How would your plan change if your patient is African American?

Racial difference influences the pathophysiology of diseases and response to therapy. If the client was African American, the risk of angioedema would be high. As a result I would have opted to channel blockers I place of ACE inhibitors. Studies show that calcium channel blockers are more effective than ACE inhibitors in African Americans (American College of Cardiology, 2017). Hence I would have chosen Amlodipine in place of Lisinopril.