Discussion

Mr. Russell is a 73-year-old Caucasian male who presents to your clinic with complaints palpitations and intermittent light-headedness for approximately 1 month. He is currently being treated for hypertension and is taking HCTZ 25mg daily. He also is complaining of heartburn and belching after eating a large meal.

Vital Signs: B/P 159/95 (right arm), B/P 162/96 (left arm), HR 88, Resp. 22, Weight 99 kilograms (previous weight at last appointment 2 months ago was 95kg

Physical Exam:

Constitutional: Alert & oriented, well-developed.

Neck: No carotid bruit or JVD.

Heart: Regular rate without murmur or gallop.

Lungs: Slight crackles in RLL but otherwise clear to auscultation.

Abdomen: Soft, non-tender with + BS.

Legs: Left leg with moderate 3+ edema on RLE and leg 2+ edema on LLE.

Labs: NA 143mEq/L, CL 99 mmol/L BUN 18mg/dL, Hbg 15, TC 234 mg/dL, LDL 137 mg/dL, HDL 35 mg/dL, triglycerides 241mg/dL,

1. What are your treatment goals for Mr. Russell today?
2. What is your pharmacologic plan and rationale? (cite with appropriate clinical practice guidelines or scholarly, peer-reviewed journals)
3. What are five key patient education points based on your plan?
4. How would your plan change if your patient is African American?