Case Study & Discussion Questions
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,
What are your treatment goals for Mr. Russell today?
What is your pharmacologic plan and rationale? (cite with appropriate clinical practice guidelines or scholarly, peer-reviewed journals)
What are five key patient education points based on your plan?
How would your plan change if your patient is African American?
Discussion Guiding Principles
The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of discussions provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
