Author Question: The primary care NP sees a new patient who has diabetes and hypertension and has been taking a ... (Read 81 times)

geodog55 · **on:** Jul 24, 2018

The primary care NP sees a new patient who has diabetes and hypertension and has been taking a thiazide diuretic for 6 months. The patient's blood pressure at the beginning of treatment was 150/95 mm Hg. The blood pressure today is 138/85 mm Hg.

The NP should: a. order a b-blocker.
b. add an angiotensin-converting enzyme inhibitor.
c. continue the current drug regimen.
d. change to an aldosterone antagonist medication.

Question 2

A primary care NP is aware that many patients in the community use herbal remedies to treat various conditions. The NP understands the importance of:

a. learning about the actions, uses, doses, and toxicities of these agents.
b. prescribing these agents when possible to ensure safe dosing.
c. counseling patients to stop using herbal products to avoid toxic side effects.
d. teaching patients that these products are unregulated and unsafe to use.

covalentbond · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
Evidence-based guidelines suggest that optimal control of hypertension to less than 130/80 mm Hg could prevent 37 of cardiovascular disease in men and 56 in women, so this patient, although showing improvement, could benefit from the addition of another medication. An angiotensin-converting enzyme inhibitor is an appropriate drug for patients who also have diabetes. B-Blockers and aldosterone antagonist medications are not recommended for patients with diabetes.

Answer to Question 2

A
It is important for primary care providers to be familiar with these products and their ingredients so that they can help patients choose the safest product for their ailments. Because there are few evidence-based recommendations for the use of these products, NPs should not prescribe them. Counseling patients to stop using the products would probably not be effective; it is more important to know about the products to assist patients in decision making. Although it is true that the products are not directly regulated by the Food and Drug Administration (FDA), there are agencies that maintain safety of the products.