You must then respond thoughtfully to two classmates’ posts. Length of each response should be at least 150 words. You must write the information in your own words and never copy from the source (that would be plagiarism).
Student Post 1 – Kevin
Coffee contains the stimulant caffeine that increases blood pressure via vasoconstriction. Certain exercises such as running also increase heart rate, which causes an increase in cardiac output, resulting in increased blood pressure. Stress is another factor that may increase blood pressure. Running late to his annual checkup may have been a stressor for Peter Barber, which may have resulted in increased blood pressure. The nurse also attended to Peter without allowing him time to rest and catch his breath, noted by his sweating as he sat down on the chair. It was apparent that Peter’s blood pressure was high after being measured by the nurse. There are several actions the nurse should have done differently from when Peter first entered the office up to when the provider was contacted. If I was the nurse, I would have inspected the client and ask if they recently exercised due to their apparent sweating and if they had anything to eat/drink before coming in for their appointment. After gathering this information, I would have accounted for erroneous readings due to several factors affecting blood pressure and instructed the patient to rest and take deep breaths prior to examination. If Peter’s blood pressure was still high even after stabilizing their breathing and temperature, I would reassess by measuring the blood pressure on the other arm to verify whether the reading is accurate. I would also ask the client for past medical history and family history and check their medical record for clues that may affect blood pressure or circulation. Hypertension is hereditary and may be passed to offspring. Diseases such as renal or hepatic failure may also result in secondary hypertension (Scordo, 2018). There is a phenomena known as the white coat effect wherein clients have elevated blood pressure in the healthcare office but have normal blood pressure readings during their daily activities outside of the office. There is no singular cause to this phenomenon, but it should be noted that one elevated reading is not enough to diagnose a client with hypertension. Rather, it would have to be consistently elevated on several different occasions (Fagard, 2004). First-line medications used to treat hypertension include calcium-channel blockers, thiazide diuretics, ACE inhibitors, and ARBs.
Student Post 2 – Ylanit
In this scenario with patient Peter Barber, a few things were not done correctly, the first mistake is that the nurse took the blood pressure right in the moment that the patient arrived, while he was sweating, by that moment the patient just come to the office running, the nurse should have inspected him and see that he was sweating and asked him why, and when he will tell her that he was running, she should have interpret that after the patient is doing a physical exercise there should be a waiting period of at least thirty minutes to start taking his vitals, because not only his blood pressure is a higher value because of the exercise but also his pulse and respiratory rate, also, she should have asked if he ate or drink in the past hour, Mr. Barber drank coffee in the way to the appointment, caffeinated beverages should not be consumed at least thirty minutes before taking the blood pressure.
If I would have been the nurse at this situation, I would have inspect the patient, talked with him and asked him why he was sweating, what he eat or drink before the visit, then I would have waited a proper time of at least thirty minutes to take his vitals, and if I would have got a result like she did, BP 135/85mm Hg, I would have asked the patient about any new symptom like headache or visual or any indicator that could be according with this finding but also I would have waited two minutes and reassess and also I would have compared with the other arm, I would not tell the Dr. that the patient might have a new diagnosis because of one isolated measure, it is require at least two blood pressures measures in at least two occasions.
The white coat effect means that a patient gets anxious or nervous in front of a provider, and this is why it is called white coat. When they take the blood pressure the value is higher than usual, people that have white coat effect are at higher risk of developing cardiovascular problems.
The first line medications that are used for treating hypertension are diuretics, the most used thiazide diuretics, they may be used alone or with another antihypertensive drugs, also, calcium channel blockers, and angiotensin-converting enzyme inhibitors or angiotensin II receptors blockers.
PS- This is the scenario/ questions the students are answering for reference
Peter Barber is a 50-year-old male that has an appointment today to have his annual checkup. He was having lunch with a friend and suddenly he realized he was late for his appointment. Fortunately, his friend got him a coffee that he could drink on his way to the office and he ran to get there on time. Once in the office, the nurse asked him to come into Room 1 and he sat in the chair, still sweating. The nurse started taking his vitals and began with the BP on his right arm. His BP was 135/85. The nurse communicated with the primary care provider and indicated that she/he suspects that the patient in Room 1 will today have a new diagnosis of Stage 1 hypertension.
Explain all the things that are wrong in this scenario.
How would you work with this patient if you were the nurse?
What is the white coat effect, and how can it be prevented?
Write down the first-line medications used to treat hypertension.
