Begin with a Head-Toe assessment, you decide if it should be treated as episodic with rationale. You have been assigned two (2) cases to provide analysis. All cases should include the following a. Pathophysiology and pharmacology of the disease b. Expected signs and symptoms of the disease. c. Nursing Diagnosis with a plan of care. d. All questions pertaining to the case as listed under each case.  You have been assigned two (2) cases to provide analysis. 

Case 1: Hypertension

Pathophysiology & Pharmacology: Over time, hypertension can cause damage to blood vessels and the heart. Genetics, age and lifestyle can all contribute to hypertension. Diuretics, beta blockers, ACE inhibitors and calcium channel blocks are the most common medications used to treat hypertension.

Signs and symptoms to expect: Hypertension can manifest as elevated blood pressure. This is easily measured by your healthcare provider. Headaches, dizziness and chest pain are also possible symptoms.

Nurse Diagnosis : Hypertension, as indicated by high blood pressure.

Plan of Care:

• Regularly monitor blood pressure and record results
• Encourage the patient to adopt a healthier lifestyle, including reducing salt intake, increasing exercise, and giving up smoking.
• Monitor adverse reactions and administer medications according to prescription
• Educate the patient on the effects of hypertension, lifestyle modifications and medication.
• For further diet counseling, refer the patient to a registered dietitian.

Questions:

1. Which are the commonest medications prescribed to treat high blood pressure?
2. How can lifestyle modifications be used to reduce hypertension?
3. How important is monitoring blood pressure for patients with hypertension

Case 2: A patient with Osteoarthritis

Osteoarthritis: A chronic disorder characterized not only by pain and stiffness but also by decreased mobility, is caused by the degeneration of joints. Although the exact cause of osteoarthritis is not known, risk factors such as age, obesity and previous joint injuries are considered. Pain relievers such as acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs) are commonly prescribed to treat osteoarthritis.

Osteoarthritis is characterized by joint stiffness, pain and reduced mobility. Some other symptoms include inflammation, warmth, or crepitus around the joint.

The nursing diagnosis is pain related to osteoarthritis, as indicated by stiffness and joint pain.

Plan of Care:

• Manage pain using medications or other techniques
• Encourage patients to do physical therapy to keep joints mobile.
• Educate the patient on how to maintain joint mobility, and why it is important.
• For further treatment and management, refer the patient to a physical therapy.
• Weight management and eating a healthy diet will reduce stress on the affected joints.

Questions:

1. What are some of the common medications used for osteoarthritis treatment?
2. What can patients with Osteoarthritis do to reduce their pain?
3. Weight management and balanced eating can help manage osteoarthritis.

Because these are chronic cases, the care should not be episodic but continuous. To maintain health and to prevent further degeneration of conditions, it is important that the condition be monitored and managed regularly.