Case study – primary hypertension

1. Mr. Tinsley is a 55-year-old lawyer who has been diagnosed with primary hypertension. The health care provider has informed the patient that lifestyle modifications must be made. He is prescribed captopril (Capoten) 25 mg PO b.i.d and hydrochlorothiazide.
a. The nurse is providing drug information to Mr. Tinsley when he asks the therapeutic action of ACE inhibitors.
b. What lifestyle modifications should the nurse instruct Mr. Tinsley to make?
c. What adverse effects should the nurse monitor in this patient?
 
2. Mr. Tinsley returns to the clinic 1 month later for reevaluation. His blood pressure is 140/72 and he is complaining of an irritating cough. The health care provider discontinued the ACE inhibitor and started on diltiazem (Cardizem)).
a. Explain why only the ACE inhibitor was discontinued.
b. How does diltiazem treat hypertension?
c. Mr. Tinsley says that his BP is really not that high so why does he really need this medication.
How should you respond?