Question: George Lucas, A 68 Year Old African American Man Who Recently Moved To Your State From Florida, Was Referred To Your Physician’s Practice For Follow-up. He Has Heard Great Things About Your Approach As A Nurse Practitioner From His Neighbor, Mrs. Channel. He Has A Past History Remarkable For Diet-controlled Diabetes Mellitus Type II. He Also Reports …

George Lucas, a 68 year old African American man who recentlymoved to your state from Florida, was referred to your physician’spractice for follow-up. He has heard great things about yourapproach as a nurse practitioner from his neighbor, Mrs. Channel.He has a past history remarkable for diet-controlled diabetesmellitus type II. He also reports previous high blood pressurereadings. His average on his home monitor is 150/85. He is notcurrently taking any medications as he has been told that his bloodpressure is not unusual for his age. He denies any history of heartor kidney disease. He has a 20-pack year history of smoking anddenies alcohol or recreational drug use. He is living alone and isfunctioning independently. Family history is positive forhypertension and stroke.

On physical exam, G.L. is 5’ 10” and weighs 197lbs. His sittingblood pressure is 162/88 mmHg. Pulse is 76/min regular and full ofvolume. You listen carefully for bruits and looked for signs oftarget organ damage. G.L.’s complete examination was otherwisenormal.

Questions:

1. What are the general considerations with HTN?
2. What are the age associated changes related to HTN?
3. What would your diagnostic evaluation entail?
4. Will you start G.L. on an antihypertensive medication at thistime?
5. What will be your follow-up plan?
6. What would your patient education involve at this point?