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Pharmacological Effect of Anti-Hypertensive Medications in the Management of Hypertension

• Pathophysiology of the disease state.
• Review of the pharmacological agents used for treatment and important information related to the advanced practice nurse.

Submission Instructions:

• APA and 5-7 pages in length, excluding the title, abstract, and references page.
• Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles within your work.

PICK ONE 

Mildred is a 45-year-old married female with three children. She presents to the clinic with complaints of fatigue and difficulty sleeping. She states she wants to get a good night’s sleep and is requesting a prescription to help her sleep. Mildred tells you she is awake off and on during the night, frequently thinking about her husband’s recent layoff from construction work and the effect this is having on the family. She lies down often during the day and has been so fatigued that she took some time off from work during the last two weeks. She is tearful at times during the visit and looks sad and anxious. On further discussion, she says she feels overwhelmed, helpless, and anxious. She tells you about an episode where she felt her heart beating rapidly, had difficulty catching her breath, felt she was going to have a heart attack, and became frightened until her husband was able to help calm her down. She is not eating as much as usual, and when she reads the newspaper, she does not remember what she has read.

Kylie, a 24-year-old female patient, comes to your office for a refill of her allergy medication. Before going into the room, you note that her Patient Health Questionnaire – Depression (PHQ-9) score is 20, and that she is not currently on any medication for depression. When you enter the room, you notice that Kylie is easily startled, and she is sitting in the corner of the room very close to the wall.

Dale, a 40-year-old construction worker, lost his 4-year-old daughter in a car accident six months ago, in which his sister was driving and he was a passenger. He is at this visit for a follow-up of a shoulder injury sustained last month. You notice that he has lost about eight pounds since his last visit, and he is somewhat disheveled in his appearance. Dale has not been back to work, and has not been able to get into a car since the accident. Before going into the room, your nurse pulled you aside to let you know that the patient was very rude to the front office staff, and was also rude to her while he was being processed for his visit. This is not Dale’s usual behavior.

Part A
Describe the stages of sleep and outline the order in which we progress through these stages during a typical night’s sleep.

Part B
Explain why damage to peripheral nerve fibers is often reversible, whereas damage to CNS fibers rarely is.