{"id":24211,"date":"2023-07-15T18:59:04","date_gmt":"2023-07-15T18:59:04","guid":{"rendered":"https:\/\/www.goodacademic.com\/blog\/questions\/what-is-the-best-approach-to-improve-bp-control-in-a-pt-with-history-of-stroke-and-gout-2-heart-failuresee-instruction\/"},"modified":"2023-07-15T18:59:04","modified_gmt":"2023-07-15T18:59:04","slug":"what-is-the-best-approach-to-improve-bp-control-in-a-pt-with-history-of-stroke-and-gout-2-heart-failuresee-instruction","status":"publish","type":"questions","link":"https:\/\/www.goodacademic.com\/blog\/questions\/what-is-the-best-approach-to-improve-bp-control-in-a-pt-with-history-of-stroke-and-gout-2-heart-failuresee-instruction\/","title":{"rendered":"What is the best approach to improve BP control in a pt. with history of stroke and gout. 2. Heart failure(see instruction)"},"content":{"rendered":"<p style=\"margin: 0.5em 0px 1em; cursor: auto; color: inherit;\">A 50yo African American woman presents to clinic feeling tired for the last 3 months. &nbsp;She also has trouble breathing when walking 2-3 blocks. &nbsp;She sleeps on 2 pillows at night to help with her breathing. &nbsp;PMH: &nbsp;HTN, arthritis. &nbsp;Physical exam: edema present in both feet. &nbsp;Medications: &nbsp;HCTZ 12.5mg daily, verapamil SA 120 mg daily, ibuprofen 200 mg BID for arthritis in knee. &nbsp;Vitals: &nbsp;height 5&#8217;2&#8243;, 63kg, BP 134\/84, HR 78, EF 30% per echocardiogram. &nbsp;Her labs are normal including a creatinine of 1.1. &nbsp;She denies chest pain or palpitations. &nbsp;Her EKG reveals normal sinus rhythm with no evidence of ischemia or recent acute coronary syndrome.<\/p>\n<ol style=\"margin-top: 1em; margin-right: 0px; margin-left: 0px; cursor: auto; color: inherit;\">\n<li style=\"cursor: auto; color: inherit;\">How would you classify her heart failure?<\/li>\n<li style=\"cursor: auto; color: inherit;\">What changes (modifications, additions, deletions) to her medications do you recommend that will:\n<ul style=\"cursor: auto; color: inherit;\">\n<li style=\"cursor: auto; color: inherit;\">Improve her symptoms?<\/li>\n<li style=\"cursor: auto; color: inherit;\">Impact long term outcomes?<\/li>\n<\/ul>\n<\/li>\n<li style=\"cursor: auto; color: inherit;\">What monitoring parameters do you recommend?<\/li>\n<li style=\"cursor: auto; color: inherit;\">What non-pharmacologic recommendations do you have?<\/li>\n<\/ol>\n<p><br style=\"cursor: auto; color: inherit;\"><br style=\"cursor: auto; color: inherit;\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 50yo African American woman presents to clinic feeling tired for the last 3 months. &nbsp;She also has trouble breathing when walking 2-3 blocks. &nbsp;She sleeps on 2 pillows at night to help with her breathing. &nbsp;PMH: &nbsp;HTN, arthritis. &nbsp;Physical exam: edema present in both feet. &nbsp;Medications: &nbsp;HCTZ 12.5mg daily, verapamil SA 120 mg daily, [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","meta":[],"disciplines":[1110],"paper_types":[],"tagged":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/questions\/24211"}],"collection":[{"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/questions"}],"about":[{"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/types\/questions"}],"author":[{"embeddable":true,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/comments?post=24211"}],"version-history":[{"count":0,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/questions\/24211\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/media?parent=24211"}],"wp:term":[{"taxonomy":"disciplines","embeddable":true,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/disciplines?post=24211"},{"taxonomy":"paper_types","embeddable":true,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/paper_types?post=24211"},{"taxonomy":"tagged","embeddable":true,"href":"https:\/\/www.goodacademic.com\/blog\/wp-json\/wp\/v2\/tagged?post=24211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}