NSG 3370 WEEK 7 PART 2 DISCUSSION
Your patient is a 77-year-old woman who has been more socially withdrawn lately and told her
daughter she had not been feeling well. Her daughter has noticed a stepwise decline. While
shopping for groceries with her daughter she became separated from daughter in the aisles. She
became confused and angry when store employees and others tried to assist her. Her current
medications are Hydrochlorothiazide, Lisinopril and Atorvastatin.
• What is your differential diagnosis based on the information you now have?
• What other questions would you like to ask her now? (Questions can be asked of patient
first, and then of reliable historian separately.)
• How would you treat this patient and discuss why you give each medication or therapy
you give?
Hydrochlorothiazide: Diuretic, used to treat blood pressure, and treat fluid retention (edema).
To make sure hydrochlorothiazide is safe for you, tell your doctor if you have:
• kidney disease;
• liver disease;
• gout;
• glaucoma;
• low levels of potassium or sodium in your blood;
• high levels of calcium in your blood;
• a parathyroid gland disorder;
• diabetes; or
• an allergy to sulfa drugs or penicillin.
Call your doctor at once if you have:
• a light-headed feeling, like you might pass out;
• eye pain, vision problems;
• jaundice (yellowing of the skin or eyes);
• pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);
• shortness of breath, wheezing, cough with foamy mucus, chest pain;
• signs of electrolyte imbalance--dry mouth, thirst, drowsiness, lack of energy, restlessness,
muscle pain or weakness, fast heart rate, nausea and vomiting, little or no urine; or
Your patient is a 77-year-old woman who has been more socially withdrawn lately and told her
daughter she had not been feeling well. Her daughter has noticed a stepwise decline. While
shopping for groceries with her daughter she became separated from daughter in the aisles. She
became confused and angry when store employees and others tried to assist her. Her current
medications are Hydrochlorothiazide, Lisinopril and Atorvastatin.
• What is your differential diagnosis based on the information you now have?
• What other questions would you like to ask her now? (Questions can be asked of patient
first, and then of reliable historian separately.)
• How would you treat this patient and discuss why you give each medication or therapy
you give?
Hydrochlorothiazide: Diuretic, used to treat blood pressure, and treat fluid retention (edema).
To make sure hydrochlorothiazide is safe for you, tell your doctor if you have:
• kidney disease;
• liver disease;
• gout;
• glaucoma;
• low levels of potassium or sodium in your blood;
• high levels of calcium in your blood;
• a parathyroid gland disorder;
• diabetes; or
• an allergy to sulfa drugs or penicillin.
Call your doctor at once if you have:
• a light-headed feeling, like you might pass out;
• eye pain, vision problems;
• jaundice (yellowing of the skin or eyes);
• pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);
• shortness of breath, wheezing, cough with foamy mucus, chest pain;
• signs of electrolyte imbalance--dry mouth, thirst, drowsiness, lack of energy, restlessness,
muscle pain or weakness, fast heart rate, nausea and vomiting, little or no urine; or
