NURSING 603 WK 3 DISCUSSIONS Q & A
WITH REFERENCES DOWNLOAD TO
SCORE A
1) What Leads Demonstrate the ST Depression?
2) Is Lorene Hypertensive per ACA 2017 Guidelines? Compare the ACA guidelines to JNC 8
guidelines and discuss what treatment you recommend for her BP and why.
3) What is the Primary diagnosis causing Lorene's chest pain? Include ICD 10 codes (no
differentials)
4) What other secondary diagnoses does Lorene have that should be addressed? (Include the
rationale and a reference for your diagnoses)
5) Design a treatment plan and discuss how each intervention is applicable to Lorene's
case. Consider the following interventions:
Labs
Durable Medical Equipment Diagnostic tests- discuss the goal/purpose
Any consultation with outside providers/services
Medications- discuss why you chose each specific medication
Referrals- who and why
Follow up- why and when
Education- specific and measureable
Lifestyle Changes- specific to her cultural preferences, values and beliefs
What Leads Demonstrate the ST Depression?
The leads that develop ST Depression in this EKG is leads II, V2, V3, V4, V5, and V6.
, NURSING 603 WK 3 DISCUSSIONS Q & A
WITH REFERENCES DOWNLOAD TO
SCORE A
Is Lorene Hypertensive per ACA 2017 Guidelines? Compare the ACA guidelines to JNC 8
guidelines and discuss what treatment you recommend for her BP and why.
According to American College of Cardiology, (2017) Lorene Blood Pressure of 146/90 places
her at stage 2 hypertension (Whelton et al., 2017). The JNC 8 and ACA have a difference in
blood pressure parameters. The ACA believes that the normal blood pressure is 120/80. Stage 1
hypertension is 130-139- or 80-89-mm Hg, and hypertension stage 2 is ≥140 or ≥90 mm Hg
(Whelton et al., 2017). In JNC 8 guidelines, they believe blood pressure should be treated when
greater than 150/90. The guidelines factor in SBP and DBP with age and comorbidity specific
treatment. The ACA has a stricter guideline, recommending lowering numbers no matter what
comorbidities that patient has (American Family Physician, 2014). When looking at both of these
guidelines, I would recommend hydrochlorothiazide 12.5 mg PO daily and monitor her blood
pressure. If her blood pressure does not respond well, then a calcium channel blocker like
Norvasc 5 mg daily will be added. Both of these medications are recommended for controlling
hypertension in African Americans by ACA (Whelton et al., 2017).
What is the Primary diagnosis causing Lorene's chest pain? Include ICD 10 codes (no
differentials)
The primary diagnosis, in this case, causing Lorene’s chest pain is acute coronary syndrome
(ACS) I24.9. This diagnosis is based on her symptoms, as well as her EKG. Lorene had
WITH REFERENCES DOWNLOAD TO
SCORE A
1) What Leads Demonstrate the ST Depression?
2) Is Lorene Hypertensive per ACA 2017 Guidelines? Compare the ACA guidelines to JNC 8
guidelines and discuss what treatment you recommend for her BP and why.
3) What is the Primary diagnosis causing Lorene's chest pain? Include ICD 10 codes (no
differentials)
4) What other secondary diagnoses does Lorene have that should be addressed? (Include the
rationale and a reference for your diagnoses)
5) Design a treatment plan and discuss how each intervention is applicable to Lorene's
case. Consider the following interventions:
Labs
Durable Medical Equipment Diagnostic tests- discuss the goal/purpose
Any consultation with outside providers/services
Medications- discuss why you chose each specific medication
Referrals- who and why
Follow up- why and when
Education- specific and measureable
Lifestyle Changes- specific to her cultural preferences, values and beliefs
What Leads Demonstrate the ST Depression?
The leads that develop ST Depression in this EKG is leads II, V2, V3, V4, V5, and V6.
, NURSING 603 WK 3 DISCUSSIONS Q & A
WITH REFERENCES DOWNLOAD TO
SCORE A
Is Lorene Hypertensive per ACA 2017 Guidelines? Compare the ACA guidelines to JNC 8
guidelines and discuss what treatment you recommend for her BP and why.
According to American College of Cardiology, (2017) Lorene Blood Pressure of 146/90 places
her at stage 2 hypertension (Whelton et al., 2017). The JNC 8 and ACA have a difference in
blood pressure parameters. The ACA believes that the normal blood pressure is 120/80. Stage 1
hypertension is 130-139- or 80-89-mm Hg, and hypertension stage 2 is ≥140 or ≥90 mm Hg
(Whelton et al., 2017). In JNC 8 guidelines, they believe blood pressure should be treated when
greater than 150/90. The guidelines factor in SBP and DBP with age and comorbidity specific
treatment. The ACA has a stricter guideline, recommending lowering numbers no matter what
comorbidities that patient has (American Family Physician, 2014). When looking at both of these
guidelines, I would recommend hydrochlorothiazide 12.5 mg PO daily and monitor her blood
pressure. If her blood pressure does not respond well, then a calcium channel blocker like
Norvasc 5 mg daily will be added. Both of these medications are recommended for controlling
hypertension in African Americans by ACA (Whelton et al., 2017).
What is the Primary diagnosis causing Lorene's chest pain? Include ICD 10 codes (no
differentials)
The primary diagnosis, in this case, causing Lorene’s chest pain is acute coronary syndrome
(ACS) I24.9. This diagnosis is based on her symptoms, as well as her EKG. Lorene had
