Junetta Cooper Highlights
Patient Introduction
The patient’s, Junetta Cooper’s, husband brought her to the
emergency department this morning at 0815 because she was
experiencing angina unrelieved by nitroglycerin. She has been
evaluated in the emergency room, and she is now awaiting
cardiac catheterization tomorrow to evaluate the extent of the
coronary artery disease.
Mrs. Cooper is a 75-year-old African American woman who has
had primary hypertension since age 55 years. Her blood pressure
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, has been treated with antihypertensive drugs. She has a 1-year
history of stable (exertional) angina pectoris secondary to CAD.
Her pain has been successfully controlled with the nitroglycerin
patch and sublingual nitroglycerin tablets.
When she arrived to the ED, vital signs were: BP 154/90 mmHg,
HR 90/min, RR 14/min, and SpO2 96%. The first set of cardiac
enzymes were negative, and she had no ECG changes indicating
that she was not experiencing a myocardial infarction, but the
angina pain persisted intermittently. The provider ordered
treatment with sublingual nitroglycerin, morphine, and aspirin to
relieve her immediate symptoms, and clopidogrel and
fondaparinux as a safety precaution. She is not complaining of
pain at this time. She took her daily meds for hypertension at
home before coming here. The provider included her home meds
in the orders, as she will need to continue on these while she is
here. Oxygen is running at 1 L/min by nasal cannula and an IV
with lactated Ringer’s and 5% dextrose is infusing at 100 mL/hr.
Mrs. Cooper’s vital signs are being continuously monitored and
documented every hour, and she is due for pain and vital signs
assessment per the provider’s orders.
Hypertension
Overview
• Elevated blood pressure (BP) characterized by two or more
BP measurements that are greater than 129/80 mm Hg
and taken on two separate occasions using a reliable BP
recording method; BP measurements may be obtained
during a health care visit, at home, or using an ambulatory
BP recording device
• Diagnosis and classification based on new BP categories
established in 2017 by the American College of
Cardiology/American Heart Association Task Force
(See Classifying hypertension.)
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