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1 Based on the history of Mr. Bailey, what are the disease entities you are entertaining? Why?
Discuss.
Mr. Michael Bailey went to my clinic because of his cough and swelling of the feet. He is
also suffering from chest and back pain. Also, he also had a history of systolic BP 2 years ago.
His father died of stroke and his mother died of complications of Diabetes Mellitus.
Based on Mr. Baileys medical history, and present condition and medical records which
is:
ROS: Respiratory system: cough; Musculoskeletal: swelling of both feet.
PPE: General: alert, cooperative, well-developed, well-nourished, not in acute distress.
VS: BP 180/95; PR 102/min, RR 22/min, T 99.8 F (oral), SpO2 96%; Ht 58,
Wt- 190 lbs, BMI-28.9; HEENT- no nasal flaring; neck no jugular vein distension;
heart tachycardic, no murmur; lungs crackles at lower lung field, bilateral; abdomen
globular, soft, non-distended, non-tender, no fluid wave noted; extremities - +1 pedal
edema.
I think the disease that I am entertaining is Hypertensive Heart Disease. This kind of
disease refers to a heart condition caused by high blood pressure. Hypertensive Heart Disease is
supported by the symptoms that were evident to his the patient based on the examination given
to him. A common symptom for Hypertensive Heart Disease is chest pain which can be the
cause of the blood flow the heart is poor. Other symptoms are to feel pain from the neck, arms,
shoulders or even back. As to the case of the patient, he is also suffering from back pain.
Though the said disease can also lose a patients appetite, however Mr. Bailey did not report
that. But, he said he is experiencing non-productive occurring on and off cough.
Also, basing on the cause of death of his parents which is stroke and diabetes mellitus, it
is possible for Mr. Bailey to get Hypertensive Heart Disease. Stroke and Diabetes mellitus could
be a cause or result of elevated blood pressure or 130 mm Hg or higher for systolic blood
pressure which can eventually develop into a heart disease.

2 What are the laboratory or ancillary procedures you will request to support your
diagnoses?
I will recommend to Mr. Michael Bailey:

electrocardiogram to monitor Mr. Baileys hearts electrical activity;

echocardiogram to take a detailed picture of Mr. Baileys heart.;

an exercise stress test to check at how exercise affects Mr. Baileys heart. I will let
him pedal an exercise bike or walk on a treadmill; and a

nuclear stress test to examine and check the flow of blood into Mr Baileys heart.

3 What would be your treatment goals for him?

Treating and recovering from hypertensive heart disease may be challenging but is still
manageable. However, this kind of disease depends on the exact state and its strength. By the use
of effective drugs, some tests and healthy lifestyle, Mr. Bailey can help himself to keep the
illness from getting worse.
4 What are the medications you will prescribe? Please give the mechanism of action and the
side effects of each drug you prescribe.
I will give Mr. Bailey with a variety of drugs, including diuretics, beta-blockers, and ACE
inhibitors.
Diuretics He should take the pill once a day; he should take it every morning before or
right after breakfast. The side effects of this drug are frequent urinations and extreme
tiredness.
Beta-blockers He should take the pill once a day; he can take it every morning or
before bedtime. He can take the pill along with a food to minimize the side effects. The
side effects of these drug are fatigue, headache, diarrhea or constipation.
ACE inhibitors He should take the pill every morning or evening; he should take it one
hour before breakfast or dinner. The side effects of this drug are skin rashes, dizziness,
and decreased ability to taste.
Though these drugs have side effects, it should not be expected at all times. Side effects
will occur depending on the body and body system of Mr. Bailey. Nevertheless, there will be
time that the patient can experience these side effects.

5 What lifestyle modifications would you advice?

By the use of effective drugs, some tests and healthy lifestyle, Mr. Bailey can help
himself to keep the illness from getting worse. To prevent Hypertensive Heart Disease to develop
more or to become worst, Mr. Bailey should follow a healthy lifestyle.
I recommend:

a healthy diet; it means he needs to eat more vegetables and milk;

enough and adequate sleep at least 8-9 hours a day;

exercising regularly; and

avoid too much lifting of heavy loads;

avoid stress; and

never forget to drink the prescribed medicine.

Maintaining all of these recommendations are possibly, if not definitely, the best habits
and methods to treat hypertensive heart disease and prevent it to get worst.

REFERENCES
Hypertensive Heart Disease. (n.d.). Retrieved April 24,
http://misc.medscape.com/pi/iphone/medscapeapp/html/A162449-business.html

2015,

from

Hypertensive heart disease. (n.d.). Retrieved

http://en.wikipedia.org/wiki/Hypertensive_heart_disease

2015,

from

April

24,