- Complete the outline templateLinks to an external site. provided for the sections highlighted in yellow and the ??click to enter text here? is indicated.
- Provide references for your protocol at the bottom of the form where indicated. References should come from the following sources:
- Clinical Practice Guidelines
- DyslipidemiaLinks to an external site. –https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625
- Clinical Practice Guidelines
- HTNLinks to an external site
- https://jamanetwork.com/journals/jama/fullarticle/1791497 You can click on ??Figures/Tables? on the right hand side of the screen to take you to the algorithm/decision tree to get directly to the information you are looking for to work through the assignment to see how hypertension is treated according to this guideline.
Fill out the outlined templete
HTN Lipid Protocol 4
HYPERTENSION PROTOCOL: INITIAL VISIT
1.
RATIONALE
0. This protocol will assist in the differentiation between essential hypertension and renal artery stenosis to aid in the identification of patients in need of referral to nephrology to prevent further renal damage from an unidentified renal artery stenosis. The design of the protocol for UTI encompasses these principles.
1.
SYMPTOMS
1.
HYPERTENSION
0. Blood pressure >140/90 mmHg
0. Other possible subjective symptoms
1. Headache
1. Visual changes
1. Dyspnea
1. Chest pain
1. Sensory or motor deficit
1.
RENAL ARTERY STENOSIS
1. Onset of hypertension age >55 years or <30 years
1. History of accelerated, malignant, or resistant hypertension
1. History of unexplained kidney dysfunction
1. History of multivessel coronary artery disease
1. History of other peripheral vascular disease
1. Abdominal bruit
1. Sudden or unexplained recurrent pulmonary edema
1. Other possible factors
7. Absence of family history of hypertension
7. Other bruits
7. History of acute kidney injury after administration of ACE inhibitor or angiotensin II receptor antagonist (ARB)
1.
HISTORY
2. Continue with treatment of hypertension but consult supervising physician if patient has:
0. History of accelerated, malignant, or resistant hypertension
0. History of unexplained kidney dysfunction
0. History of multivessel coronary artery disease
0. History of other peripheral vascular disease
0. Abdominal bruit
0. Sudden or unexplained recurrent pulmonary edema
1.
PHYSICAL EXAM
3. Perform the following examinations:
0. Vital Signs (blood pressure, pulse)
0. Auscultation for bruits (carotid, abdominal, and femoral)
0. Palpation of thyroid
0. Cardiac
0. Respiratory
0. Lower extremities for edema and pulses
0. Neurological
3. Consult supervising physician if findings of:
1. Abdominal bruit
1. Another bruit
1.
LAB TESTS
4. Metabolic panel
0. Cholesterol
0. Blood sugar
0. Uric acid level
4. Glomerular filtration rate
4. Consult supervising physician if:
2. GFR indicates chronic kidney disease (CKD) or renal failure
1.
PHARMACOLOGICAL TREATMENT
5. List the hypertension drug classifications and examples you would prescribe in order of treatment a
Rubic
Pharmacological Treatment: 6a: HTN Clinical Practice Guideline- Includes no fewer than 20 blanks completed correctly. Requirements: ?¢ 4 Drug Category/Classifications listed in order according to CPG ?¢ 4 Generic named examples for each category (20 Total blanks to complete correctly)
Pharmacological Treatment: 6b: 1st line treatment for non-African American- Includes no fewer than 8 requirements. Requirements: 1. Drug 2. Dose 3. Route 4. Frequency 5. Instructions 6. Cautions/Precautions 7. Cost 8. Patient Education
Pharmacological Treatment: 6c: 1st line treatment for African American- Includes no fewer than 8 requirements. Requirements: 1. Drug 2. Dose 3. Route 4. Frequency 5. Instructions 6. Cautions/Precautions 7. Cost 8. Patient Education
6d and 8a- Includes no fewer than 4 blanks completed correctly. Requirements: Answer the prompts for 6d and 8a which includes 4 blanks to complete.
Statin Therapy 6e- Includes no fewer than 14 blanks completed correctly. Requirements: 14 blanks to complete table
Treatment Monitoring 7a-c- Includes no fewer than 5 blanks completed correctly. Requirements: 1. Follow up timeframe 2. BP Medication Monitoring a. Physical Assessment b. Labs/Diagnostics 3. Statin Medication Monitoring a. Physical Assessment b. Labs/Diagnostics
References- Includes no fewer than 4 requirements. Requirements: 1. Only the 3 sources provided in instructions are used in conjunction with a pharmaceutical cost estimating website such as Good RX. 2. Citations are provided where indicated on the form. 3. Citations and references are in current APA edition format. 4. There is a reference to match every citation provided. References within 5 years
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