Instructions
John B. Heart is a 51-year-old male who has smoked one pack per day since the age of 20 (31 pack
years). He has no current diagnosed medical problems. He became concerned and came to the
emergency department because he is more easily fatigued, he has had a headache the past three days
that has not improved, and his wife has been monitoring his blood pressure the past week which has
been high.
years). He has no current diagnosed medical problems. He became concerned and came to the
emergency department because he is more easily fatigued, he has had a headache the past three days
that has not improved, and his wife has been monitoring his blood pressure the past week which has
been high.
Physical exam:
VS: HR 88 bpm, temp 98.9 F (37.2 C), RR 20 breaths per minute, BP 174/95, SaO2 95% on RA
On assessment, John appears to be uncomfortable, occasionally grimacing in pain.
John reports continuous headache (8/10).
John B. Heart is diagnosed with hypertension.
VS: HR 88 bpm, temp 98.9 F (37.2 C), RR 20 breaths per minute, BP 174/95, SaO2 95% on RA
On assessment, John appears to be uncomfortable, occasionally grimacing in pain.
John reports continuous headache (8/10).
John B. Heart is diagnosed with hypertension.
The primary care provider (PCP) initiates lisinopril and writes a prescription for:
lisinopril (Zestril) 10mg orally daily.
After taking lisinopril for 2 months, John developed a persistent nonproductive cough and has recently
noted swelling of his lips. John’s PCP decides to start him on metoprolol.
metoprolol (Lopressor) 50mg orally daily
1. Explain to John why his PCP ordered lisinopril and what is the therapeutic effect of this drug? What is the mechanism of action (MOA) of this drug?
2. What other effects do Angiotensin Converting Enzymes (ACE) inhibitors have on the human body?
3. In the Analysis of Relationship section, make a strong connection between the medications lisinopril and metoprolol as it relates to hypertension. Why did John’s PCP change his medications? Why is it important to do vital signs before taking antihypertensive drugs?
3. In the Analysis of Relationship section, make a strong connection between the medications lisinopril and metoprolol as it relates to hypertension. Why did John’s PCP change his medications? Why is it important to do vital signs before taking antihypertensive drugs?
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