Implementing Clinical Practice Guidelines in Adults with Hypertension: An Effective Practice Change in Urgent Care

Implementing Clinical Practice Guidelines in Adults with Hypertension: An Effective Practice Change in Urgent Care

Urgent message: Too often, patients first learn that they have hypertension secondary to an unrelated presenting complaint—often, in the urgent care setting. Improving adherence to treatment guidelines may improve management and, ultimately, outcomes. Jennifer Iacovo, DNP, APRN, FNP-C; Bonni Cohen, PhDc, DNP, APRN, ANP-C, FNP-C, CHFN, CNE, FAANP; and Judith Butler, DNP, CNM, WHNP, CNE Abstract Background: There are approximately 100 million adults in the U. S. with hypertension (HTN); almost half go undiagnosed. The …

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Clinical Challenge: July/August, 2011

The patient is a 37-year-old female who presents with a history of long-standing hypertension and diabetes mellitus. She had recently started on a new diuretic and felt very weak and light-headed. Her blood pressure was 88/56 mmHg with a pulse of 44 beats per minute. View the patient’s ECG (Figure 1). Consider the type of diuretic is she likely to be taking and what your next steps would be. Resolution of the case is described …

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Management of Hypertensive Urgency in an Urgent Care Setting

Management of Hypertensive Urgency in an Urgent Care Setting

Urgent message: Effective management of patients presenting to urgent care with acute high blood pressure starts with differentiating between hypertensive emergency and hypertensive urgency and ends with appropriate treatment and counseling. Sanjeev Sharma, MD, Christy Anderson, PharmD, Poonam Sharma, MD, and Donald Frey, MD Introduction Urgent care physicians routinely encounter patients with high blood pressure, but management – particularly for those patients with precarious elevations – remains controversial. Alternative options involve the use of various …

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