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Hypertension: Apurva Shrestha Aamppipal

Kamala Sunwar, a 56-year-old female homemaker, presented for her regular checkup and medication refill for hypertension. She has a history of hypertension for 6 years and had a stroke 6 years ago resulting in right-sided hemiparesis. On examination, her blood pressure was 130/80 mmHg and she had decreased strength in her right upper and lower limbs. She was prescribed losartan 50 mg daily and amlodipine 25 mg at bedtime for one month and advised to continue physiotherapy. Areas for further revision included hypertensive urgencies/emergencies and long-term complications of hypertension.

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62 views15 pages

Hypertension: Apurva Shrestha Aamppipal

Kamala Sunwar, a 56-year-old female homemaker, presented for her regular checkup and medication refill for hypertension. She has a history of hypertension for 6 years and had a stroke 6 years ago resulting in right-sided hemiparesis. On examination, her blood pressure was 130/80 mmHg and she had decreased strength in her right upper and lower limbs. She was prescribed losartan 50 mg daily and amlodipine 25 mg at bedtime for one month and advised to continue physiotherapy. Areas for further revision included hypertensive urgencies/emergencies and long-term complications of hypertension.

Uploaded by

Apurva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Hypertension

Apurva Shrestha

Aamppipal
Patient particulars

• Name: Kamala Sunwar

• Age: 56years/ F

• Occupation: Homemaker

• Religion: Hindu

• Marital status: Married

• Address: Siranchowk-5, Gorkha

• Presented to OPD
Chief Complain

• k/c/o Hypertension with hemiparesis (under medication)

• Came for regular check up and to refill medications

• No fresh complaints
Past Medical History

• She has been taking medication for hypertension for 6 years.

• She had an episode of stroke on Baisakh following which she had right
sided paresis .

• Now, She has decreased power of right upper and lower limb which is
associated with tingling sensation in the right upper limb

• No history of numbness, headache, blurring of vision, loss of


consciousness or palpitation.
• Surgical history: No any surgical interventions

• Drug and allergic history: She is taking


• Tab. Losartan 50 mg od
• Tab. Amlodipine 25mg hs
• She has no known allergies

• Personal history: She quit smoking 3 years ago on medical advice. (18 pack
years)

She doesn’t consume alcohol.


• Family history: There are 4members in her family. There is no
significant family history.

• Social history: She lives in a cemented house with 3 rooms and a well-
ventilated separate kitchen. She uses LPG for cooking and drinks
spring water without boiling/ filtering
Examination
• General Physical Examination:
She was moderately built, co-operative and well oriented to time, place
and person.

• Vitals:
• BP: 130/80 mmHg in Left arm
• Pulse: 80 bpm, regular, normal volume, no radio- radial/ radio- femoral
delay.
• RR: 20/min
• Temp: afebrile
• Chest: Bilateral equal air entry, NVBS, no added sound

• CVS: S1, S2, M0

• P/A: soft, non-tender

• Eye examination: not done

• Power: 5/5 in all limbs


• Investigations : not done

• Management:
• Tab Losartan 50 mg od
• Tab Amlodipine 25 mg HS
• These medications were prescribed for a month

• Advice: Follow up in 1 month.

Continue physiotherapy
Socio-cultural factors

• Age

• Cigarette smoking

• Health insurance

• CVA history leading to hemiparesis


Disease prevention advice

• Continue Physiotherapy

• Less salt intake

• Continue regular medications


Areas needed to revise

• Hypertensive urgency and emergency.

• Long- term complications of hypertension


Reflection

• Revised about the theory and the clinical aspect of hypertension

• Also learnt about the complication of hypertension i.e. CVA

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