NURS 6521N-26: ADVANCED PHARMACOLOGY RESPONSE to Instructor DISCUSSION POST (Week 2): (Dr. Claudia Robin) (Scenario 1) Deborah Lucero, RN, BS, CVRN-BC, FACCN Pharmacotherapy for Cardiovascular Disorders Dear Dr. Robin, My initial thoughts were to continue Atenolol and increase dose to 25 mg I am not sure why hydralazine and doxazosin were added to patients treatment, when beta-blocker was not titrated up to the very least target dose first. Additionally if hydralazine and doxazosin were started before b-blocker, WHY?? Secondly, I would add hydrochlorothiazide 25 mg and monitor his blood pressure and weight gain status. There was no mention of CHF, but one has to wonder if he has developed it , so I’d order a baseline BMP & BNP. If BNP within normal limits and patient continued to have pitting peripheral edema, the possibly increase HCTZ dose or start Lasix and discontinue HCTZ. However, if BNP normal without peripheral edema or pulmonary congestion, I’d have to say it is lifestyle behaviors contributing to his weight gain.
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- Summer '15