Case Exemplar Patient Assignment Help: How to Answer This Question
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Original Question
CASE EXEMPLAR: Patient With Likely Unintentional Nonadherence JS is a 75-year-old male who visits the clinic today for continued elevation of his blood pressure and for medication refills. Today his pressure is 170/110 in his left arm and 168/106 in his right arm. His wife is with him and asks if she could speak to you for a moment while JS is getting dressed. She relates that he still manages his medication by himself after she places them in the weekly pill holder at the beginning of each week. She is not certain he is taking his blood pressure medicine and is not totally sure about all of his meds. Past Medical History • History of hypertension 30+ years • No known allergies • Surgery 4 years ago for swallowed fish bone • No history of any injuries or hospitalizations Medications • Simvastatin, 40 mg once daily • Lisinopril, 40 mg once daily • Daily iron tablet for chronic anemia Family History • Father and mother had a history of hypertension and elevated cholesterol. Social History • Smoked one pack of cigarettes per day; quit 15 years ago Physical Examination • Chest clear to auscultation • Denies chest pain • No dyspnea on exertion • EKG: rsR, right bundle branch conduction abnormality (RBBB) Discussion Questions 1. The clinician decides to have JS complete an initial health literacy screening. What does the clinician anticipate finding? 2. After visiting with JS, the clinician believes JS is unintentionally nonadherent. What factors would help the clinician come to this conclusion, especially given JS’s age? 3. JS’s wife fails to confirm there are any financial problems relative to medication acquisition. How could the clinician discuss this with JS’s wife, and using the discussion regarding health literacy, how could the clinician assist this couple?
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