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CASE STUDY: Leroy Thomas is a 60-year-old African American man who works as a band director for a local high school. He also plays the trombone in a brass band. He has a wife and three adolescent boys. He has been healthy until now, but his physician has just told him that he needs to be treated for high blood pressure. Eight months ago, his blood pressure reading was 154/94 mm Hg. However, he did not return for a follow-up until 2 months ago. He tells you that his schedule is very hectic and that his band has taken trips to both New York and California during the past few months. At the visit 2 months ago, his blood pressure was 148/92 mm Hg; 1 month later it was 150/90 mm Hg. Today, during an annual physical examination with Dr. Simmons, his blood pressure is 154/96 mm Hg. He voices surprise at this, saying, “I feel fine! I don’t feel a thing!” After the physical examination, Dr. Simmons speaks to Mr. Thomas about his hypertension and its management. Mr. Thomas expresses concern, notes that both his father and his brother have been treated for it, and says, “I guess it’s my turn now.” He says that he is “worried about the future” and really wants to “do what is necessary to get better.” You will be reviewing the physical assessment report and the prescriptions with Mr. Thomas. Answer the following questions 1. What assumptions could be made regarding Mr. Thomas’ health beliefs? What evidence in the case study supports your assumption? 2. In 3-4 sentences, explain how you would respond to Mr. Thomas’ concern as the nurse? 3. What response from a registered nurse could potentially violate ethical principles? Provide clear definitions of the ethical principle and how it can be violated. 4. What risk factors do you assume contributed to Mr. Thomas’ hypertension diagnosis? How does this connect with your current knowledge about hypertension? 5. In your opinion, what could be contributing to the lack of blood pressure control with Mr. Thomas?

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