Rudd Case Study

The physician has written discharge order for Rudd. Rudd`s son, Matthew is also at the bedside, waiting for the nurse to bring the discharge paperwork. Rudd`s blood work and X-ray, CT scan results do not show any signs of organ damage. The assigned RN checked vital signs before discharge. The vitals are as follows: Temperature: 97.20F, Heart rate: 70 beats per minute, BP: 130/76 mmHg, respiration: 18breaths per minute, and Pulse oximetry: 98% on room air. Rudd reports no pain on pain assessment using PQRST pain assessment method. Rudd is looking very happy to go back home. The nurse brings the discharge paperwork, educational booklet and discharge medication reconciliation form. The nurse also calls the hospital pharmacy and gets the one month supply of Rudd`s medications as per discharge medication reconciliation orders.

Questions:

What are the important discharge instructions that should be given to patients admitted with a hypertensive crisis?

The discharge instruction should mainly focus on the complications of hypertension, signs, and symptoms of hypertensive crises, etiology and prevention of the hypertensive crisis. The teaching should also involve the importance of taking antihypertensive medication as per order and not skipping medications. The complications of not following the medication schedule should be reinforced to the patient.

2. Do you feel that Rudd should have an arrangement for the walk-in pharmacy to deliver his medication at the doorstep?

Yes, Rudd should have the walk-in pharmacy deliver medication monthly since Rudd`s sons live in different states and Rudd lives alone at home. The monthly delivery of the medication may avoid Rudd skipping the medications and preventing further