Case: Mr. Edwards is a 73-year-old man that you are seeing for the first time at
ID: 242379 • Letter: C
Question
Case: Mr. Edwards is a 73-year-old man that you are seeing for the first time at the clinic because his previous primary care provider has recently retired. He is feeling well and presents to the office today for a routine initial visit. He has a history of hypertension, but denies chest pain, shortness of breath, palpitations, and dyspnea on exertion, fatigue or any other symptoms.
Physical Examination
Height: 69 inches; Weight: 190 lbs.; BMI 28.1
Pulse: 68 regular RR: 18
BP: 140/95
Gen: healthy, well-nourished male, appearing younger than stated age with somewhat poorly controlled hypertension.
Social History
Mr. Edwards is married and lives in his own home with his third wife of 2 years. He has two grown children, both married. He is retired and living off his pension, investment income and social security income.
Dietary and Other Lifestyle Habits:
He would prefer not to change his medications.
He’s a “meat and potatoes” man with less than 3 small servings of vegetables per week and approximately one serving of fruit (as OJ) per day.
He denies smoking cigarettes but admits to smoking a cigar approximately 2-3x/mo.
He drinks 3-4 glasses of scotch and soda a day.
He enjoys walking 2-3 miles per day for exercise.
Questions for Discussion:
What dietary or other lifestyle modifications would you suggest Mr. Edwards make to help control his hypertension?
How would you modify these recommendations if he was obese?
Would you prefer to counsel him yourself or refer him to a dietitian?
Explanation / Answer
Mr.Edward 73 years old man should strictly adhere to the following to lead a quality healthy life
Diet:
Eating Meat and Potatoes has an effect of increasing the blood pressure.So the intake of this food has to be restricted,but he enjoys eating it so restrict than to stop eating. Increasing the quantity of vegetables will help him.
Lifestyle:
Walking is good for him
Smoking has to be seized because it causes ill-effects on heart directly
Drinking Scotch and soda also has the same effect.
Considering his BMI 28.1 , which is over weight.
He is not obese.
A dietitian is the best person to modify his dietary requirements and do meal plan. Counseling this client and then sending him to dietitian will help him to come out of the problem.