Harvey Hoya iHuman Case Study Assignment Help

The Harvey Hoya iHuman case study is an essential learning tool for students pursuing medical and nursing degrees, particularly those focused on patient care related to cardiovascular diseases. This case introduces a 57-year-old Hispanic male construction worker with a significant health issue, hypertension (high blood pressure), along with related comorbidities and risk factors. Through this case, students are tasked with assessing the patient’s history, identifying key findings, formulating a problem statement, and developing a management plan.

At iHumanAssignmentHelp.com, we provide comprehensive assistance with such assignments, ensuring students understand the case, key clinical elements, and how to apply theoretical knowledge to real-life scenarios.

History and Physical Exam: Harvey Hoya

The Harvey Hoya case begins with a detailed history and physical examination. As the healthcare provider, you are tasked with conducting a thorough assessment by asking the patient specific questions that help you gather information on his condition.

Some of the critical questions in the Harvey Hoya case study include:

• How can I help you today?
• Do you have any other symptoms or concerns that we can discuss?
• When did your high blood pressure start?
• How severe is your high blood pressure?
• Have you gained weight?
• When did your headache start?

These questions are aimed at understanding the patient’s medical history, lifestyle, and symptoms, which are crucial in forming an accurate diagnosis and management plan. Harvey Hoya presents with elevated blood pressure, headaches, and other related symptoms, which makes it essential to dig deeper into the potential causes and implications of these findings.

Harvey Hoya iHuman Case: Key Findings and Problem Statement

The Harvey Hoya case study identifies several key findings that contribute to the patient’s health issues. These findings provide valuable insights into the potential causes of his symptoms and help students make informed decisions when formulating a diagnosis and treatment plan.

Key Findings in the Case:

• Elevated blood pressure: Harvey’s blood pressure readings are significantly above the normal range, with values of 172/94 on the left arm and 178/98 on the right arm.
• Headaches: Harvey reports experiencing intermittent mild headaches.
• Daytime somnolence and fatigue: These symptoms suggest the possibility of an underlying condition, such as sleep apnea.
• Smoking: Harvey is a smoker, which increases his risk for cardiovascular diseases.
• Overweight status: His weight is above the recommended range, contributing to hypertension and other potential health complications.
• Hypertensive retinopathy (AV nicking): Funduscopic examination reveals signs of hypertensive damage to the retinal blood vessels.
• Laterally displaced PMI (point of maximal impulse): This finding suggests left ventricular hypertrophy, a common complication of long-term hypertension.
• Snoring and interrupted sleep: Harvey’s wife reports that he frequently snores and wakes up during the night due to breathing difficulties, which indicates a high likelihood of sleep apnea.
• NSAID use: Harvey’s use of nonsteroidal anti-inflammatory drugs (NSAIDs) is significant, as these drugs can worsen kidney function and contribute to hypertension.
• Poor eating habits: His diet is characterized by high salt and fat intake, contributing to weight gain and elevated blood pressure.

Problem Statement: Harvey Hoya iHuman Case

Based on the key findings, the problem statement for Harvey Hoya can be developed. Harvey is a 57-year-old overweight Hispanic construction worker who presents for evaluation of elevated blood pressure, as noted at a recent health fair. He has a history of intermittent mild headaches, interrupted sleep due to snoring, and has been told in the past that his blood pressure was elevated. He did not seek treatment at that time.

Physical examination findings include:

• BP readings of 172/94 (left arm) and 178/98 (right arm).
• Laterally displaced PMI (indicating left ventricular hypertrophy).
• Hypertensive retinopathy (AV nicking on funduscopic examination).

Harvey’s family history is positive for hypertension and related complications. He smokes, is overweight, and has poor dietary habits, which all contribute to his elevated blood pressure and overall health status.

Differential Diagnosis

The primary issue for Harvey Hoya is hypertension (HTN). However, several other conditions could be contributing to his symptoms, such as sleep apnea, obesity, smoking-related complications, and the use of NSAIDs. The differential diagnosis should consider the following:

• Primary hypertension: This is likely the most significant active problem (MSAP) based on his elevated BP, family history, and lifestyle factors.
• Obstructive sleep apnea: Harvey’s snoring, daytime somnolence, and reports of interrupted sleep suggest that sleep apnea could be contributing to his hypertension.
• Hypertensive heart disease: The laterally displaced PMI suggests left ventricular hypertrophy, which is a common complication of long-standing, uncontrolled hypertension.
• Renal artery stenosis: The presence of a renal bruit could indicate this condition, which can cause secondary hypertension.

Harvey Hoya iHuman Case: Management Plan

The management plan for Harvey Hoya should address his hypertension, sleep apnea, and associated lifestyle factors. Below are key elements of the patient’s treatment plan:

Hypertension (HTN) management:

• BP goal: Harvey’s target blood pressure should be 120/80 mmHg due to his age and risk factors.
  • Medication selection: Since Harvey is non-black (Hispanic), the JNC 2013 guidelines recommend initiating treatment with a thiazide-type diuretic, ACE inhibitor (ACEI), angiotensin receptor blocker (ARB), or calcium channel blocker (CCB).
    • Start hydrochlorothiazide (HCTZ) 25 mg once daily for one week.
    • Follow-up after two weeks to assess BP control. If still hypertensive, consider increasing HCTZ to twice daily or adding Lisinopril 10 mg once daily (ACEI).
  • Home BP monitoring: Encourage Harvey to monitor his blood pressure regularly at home.
  • Baseline tests: Obtain a lipid panel and hemoglobin A1c (HgA1c) to assess his cardiovascular risk and screen for diabetes.
  • Nutritional consultation: Refer Harvey to a nutritionist for weight loss and dietary counseling to reduce salt and fat intake.

Sleep apnea management:

• Continuous positive airway pressure (CPAP) assessment: Refer Harvey for a sleep study to confirm obstructive sleep apnea and arrange for CPAP therapy if needed.
  • Lifestyle counseling: Advise Harvey on the importance of weight loss, smoking cessation, and reducing alcohol consumption to improve his overall health and reduce the severity of his sleep apnea.

Patient lifestyle counseling:

• Dietary recommendations: Encourage Harvey to reduce his intake of fatty and salty foods while increasing foods rich in potassium, such as fruits and vegetables.
  • Weight reduction: Recommend a goal of losing 13 pounds to help lower his blood pressure and improve his overall health.
  • Avoidance of NSAIDs: Advise Harvey to minimize the use of NSAIDs, as they can worsen hypertension and kidney function.
  • Smoking cessation: Help Harvey develop a smoking cessation plan to reduce his risk of cardiovascular disease and lung problems.
  • BP monitoring and follow-up: Schedule a follow-up visit in two weeks to assess his BP, with regular check-ups thereafter to monitor his progress.

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