Questions: On January 17, 2028, you are caring for a 49-year-old female patient named Juanita Sanchez. Her birth date is 04 / 19 / 1979, and her ID number is 364972. She is in room 302. She was admitted January 13, 2028, for a hypertensive crisis. Her blood pressure was brought under control, and she will be discharged on valsartan (Diovan) 160 mg once daily and hydrochlorothiazide 25 mg once daily. During her hospital stay, her cholesterol level was found to be mildly elevated at 217 mg / dL. She is 5 feet, 3 inches tall and weighs 181 lbs. She works from home doing data entry so she can be home for her three children, ages 3, 6, and 12 years. She is to go home on a healthy-heart diet and with orders to walk for 30 minutes a day, 5 days per week. Her mother also lives with the family, but she is on hospice care related to end-stage breast cancer. Mrs. Sanchez is anxious to get home to care for her mother and children. Mr. Sanchez works the night shift. You meet with Mr. and Mrs. Sanchez at 10:15 a.m. and perform discharge teaching. When you return at 10:50 a.m., Mrs. Sanchez states that her 12-year-old daughter is having trouble dealing with the impending death of her grandmother. Mrs. Sanchez is also upset knowing that her mother has only a few more months to live. She says she thinks her blood pressure was up as a result of the stress of caring for her mother and from her diet and lack of exercise. She begins to cry, stating that she feels overwhelmed with her mother's care. You discuss the hospice services she is receiving and bring up the possibility of additional help. Mr. Sanchez says that he would be willing to pay for help but does not know how to hire trained, reliable nursing assistants. You offer to arrange a consultation with their current hospice agency regarding more assistance for them. You make the call after leaving the room, at 11:15 a.m.

Transcript text: On January 17, 2028, you are caring for a 49-year-old female patient named Juanita Sanchez. Her birth date is $04 / 19 / 1979$, and her ID number is 364972 . She is in room 302. She was admitted January 13, 2028, for a hypertensive crisis. Her blood pressure was brought under control, and she will be discharged on valsartan (Diovan) 160 mg once daily and hydrochlorothiazide 25 mg once daily. During her hospital stay, her cholesterol level was found to be mildly elevated at $217 \mathrm{mg} / \mathrm{dL}$. She is 5 feet, 3 inches tall and weighs 181 lbs . She works from home doing data entry so she can be home for her three children, ages 3,6, and 12 years. She is to go home on a healthy-heart diet and with orders to walk for 30 minutes a day, 5 days per week. Her mother also lives with the family, but she is on hospice care related to end-stage breast cancer. Mrs. Sanchez is anxious to get home to care for her mother and children. Mr. Sanchez works the night shift. You meet with Mr. and Mrs. Sanchez at 10:15 a.m. and perform discharge teaching. When you return at 10:50 a.m., Mrs. Sanchez states that her 12-year-old daughter is having trouble dealing with the impending death of her grandmother. Mrs. Sanchez is also upset knowing that her mother has only a few more months to live. She says she thinks her blood pressure was up as a result of the stress of caring for her mother and from her diet and lack of exercise. She begins to cry, stating that she feels overwhelmed with her mother's care. You discuss the hospice services she is receiving and bring up the possibility of additional help. Mr. Sanchez says that he would be willing to pay for help but does not know how to hire trained, reliable nursing assistants. You offer to arrange a consultation with their current hospice agency regarding more assistance for them. You make the call after leaving the room, at 11:15 a.m.