61 year old African American female presents for a follow up for blood pressure control. Pt.

states that she is

continuing her prescribed medication but admits that since returning to work, her daily exercise has decreased and
her job stress has increased. She has been tracking her blood pressures since last visit and has seen an upward trend
over the last month. She denies having any symptoms of headaches, CP, SOB, palpitations, or vision changes.

ROS:
General: No drastic weight change, generally healthy, no change in strength or exercise tolerance.
Head: No headaches
Eyes: Normal vision, no diplopia, no tearing, no scotomata, no pain.
Ears: No change in hearing
Chest: No dyspnea, no wheezing, no hemoptysis, no cough.
Abdomen: No change in appetite, no dysphagia, no abdominal pains, no bowel habit changes, no emesis, no melena.
Objective
GEN: A/O x4, appears stated age, NAD
HEENT: PERRLA, TM intact, pearly gray
Nose: clear, no redness or drainage noted
Throat: Clear, no exudates
Cardiac: RRR w/o murmur
Lungs: CTA bilaterally
Musculoskeletal: moves all extremities without limitations
Ext: No edema noted

Assessment
Hypertension- suboptimal control
Job Stress
Plan
1. Changed and increased to losartan/hctz 100/12.5mg 1 po daily
2. Low sodium diet, resume regular exercise
3. Patient to schedule Healthy Heart Screening at Baptist
4. Refer to GI Associates for Screening C/Scope
5. Keep upcoming women's health appt mid November.
6. Check urinalysis
7. Encouraged stress management through exercise. She states that she is also looking for other employment.
8. RTC 2 weeks telemedicine follow-up, then January for yearly Primary Care Wellness