CC: Headache

HPI: Patient complains of a constant, “pounding” headache for two days associated with blurry vision.

PFSH: No allergies. Father died at age 55 of CVA. Smokes 2 PPD.

ROS: Positive per HPI. No chest pain or SOB. No N/V. All other systems reviewed and are negative.

Exam: NAD. BP 210/105, RR 22, HR 88. The following organ systems were normal: EYES, ENMT, CARDIOVASCULAR, RESPIRATORY, GI, NEUROLOGIC, PSYCHIATRIC.

Data: EKG was reviewed and showed NSR with no ST changes. CT of the head was read as NAD. Labs show normal electrolytes, CBC and normal creatinine.

Impression: New diagnosis of HTN presenting with hypertensive urgency

Plan

1. Admit to ICU
2. LABETOLOL drip
3. Titrate dose to maintain SBP < 180
4. Start oral LABETOLOL 200 mg BID
5. Start LISINOPRIL 40 mg PO QD
6. Start AMLODIPINE 10 mg PO QD
7. Check renal artery Doppler studies to rule out renal artery stenosis

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