Module 04: Gerontology Health Care of the Elderly (Assessment)
A 76-year-old lady with heart failure secondary to ischaemic heart disease is reviewed in the outpatient clinic. She is on perindopril 2mg OM, Bisoprolol 1.25mg bd and has recently had her dose of frusemide increased from 40mg to 80mg OD. During the consultation she complains of recent episodes of dizziness, particularly when standing upright after being seated. There are no clinical signs of cardiac failure. Blood pressure is 130/80.
Serum urea and electrolytes showed:
Serum Urea: 13.3 mmol/L (2.5-7.5)
Serum Creatinine: 221 umol/L (60-110)
What is the next step in her management?
A. Increase the dose of Perindopril
B. Stop the bisoprolol
C. Add an angiotensin-2 receptor blocker
D. Stop the frusemide temporarily and restart at a lower dose within a few days
E. Stop the perindopril
A 76-year-old lady with heart failure secondary to ischaemic heart disease is reviewed in the outpatient clinic. She is on perindopril 2mg OM, Bisoprolol 1.25mg bd and has recently had her dose of frusemide increased from 40mg to 80mg OD. During the consultation she complains of recent episodes of dizziness, particularly when standing upright after being seated. There are no clinical signs of cardiac failure. Blood pressure is 130/80.
Serum urea and electrolytes showed:
Serum Urea: 13.3 mmol/L (2.5-7.5)
Serum Creatinine: 221 umol/L (60-110)
What is the next step in her management?
A. Increase the dose of Perindopril
B. Stop the bisoprolol
C. Add an angiotensin-2 receptor blocker
D. Stop the frusemide temporarily and restart at a lower dose within a few days
E. Stop the perindopril