<< Hospital Management Of Hypertension: Urgencies And Emergencies

Case Presentations And Conclusions

A 60-year-old man is admitted through the emergency department with acute onset of severe left lower quadrant pain associated with a fever to 38.7°C (101.7°F), nausea, and vomiting. A CT scan is consistent with diverticulitis, though there is no abscess, perforation, or obstruction. His initial blood pressure on presentation was 185/98 mm Hg. He was started on intravenous hydration and antibiotics and was made NPO. He was also given intravenous morphine to control his pain. He has a history of hypertension and hyperlipidemia and reports compliance with his home regimen of ramipril 10 mg daily and atorvastatin 40 mg daily. As you evaluate the patient, you note that he is still nauseated and cannot tolerate oral intake. His blood pressure remains elevated at 174/97 mm Hg. How should you manage his blood pressure now?

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