What should be assessed first in a 59-year-old patient with a history of hypertension?

In a patient with a history of hypertension, the assessment that is imperative to address first is blood pressure. This is because hypertension directly affects cardiovascular health, and monitoring blood pressure provides essential information about the patient's current status and potential risks. Elevated blood pressure can lead to significant complications such as stroke, heart attack, or renal impairment.

Assessing blood pressure allows the healthcare provider to determine if the patient is experiencing hypertension-related symptoms, such as headache, dizziness, or other indications of elevated blood pressure levels. After establishing a baseline reading, further assessments related to heart rate, breath sounds, and mobility can be conducted in a systematic way.

While heart rate is relevant in cardiovascular assessments and can indicate issues such as tachycardia or bradycardia, it does not provide immediate information about the patient’s hypertension status specifically. Breath sounds are critical for pulmonary health but do not directly correlate with hypertension unless there is an underlying cardiac issue. Impaired mobility is important to assess, particularly for functional status, but it does not have the same immediate relevance to the management of hypertension.

Thus, starting with a blood pressure assessment is a prudent and evidence-based approach in the context of this patient’s medical history.