Conclusion – 

     For the registered nurse who is working with idiopathic and/or “essential “acute secondary “target organ” disease patients, or just simply running a routine annual complete physical examination, your primary assessment skills along with any visual and articulation feed-back will become the most relevant and in many cases, the “trigger point” that will set forth in motion the investigation from both the primary clinician and the treating physician. 

     Therefore, upon opening the door and greeting your patient, your eyes, ears, and hands will become receptors within the examination which should be oriented toward clues for secondary causes of HTN, such as decreased femoral pulses, abdominal bruits, and cushingoid  stigmata (i.e., signs and symptoms of Cushing disease or syndrome: moon facies, obesity, striations, diabetes, and osteoporosis).  

     Guidelines should not be applied as a “cookbook” approach, but used as tools to assist in decision making for individualized patient care, as well as ensuring that the appropriate structures and supports are in place to provide the best possible plain of action. 

   Critical care nursing over the last decade has bridged the gap between hard-science within the scope of critical-skill-thinking and utilized correct technical skills in practice from advanced computerized medical devices that can detect abnormalities within the hypertensive patient also, promote assessment, development, and treatment plans.  

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Short Bio of Dr. Gary D. Goldberg, PhD

Over 30 years experience in the Medical field, At UCLA and Pacific Hospital of the Valley, as a Chief Technologist and Analyst, Visiting Professor and Instructor for continuing education at UCLA School of Nursing and Writer/Speaker at the School of Medicine from 1995-2008.

From 2003-2008 Dr. Goldberg has collaborated and published through the Blackwell Publishing Co. (Medical Division), and Journal of American College of Cardiology, plus 15 published abstracts within UCLA Dept. of Bio-Medical Engineering and the Dept. of Cardiology.

Current title: Clinical Professor of Medical Education with Angeles College of Nursing, in Los Angeles, Ca.  

Dr. Goldberg has written two major academic course textbooks for Angele College of Nursing and has represented advanced nursing education course curriculum through the State Dept. of California and approved by the ANA for CEU(s) and the AMA CMU Level- 1 Credit for physicians.

His wife, Cindy L. Capute-Goldberg, has been a registered nurse for over 17 years and has managed a 200-bed acute care facility with over 100, professional nurses from RN’s through CNA in the Los Angeles area.  She has co-authored with Dr. Goldberg in 2005, a manuscript presented to the Cardiology-Electrophysiology Research Group (i.e., DMPG), that has changed the dynamics of electro-static reading with regards to acute atrial anomalies. 

This finding allowed the author to publish the ‘Goldberg Protocol’  for Cardiac placements in the field and under the Dept. of Medicine Chair, in using a tilt-table with the 12 +3 Leads or the vector positioning for additional cardiac patient information.

To reach Dr. Gary D. Goldberg, for comments and/or professional consultation, please use e-mail address:  

 
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