hi , susan , how are you ?
[patient] good . how are you ?
[doctor] good . are you ready to get started ?
[patient] yes , i am .
[doctor] so , susan is a 26-year-old female here for a high blood pressure check . susan , what's going on with your blood pressure ?
[patient] so , i've always struggled with , um , high blood pressure , but it's seeming to get really out of control lately . so , i wanted to come in and see if there's any type of new medication i can be on to help it get steady or if there is diet restrictions i should take , um , things like that .
[doctor] okay . so , i know that we've had you on the norvasc and we had to increase your dose , so you're on 10 milligrams a day now . and what are your blood pressures running at home ? you c- ... like , have they been like over 150 ?
[patient] yeah , they have been .
[doctor] okay . all right . and , have you had any headaches ?
[patient] i have had some headaches . i do n't know if that's just because of more stress at work or , um , because of the high blood pressure .
[doctor] okay . all right . so , you've had some headaches . have you had any chest pain , shortness of breath , anything like that ?
[patient] no , nothing like that .
[doctor] okay . um , and , you know , i know that you've had a kidney transplant a few years ago .
[patient] yes .
[doctor] everything is okay with that ?
[patient] everything's been good and solid there .
[doctor] and you're taking all of your auto , um , i- um , your immunosuppression medications ?
[patient] yes , i am .
[doctor] all right .
so , let's go ahead and we'll do a quick physical exam . so , looking at you , you do n't appear any distress . your neck is nice and supple . your heart is irregular rate and rhythm . i do hear a slight , uh , two out of six systolic ejection murmur . your lungs are clear . i do see the scar on the left , uh , left plank for your kidney transplant which is healed . and you have no lower extremity edema . so , let's go ahead and look at some of your results , okay ?
[patient] okay .
[doctor] hey , dragon , show me the creatinine . so , your kidney function looks really good . so , that's really promising after your transplant . hey , dragon , show me the ekg . and your ekg looks great , uh , perfectly normal , so that's good . um , so , my impression of you at this time ... , let me see your blood pressure .
[patient] okay .
[doctor] hey , dragon , show me the blood pressure . yeah , and you're right , it-
[patient] hm .
[doctor] . it is high . so , there is something that we can do for that . so , let's go ahead and we'll put you on ... so , my impression of you is that your , your blood pressure is high and the norvasc is n't controlling it . and , you know , we can definitely get it under better control . so , what i would like to do is prescribe you coreg 25 milligrams , twice a day . and that will help bring your blood pressure down , okay ?
[patient] okay .
[doctor] hey , dragon , order carvedilol 25 milligrams , twice a day . uh , i'd also like to go ahead and , uh , get a lipid panel and some routine labs on you just to make sure that everything is okay .
[patient] yeah .
[doctor] hey , dragon , order a lipid panel . hey , dragon , order a complete metabolic panel . all right . and then , um , from a transplant standpoint , everything looks fine . your kidney function looks great , so we're just gon na continue you on all of those medications .
so , the nurse will come in soon and she'll help you schedule all of the al- schedule a follow-up appointment with me , and we'll see what your blood pressure looks like in a couple weeks after taking that medication . okay ?
[patient] okay .
[doctor] all right . thanks , susan .
[patient] thank you .
[doctor] hey , dragon , finalize the note .

Medical orders:
description: milligrams coreg 25 twice a day
order_type: medication
reason: high blood pressure , but it's seeming to get really out of control
description: lipid panel
order_type: lab
reason: high blood pressure , but it's seeming to get really out of control
description: complete metabolic panel
order_type: lab
reason: high blood pressure , but it's seeming to get really out of control
description: follow-up
order_type: followup