Hypertension
Order Instructions:
HYPERTENSION
In clinical settings, advanced practice nurses frequently use various strategies to treat and manage patients with hypertension and other cardiovascular disorders. These strategies often include pharmacologic and nonpharmacologic therapies, natural remedies, and/or changes in patient behavior. For hypertension patients, behavioral changes including increased exercise, healthier diet, and smoking cessation have proven to be particularly beneficial. However, it is important to recognize that treatment and management plans centered around changes in behavior often require greater patient commitment. This creates the need for patient-provider collaboration, as well as appropriate patient education. When patients are actively involved in their own care and better understand implications of their disorders, they are more likely to adhere to treatment plans.
To prepare:
• Review Part 11 of the Buttaro et al. text and the National Heart Lung Blood Institute article in this week’s Learning Resources.
• Reflect on your Practicum Experiences and observations. Select a case from these experiences that involves a patient who presented with a hypertension problem. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.
• Think about the patient’s history including drug treatments and behavioral factors such as diet, exercise, smoking, etc.
• Review the National Heart Lung Blood Institute article in the Learning Resources. Reflect on health promotion strategies for the patient. Consider ways to reinforce hypertension management.
Post on or before Day 3
1) A description of a patient who presented with a hypertension problem during your Practicum Experience.
2) Explain the patient’s history including drug treatments and behavioral factors.
3) Then, suggest two health promotion strategies for the patient.
4) Include suggestions for reinforcing hypertension management.
Readings/ Required Reference Resources
• Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.
o Part 11, “Evaluation and Management of Cardiovascular Disorders” (pp. 487–611)
This part explores diagnostics of cardiovascular disorders, including how to differentiate between normal and abnormal test results. It also examines how patient history and physical exams contribute to differential diagnoses for cardiovascular disorders.
• National Heart Lung and Blood Institute. (2002). Primary prevention of hypertension: Clinical and public health advisory from the National High Blood Pressure Education Program. Retrieved from http://www.nhlbi.nih.gov/health/prof/heart/hbp/pphbp.pdf
this article reviews factors that impact the patient education of hypertension. Hypertension prevention and intervention methods are also explored.
Optional Resources
• American Heart Association. (n.d.). Retrieved November 28, 2012, from http://www.heart.org/HEARTORG/
• Drugs.com. (n.d.). Retrieved November 28, 2012, from www.drugs.com
• Institute for Safe Medication Practices. (n.d.). Retrieved November 28, 2012, from http://www.ismp.org/
• Million Hearts. (n.d.). Retrieved November 28, 2012, from http://millionhearts.hhs.gov/index.html
• WebMD. (2012). Medscape. Retrieved from http://www.medscape.com/
SAMPLE ANSWER
High Blood Pressure is a cardiovascular disorder that needs good treatment and management plan. This plan needs a patient-provider collaboration. It is important for the patient to have appropriate education and great commitment to the treatment and management plan. Different strategies can be used to give better results in the management of the condition to the comfort of the patient. Alongside the plan, patient’s behavioral changes can particularly yield good results in management of the condition. These include increased exercises, eating a healthy diet, and avoiding smoking. Two approaches are recommended for the treatment and management of Hypertension. Pharmacologic therapy approach is much dependent on standards set by government agencies and professional associations like the American Heart Association while non-pharmacologic therapy deal with patient’s behavioral change (Buttaro &Trybulski, 2013).
Mr. Lewis’s case
During my Practicum one patient, Mr. Lewis aged 55 years (not his real name) came for observation after having breathing difficulties. Going through the patient’s file revealed that indeed he has had this condition for about two years. A closer observation gave further evidence to confirm my worries. Mr. Lewis was overweight as he had a BMI of 28/m2, BP at 150 mm Hg and a waist circumference of 130 cm, way above the recommended (NHLBI, 2002).
He has been experiencing unusual fatigue for the last two years. Overweight people experience breathlessness when performing a task, yet unknown to them it might be a symptom of hypertension. Other symptoms of hypertension include chest pain, blood in urine, severe headache, vision problem, irregular heartbeat and pounding in the chest (Medscape 2014).
Mr. Lewis was a smoker, had poor eating habits and exercised less. Perhaps he could not remember the last time he was in a gym. Mr. Lewis has not been on any serious medication.
This condition meant that I had to put him on immediate treatment and management of his condition. At an early stage, BP can be managed by lifestyle modifications and low combination of thiazide diuretic and an ACE inhibitor as recommended by American Heart Association and the Center for Disease Control and Prevention algorithm (Medscape, 2014). He responded well and within a week I reviewed his condition with remarkable results. His condition was stage 1 hypertension that needed more of lifestyle modification than drugs treatment. Fatigue levels reduced drastically and the congestion in his chest was notably down.
Two health promotion strategies for the patient (Mr. Lewis)
Mr. Lewis can do better by exercising regularly and eating healthier. Losing weight helps prevent hypertension. He needs to eat a diet rich in fruits and vegetables, free or law fat milk products and adequate intake of minerals like potassium, calcium, and magnesium. He needs to reduce sodium chloride intake in his diet too (Medscape, 2014).Smoking affects the quality of oxygen that one gets in the bloodstream. Mr. Lewis should stop smoking and go for aerobics to help burn the fats in his body.
High Blood Pressure Management
Hypertension needs to be managed as it is a serious health challenge. It increases the risk for diabetes and is very fatal in pregnancy. It can lead to a higher risk of stroke, renal disease and poor vision.. Treatment is best recommended for younger patients as a management plan with maxima doses depending on disease’s status and progression. At an early stage, change in lifestyle is the best way to manage high blood pressure (Medscape, 2014).
References
Buttaro, T M., Trybulski, J., Polgar BP., & Sandberg, CJ. (2013). Primary care: A collaborative practice (4th Ed.). St. Louis, MO: Mosby. Part II, “Evaluation and Management of Cardiovascular Disorders” pp 486- 611)
National Heart Lung and Blood Institute. (2002). Primary prevention of hypertension: Clinical and public health advisory from the National High Blood Pressure Education Program. Retrieved from http://www.nhlbi.nih.gov/health/prof/heart/hbp/pphbp.pdf on 13th Dec. 2014.
Meena, SM., Kamran R., & David GH. (2014). Treatment and Management of Hypertension. Medscape medical journal. Edited by David JM. Retrieved from http://www.medscape.com/ on 13th Dec. 2014.
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