Armstrong (2014) recommends to start medication treatment when systolic BP is 140 mm Hg or higher or diastolic pressure is 90 mm Hg or higher among patient younger than 60 years. I should have ordered fasting blood work because fasting blood glucose and accurate lipid level can be obtained (Weber et al., 2014). I agree with the order of CMP because it helps us know potassium level, glucose level, kidney function, and liver function. Also, monitoring potassium is important if patient is on ACE or ARBS. I should have ordered CBC, lipid profile and EKG to have a baseline (Cash, 2015). EKG is a screening tool to assess cardiac target organ damage in the patient with HTN (Dunphy et al., 2015). I should have included to monitor uric acid, creatinine …show more content…
I should have educated about healthy diet and daily 30 minutes of aerobic exercises. I should have encouraged to increase fruits, vegetables, reduce salt intake, low fat/cholesterol diet, serving sizes and avoiding canned and fast food. Also, I should have educated about maintaining proper intake of dietary potassium, calcium and magnesium (Madhur, 2014). I should have educated about the increase bBP with decongestants. Regular aerobic exercises can be walking, using bicycles and climbing stairs. Effectiveness of lowering BP increases when diet and lifestyle modification are combined together (Cash, 2015). Also, I should have mentioned about not exceeding 2 drinks of alcohol per day and smoking cessation (Weber et al., 2014). This is because most of the patient with high BP have other cardiovascular risk factors such as diabetes, hyperlipidemia, tobacco use and inactivity. Hence, while treating HTN, we must address all these risk factors and take preventive measures (Dunphy et al., 2015). I should have educated on relaxation techniques and lowering stress level (Cash, 2015). Diuretics, ARB, ACE and calcium channel blocker are the first line therapy for the HTN (Hernandez-Vila,
The educational intervention will focus on diet approaches to stop HTN (DASH) diet, alcohol intake, smoking cessation, weight management, adherence to medication, self-management, stress management, and exercising based on prevailing guideline recommendations developed by Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (James et al., 2014).
U.S. Customs and Border Protection (CBP) Office of Field Operations (OFO) officers from the Port of Eagle Pass attended the inaugural Career Day event held at Pete Gallego Elementary.
JNC 8 has a hypertension guideline algorithm. Patients older than 60 should be placed on pharmacological treatment if SPB is 150 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 150/90 Patient less than 60 should be placed on pharmacological treatment if SPB is 140 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 140/90. Initial drug of choice for nonblack patients is an ACEI, ARB, thiazide or CCB alone or in combination. Black patients should be started on a thiazide or CCB alone or in combo. It is recommended to start one drug titrate to maximum dose and then add another drug if target goal has not been achieved. Combination therapy is recommended if BP is greater than 20/10 mm Hg from target. I also gives a guideline for all ages if the patient is diabetic without kidney disease or the patient has kidney disease without diabetes (Armstrong, 2014).
* Physical exercise was recommended as well. Previous research has proven that physical exercise and good diet can efficiently control the patient blood pressure.
Good afternoon. Kenneth I have this outreach opportunity that I was hoping you would be interested in participating in. I have been in contact with Ms. Terri McGee, National President, National Association of Blacks in Criminal Justice in efforts to build a relationship with their organization. I will be keeping their organization abreast of job vacancies and organizing guest speaking opportunities.
Strategy/Tactics: Strategies of the BPP were Self Determinism, Armed Self Defense, Community Empowerment and Survival Programs. Tactical innovation of the BPP were Armed a self-defense, and the BPP’s use of the U.S. Constitution and the 2nd and 14th Amendment to validate their platform and programs (seale 20). The BPP created 35 survival programs in black communities and engaged in political activities in those same black communities. As their popularity grew, the Black Panthers drew widespread support from large minority cities and communities, across the nation, including Los Angeles, Chicago, New York and Philadelphia where national Chapters of the party opened. In 1968, as mentioned it estimated that the BPP had roughly 5,000 members nationwide
In November 2007, Brooks Bassler founded BB’s with the first 1,100- square restaurant at Montrose and Westheimer in Houston, Texas. Bassler opened BB’s with the thought of creating a Tex- Cajun Mex type of theme. Serving Delicious fresh po-boys and Tex- Orleans cooking with a different menu. BB’s dine in menu was inspired by Bassler’s grandmother ‘’Maw Maw’’. Till this day all of the recipes are secret from the public and servers like I. BB’s is the best restaurant in town because Customer Is King, #1 Crawfish in town, and the atmosphere.
I did the Same Beacon Contract with mercy and after that started with Employ Benefit Plan Administration (EBPA) with EMHS I started reading it and found that EBPA is Just looking at the claims and submitted by the Provider it is just acting as Administrator and the actual money is payed by CMS to the provider. I then Prepaid Inventory and updated the rate sheet
Patients who have increase in DBP > 20 mmHg above baseline may not always cross the 140/90 mmHg threshold for HTN. It is recommended to start antihypertensive medication to keep the DBP within 20mmHg of
Low back pain (LBP) is a prevalent complaint of pain for patients, with the severity ranging from discomfort to disabling. Various chronic low back pain treatments exist, one of which is the osteopathic spinal manipulative therapy (SMT) using high velocity low amplitude (HVLA) techniques. This case report shows that osteopathic manipulative treatment (OMT) provides pain reduction and improvement in vertebral functioning. It also aims to summarize literature that supports the use of HVLA in LBP and to know when to use SMT
Thank you for your post and for sharing important information about the clinical trials currently being conducted at Memorial Regional Hospital. It is impressive to see how research findings impact the ever-changing healthcare setting and modify treatments, procedures, and the way the care is provided. Definitely, research has changed the patient care in a positive way improving, as you mentioned, the overall patient experience and outcomes. Nurses must be able to use research and integrate it into care; also they are expected to have skills to use evidence-based practice (EBP) in an appropriate manner to take advantage of its benefits. EBP emerged in nursing education and practice as a necessity and guiding principle for quality care.
Thank you for your great post. I do agree that the organization should have more BSN nurses to participate and work on implementing EBP. The best solution for the problem is to release the information about IOM the goal of 2020 and discuss what you learn and gain in the BSN program. In my organization, most of the people share the experience about the BSN program and it makes more people to attend the BSN program. I also told them that I could do it so you could do it.
The PREMIER study was a National Heart, Lung, and Blood Institute (NHLBI) sponsored, multicenter, 3-group, parallel-arm randomized trial conducted in the United States.1 For the study, a total of 810, of which 62% were women and 34% were black, healthy adults with untreated prehypertension or stage 1 hypertension who met the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure criteria for a 6-month trial of nonpharmacological BP treatment, were recruited.1 The participants were randomized to 1 of 3 intervention groups: An “advice-only” group, an “established” group (EST) that used established lifestyle recommendations for blood pressure control (reduced sodium intake, weight loss, and increased physical activity), or an “established-plus-DASH” group (EST+DASH) that combined established lifestyle changes with the DASH (Dietary Approaches to Stop Hypertension) diet.1 The mean age of the participants were 50 years, the mean systolic/diastolic
I have worked many years with people who had LBP in the past. Some of them had chronic LBP, and these groups of patients were difficult and challenging, because there were so many things that affected the dysfunction and disability. I remember that among my colleagues, nobody wanted to take the patients with CLBP. Back then, there also were many LBP who had to quit or change their job, daily life and activities. We, physical therapists, traditionally look at signs and symptoms, but systems need to take account of the fact that there are other factors too. For chronic patient, we need an integrated approach of sorting through the multiple layers of a personal presentation.
You should engage in moderate exercise at least 30 minutes a day, 5 or more days a week. This will help lower blood pressure.