Mrs. Greenwood's Plan Of Care

Although medications are very effective, lifestyle and dietary changes can help treat or prevent high blood pressure more effectively.

Mrs. Jones is an 89 year-old woman who migrated to Australia from Germany 40 years ago. Since the passing of her husband two years ago, Amaile’s health has begun to slowly deteriorate obliging her to leave her active lifestyle.

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

Resistance is the active process of pushing against reason for change (Herman et al 2011). This active process can be influenced by nurses either positively or negatively. Increased resistance may occur by convincing the patient they have a problem, arguing the benefits of change if the patient changes, by telling the patient how to change and by warning the patient of the consequences if they do not change (Moyers et al, 2007). In the digital recording, I can see myself using these negative influences, I warn the patient of serious health consequences caused by smoking, I also say that her “angina is linked with smoking”. In future I will not take such a harsh approach and let the patient realise him/herself the situation with guidance from myself. I can see I interrupt the patient quite frequently which naturally enough puts strain on the conversation. However, as nurses we can positively influence the patient by using the concept developed by Rollnick and Miller (2002);

Cooper L.A., & Roter D.L., & Carson K.A., & Bone L.R., & Larson S.M., & Miller E.R. III, & Levine D.M. (2011). A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. Journal of General Internal Medicine, 26, 1297 â[euro]" 1304. 10.1007/s11606-011-1794-6

K.H. is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and stethoscope with her in the hope of learning to take her husband’s blood pressure at home.

“I want to exercise, and I think I can do it, but I will need some support” (Preparation)

Patient states he is “in very good shape overall,” he has had some concerns in the past with his blood pressure which was too high, but it's been a long time since

Managed adult patients with chronic conditions such as diabetes, hypertension, and hyperlipidemia. In collaboration with the physician, develops a treatment plan along with the patients and significant others.

According to JNC 8 guidelines, close monitoring is essential when patients start on new hypertensive medication. Therefore, Mr. Hightower will require frequent visits to the clinic to ensure improvement in his health condition. His blood pressure will be monitored at each visit and blood work will be done to monitor his kidney and liver functions and to determine his adherence to treatment. In case of noncompliance, a third category of antihypertensive must be added to improve hypertension outcomes and prevent cardiovascular disease.

I have use evidence base practice often in homecare. I had a homecare patient who has hypertension and don’t check his blood pressure regular. I explained to him the important of checking blood pressure daily. Evidence based practice shows self-management of blood pressure is a useful tool in monitor hypertension and preventing stroke (McNamar, Versace, Marriott & Dunbar, 2014). I requested the family to buy an electronic blood pressure cuff. I encouraged patient to record blood pressure daily and record. I also instructed patient to take results to next doctor appointment.

Bosworth, Olsen, Grubber, Powers, and Oddone (2012) conducted a three-arm randomized controlled trial to determine the differences in AAs and Caucasians in two self-management hypertension interventions (N=636; non-whites n=328, and whites n=308). The subjects were randomly placed in the usual care (UC), home BP monitoring (HBPM), a tailored behavioral self-management intervention (TBSMI), and the two groups combined (TBSMI + HBPM). Data collection was done at the initiation of the research, 12 months, and 24 months from the control and intervention groups. BP results on whites at the baseline and intervention groups did not differ, but there was significantly reduction in the systolic BP of 7.5 mm Hg in AAs. This study denotes that a home BP monitoring in combination of nurse-administered telephone behavioral intervention was most effective in BP control in AAs.

When a stroke occurs statistically speaking , 8 out of 10 people had high blood pressure when the suffered a stroke . Again with heart failure . Patients who have heart failure also had high blood pressure . The exact causes of high blood pressure are not known , but several factors and conditions may play a role in its development , including : smoking , being overweight or obese , lack of physical activity , too much salt in the diet , too much alcohol consumption (more than 1 to 2 drinks per day ) , stress , older age , genetics , family history of high blood pressure , chronic kidney disease , adrenal and thyroid disorders , sleep apnea . Although you cannot control all of your risk factors for high blood pressure , you can take steps to prevent or control high blood pressure and its complications . Even by changing your diet and reducing the foods that contain high sodium and salt and eating healtheir can reduce your blood pressure and risk for heart disease . Even by reducing stress from your daily life can help to lower blood pressure . Adequate exercise can help with lowering hypertension and lowering your risk for heart disease . However in today's nursing workforce it is important to inform our patients the steps they can take to live healtheir and to reduce their risk of heart disease and

Medical conditions like ischemic heart disease, lung cancer, stroke, and COPD were the highest mortality and largest number of years of lives lost. Although life expectancy increased, morbidity and chronic disability now account for nearly half of the United States disease burden. The implication of these reports to the Advanced Practice Nurses (APNs) is to be consistent on the health promotion and disease prevention measures. The disease mentioned can be prevented and managed, if proactive measures are taken such as following a healthy diet, physical exercises, tobacco cessation, and if on prescription medications, to adhere with the treatment regimen. It is vital as APNs to ensure that our patients understand their disease process, and the complications that could arise due to poor management and

Another intervention is patient education such as teaching what is considered hypertension, how to check the