Week 5: Plan of Care for Hypertension Research Paper

Care Plan for Hypertension

Description of the Chronically Ill Group

Chronic diseases impact a person’s lifestyle and association with other members of society. The health effects of such illnesses linger for a prolonged period and force people to change their lifestyles and daily activities to prevent their progression. Chronic diseases also necessitate regular therapy and specialized care, which eats into a person’s financial wellness. Among the most prevalent chronic disease in the contemporary world is hypertension. The condition is characterized by a persistent increase in blood pressure, creating tension in blood vessels. The condition may cause more severe health implications, necessitating consideration of various treatment and management strategies to reduce the risk of disease progression among people with hypertension. Due to the health, social, and economic implications of hypertension, Healthy People 2030 aims to reduce the proportion of adults living with high blood pressure in society. This study seeks to assess various treatments, disease management, and follow-up strategies that could help in relieving adverse symptoms of hypertension and reduce its prevalence in society per Healthy People 2030 goals.

Rationality for Choosing Hypertension

The focus on hypertension is due to the alarming statistics revealing its prevalence in modern society. According to a report by the Centers for Disease Control and Prevention (2020), the prevalence of age-adjusted hypertension was 45.4% among adults between 2017 and 2018. Predisposition to high blood pressure was observed to increase with age, whereby 22.4% of youths have the condition while 74.5% of seniors report elevated symptoms of hypertension (Centers for Disease Control and Prevention, 2020). Since the condition is associated with cardiac disorders and kidney failure, it is important to establish key interventions that could help to reduce its prevalence in society and minimize the risk of progression among individuals who have been confirmed to have hypertension. In addition to statistical evidence regarding the prevalence of hypertension, my focus on hypertension is due to my aspiration to assist a family member in improving her health. My mother-in-law has been living with hypertension, which has affected her personal and professional life. I am, therefore, determined to establish effective interventions and disease management strategies to improve her condition.

The rationale for the Healthy People 2030 Topic

One of the primary objectives of Healthy People 2030 is to promote healthy living in society and reduce the proportion of people who live with chronic conditions. Many public health initiatives have been laid down to reduce the number of adults with hypertension and lessen the severity of symptoms among people with the condition to prevent chronic kidney disease, heart failure attack, stroke, and death (Healthy people 2030, 2021). To achieve such objectives, it is important to establish effective ways to conduct screening for hypertension, healthy lifestyle practices that could reduce the risk of progression, and treatment interventions to alleviate severe symptoms. Controlling blood pressure could also help to address other chronic diseases, such as end-stage kidney disease and stroke, whose severity increases with excessive blood pressure. Therefore, the Healthy People 2030 objective to reduce the prevalence of hypertension among adults will attract multiple benefits in public health as it supports the fight against several chronic diseases.

Create a care plan for a patient with hypertension

The main nursing diagnoses will include deficient knowledge, ineffective coping, and risk for decreased cardiac output. Although the patient has made a few lifestyle changes to improve her capacity to cope with and overcome symptoms of hypertension, she demonstrates a lack of adequate health literacy to cope with the condition. She reports that her strategy to cope with the condition is to take her medications daily and consistently adhere to treatment. She also demonstrates ineffective coping. After being diagnosed with hypertension, the patient made nutritional changes to control her weight. However, she adopts a passive lifestyle as she stays at home all the time and does not engage in physical exercise. A sedentary lifestyle increases the risk of disease progression among individuals with hypertension (Guo et al., 2020, p. 79). The patient is at risk of experiencing a decrease in cardiac output. Due to her sedentary lifestyle, the patient’s blood flow to the heart muscle may be obstructed by a partial coronary artery blockage by a build-up of plaques and fat deposits.

Assessment Data

Objective

1. Heart rate: 86 beats per minute
2. Respiratory rate: 26 breaths per minute
3. Blood glucose concentration: 83 mg/dL
4. Systolic value: 140 mm Hg
5. Diastolic value: 91 mm Hg

Subjective

1. Severe headache
2. Irregular heartbeat
3. Trouble sleeping

Desired Outcomes

1. Show stable cardiac rhythm and rate.
2. Maintain blood pressure within an acceptable range.
3. Participate in activities that lower blood pressure and cardiac load
4. Relieve the patient of headache

Evaluation criteria

The initial evaluation of the patient’s condition will involve measuring blood pressure in both arms simultaneously to establish whether there is a consistent difference in blood pressure between the two arms. Since the evaluation is meant for a treated case of hypertension, it will be necessary to measure the patient’s blood pressure after a few minutes, especially if the patient’s emotions seem to have changed, to detect the possibility of postural hypertension. The patient’s medical history and overall cardiovascular risk will be assessed to assess the existing factors that may expose the patient to disease progressions, such as transient ischemic attacks, diabetes, dyslipidemia, and chronic kidney disease. The evaluation criteria will, therefore, include assessing symptoms of coexistent illnesses.

Actions and Interventions

Major interventions will include administering antihypertensive medication, advising the patient regarding her sedative lifestyle, and introducing the patient to self-care strategies to improve her health literacy and coping capacity while outside the facility. Angiotensin-converting enzyme inhibitors will be administered to help relieve pressure in the patient’s blood vessels. Patient education will also be carried out to help her identify the available options for lifestyle changes that could improve her physical activity and reduce the risk of disease progression and the development of coexistent illnesses. It will be important to introduce the patient to different self-care strategies, such as nutritional changes and non-pharmacological approaches that could improve her condition.

Evaluation of Patient Outcomes

An improvement in the patient’s condition will be confirmed by the return of her blood pressure to the normal range, her ability to take medications and the recommended lifestyle changes on her own, and a decline in her blood glucose concentration. The patient will be scheduled to visit the facility once every two weeks for a post-treatment assessment. Objective and subjective data will be collected and analyzed to confirm a positive patient outcome during every visit. If the patient’s blood pressure and glucose concentration have decreased to a normal range, the interventions administered will be termed effective. If otherwise, a treatment change may be recommended based on the available presentations.

Strategies for the Family

To help the patient avoid risk factors for hypertension while at home, her family will be advised to impose strict dietary control, ensure that she sticks to prescriptions, and offer her a stress-free experience at home. The patient needs to avoid taking food with high sodium chloride and cholesterol. Such foods affect glucose concentration in the blood and the amount of fat in blood vessels, which may progress the condition (Grillo et al., 2019, p. 1970). She also needs to take medication as instructed by the physician to enhance her capacity to cope with and overcome the condition’s symptoms. The patient’s family needs to offer her a stress-free experience at home since stressful situations are associated with high levels of blood pressure, which may result in disease progression or the development of more severe conditions such as stroke.

References

Guo, C., Zhou, Q., Zhang, D., Qin, P., Li, Q., Tian, G., … & Hu, D. (2020). Association of total sedentary behavior and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose-response meta‐analysis. Diabetes, Obesity and Metabolism, 22(1), 79-90. https://dom-pubs.onlinelibrary.wiley.com/doi/abs/10.1111/dom.13867

Centers for Disease Control and Prevention. (2020). Hypertension Prevalence Among Adults Aged 18 and Over: the United States, 2017–2018. https://www.cdc.gov/nchs/products/databriefs/db364.htm

Healthy people 2030. (2021). Heart Disease and Stroke: Improve cardiovascular health and reduce heart disease and stroke deaths. https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke

Grillo, A., Salvi, L., Coruzzi, P., Salvi, P., & Parati, G. (2019). Sodium intake and hypertension. Nutrients, 11(9), 1970. https://www.mdpi.com/519486