March 24, 2013
Patient Education Plan-Larry Garcia
Hypertension or otherwise known as high blood pressure is a term that millions of us are familiar with. According to Center for Disease Control and Prevention “more than 65 million individuals have hypertension” ("High Blood Pressure", 2010). Blood pressure is defined as the force of blood against the artery walls as it circulates through the body. It can cause health problems if it stays high for a long time. It is measured using two numbers. The first, systolic, number represents the pressure in your blood vessels when your heart beats. The second, diastolic, number represents the pressure in your vessels when your heart rests between beats ("High Blood Pressure", 2010). A healthy blood pressure reading is lower than 120/80mmHg and pre-hypertension is between 120/80mm Hg and 139/89mmHg. Stage one hypertension is between 140/90mm Hg and 159/99mm Hg and stage two hypertension is a reading of 160/100mm Hg or higher ("About High Blood Pressure", 2012). High blood pressure raises your risk for heart disease and stroke and is one of leading causes of death in the United States. It is often called the "silent killer" because many people don't realize they have it and often has no warning signs or symptoms ("High Blood Pressure", 2010). High blood pressure, if left untreated, can cause severe damage to the body's organs, including the brain, heart, blood vessels, and kidneys. Risk factors for hypertension include: increasing age, male, race (African Americans, Hispanics), diabetes, family history, high sodium diet, obesity, physical inactivity, alcohol, and tobacco use. The goal for treating people with this chronic condition is to decrease mortality and increase quality of life (Wang, MD & Vasan, MD, 2005 ). In Mr. Garcia case, he was asymptomatic and was found during routine examination. He is a perfect example of a person at risk for hypertension. His age, race, and family history and the stress he receives from work in sales, caring for his elderly parents are the significant attributes in this case. Mr. Garcia’s mother has had high blood pressure for years; this genetically predisposes Mr. Garcia to high blood pressure as well. Last major risk factor to high blood pressure is weight. Mr. Garcia is 12 pounds over his ideal weight. His condition was discovered early so with the right lifestyle change he may avoid the complications associated with hypertension. He has also chosen to not treat his condition with medication at this time. His will have to make some lifestyle changes or he will be facing the consequences of possible stroke, kidney damage and heart attack. The gaps in educating Mr. Garcia are avoiding stress, diet, and exercising. He cannot change his genetic predisposition, but he can make some lifestyle modifications to decrease his chances of suffering from the bad outcomes of high blood pressure. The first educational goal is measuring his blood pressure daily and documenting it. Mr. Garcia will learn to obtain his blood pressure and record it to bring in to next doctor appointment. Blood pressure cuffs or electronic blood pressure monitors are available for purchased over the counter at most large or drug stores. When monitoring at home remember that the numbers can fluctuate with times of the day, after exercise and excitement (Moser, 2012). A record keeping journal is used for ease of keeping track of the measurement. The second educational issue is his diet. The goal will be that Mr. Garcia will verbalize the importance of diet and make changes. A dietitian will be able to guide and assisting in making the necessary changes for him to make better food choices. If Mr. Garcia chooses not to use a dietitian there are abundance of websites that have information on diet plans for people with High blood pressure. The National Institute of Health, (NIH) is a valuable resource and has published dietary guidelines that when followed can reduce blood pressure. Dietary Approaches to Stop Hypertension (DASH) is an eating plan they have published for the public to use as a guide for persons diagnosed with Hypertension. The plan stresses a diet low in fats, cholesterol, sodium, red meats, sweets, and sugary products. A diet high in fruits, vegetables, whole grain, fish, poultry and nuts ("Your Guide To Lowering Your Blood Pressure With Dash", 2006). Next Mr. Garcia’s needs to incorporate an exercise plan into his life. Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure ("Physical Activity And Blood Pressure", 2012). The other benefit to exercising is weight loss. Mr. Garcia is 12 pounds over his ideal weight. Exercise and diet will help address the issue with his weight. The American Heart Association recommends you get at least “150 minutes of moderate exercise, 75 minutes of vigorous exercise or a combination of both each week. Aim for at least 30 minutes of aerobic activity most days of the week. If you can't set aside that much time at once, remember that shorter bursts of activity count, too. You can break up your workout into three 10-minute sessions of aerobic exercise and get the same benefit as one 30-minute session” ("Physical Activity And Blood Pressure", 2012). He could join a wellness center or a gym with his family to get a routine of exercising started. He states money is tight, but he can shop around at different places to find good deals, some places offer discounts and or free memberships. His work may offer a discount as part of their employee benefits. Stress is another factor that can cause an increase in blood pressure. All of us experience some form of stress in our lives, but there are times when it can get out of control. Mr. Garcia has mentions the stressor in his life and could use the help in learning some stress management techniques to incorporate into his life. Everybody handles stress relief differently. Mr. Garcia will have to find a plan that works for him. Referring him to a stress management class could be beneficial for his situation or he might find a hobby or a program to join to help him manage his stress. He prefers written material over verbal. The information that he receives should also be accompanied with written material. A diagnosis of high blood pressure can be overwhelming for anybody and in Mr. Garcia case it will be another thing that cause stress in his life. He will have to manage this for the rest of his life. He will have to incorporate a new healthier lifestyle or the option of not taking medicines will not be possible. He also needs to have his preventive health checkups done in the time in which they are due. As noted in his history he has not had a colonoscopy which is recommended to have one done by age 50 ("Susan Cohan Colon Cancer Foundation", 2010). He stated he had an eye exam eight years ago. So instruction on regular preventive checkups will be reinforced in his care plan. In conclusion people with high blood pressure can lead normal, active lives, providing they follow the doctor’s orders. Mr. Garcia was fortunate enough to find his condition out before it started to effect his quality of life. He needs to keep a record of his blood pressure, modify his eating habits, find ways to relieve stress, and add exercise to his daily life. He will be referred to dietitian, and he will have to work on stress and time management skills. Involving his spouse might help him adhere to the plan. If Mr. Garcia can implement these changes he should be able to get his blood pressure within normal range.
About High Blood Pressure. (2012). Retrieved from http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp Colon Cancer Foundation. (2010). Retrieved from http://Susan Cohan Colon Cancer Foundation High Blood Pressure. (2010). Retrieved from http://www.cdc.gov/bloodpressure/diastolic_systolic.htmSusan Cohan Physical Activity and Blood Pressure. (2012). Retrieved from http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Physical-Activity-and-Blood-Pressure_UCM_301882_Article.jsp Moser, M. M. F. F. F. (2012). High Blood Pressure: Lower It and Live Longer. Retrieved from http://www.hypertensionfoundation.org/home.cfm Your Guide to Lowering Your Blood Pressure With Dash. (2006). Retrieved from http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf Wang, MD, T. J., & Vasan, MD, R. S. (2005). Epidemiology of Uncontrolled Hypertension in the United States. Circulation: American Heart Association, (112), 1651-1662. doi:
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