Risk factors for hypertension
Write a 2-page paper
Mrs. Johnson is a 72-year-old African American woman with primary hypertension diagnosed 22 years ago after she went through menopause. According to her family history, her father had high blood pressure and her grandfather died of a stroke at the age of 63. She worked at an insurance office for about 40 years until she retired 5 years ago. She states she feels “pretty overwhelmed” since her husband was diagnosed with Alzheimer's disease 6 months ago. At this time, she takes hydrochlorothiazide (Microzide) 50 mg twice a day and amlodipine (Norvasc) 10 mg a day. She tells you that she has missed doses lately because she has been so busy with her husband.
1. What are Mrs. Johnson's risk factors for hypertension?
2. What teaching should the practical nurse reinforce for Mrs. Johnson about her antihypertensive drugs?
3. Please describe concerns you have as a practical nurse considering her history and assessment findings.
Sample Solution
Mrs. Johnson's risk factors for hypertension include:
- Age: Hypertension is more common in older adults, especially after the age of 65.
- Race: African Americans are more likely to have hypertension than white Americans.
- Family history: Hypertension tends to run in families.
- Gender: Hypertension is more common in men than in women before menopause, but women are more likely to develop hypertension after menopause.
Full Answer Section
2. What teaching should the practical nurse reinforce for Mrs. Johnson about her antihypertensive drugs?
The practical nurse should reinforce the following teaching for Mrs. Johnson about her antihypertensive drugs:
- Take your medications as prescribed. It is important to take your medications at the same time each day and to not miss any doses. If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
- Be aware of the possible side effects of your medications. The most common side effects of hydrochlorothiazide and amlodipine are headache, dizziness, and fatigue. Less common side effects include nausea, vomiting, constipation, and diarrhea. If you experience any side effects, talk to your doctor or pharmacist.
- Store your medications properly. Store your medications in a cool, dry place out of the reach of children and pets.
3. Please describe concerns you have as a practical nurse considering her history and assessment findings.
As a practical nurse, I would have the following concerns about Mrs. Johnson's history and assessment findings:
- Nonadherence to medication: Mrs. Johnson admits to missing doses of her antihypertensive medications lately because she has been so busy with her husband. This is a concern because nonadherence to medication is a major risk factor for uncontrolled hypertension.
- New stressor: Mrs. Johnson's husband was diagnosed with Alzheimer's disease 6 months ago. This is a major life stressor that could worsen her hypertension.
- Age: Mrs. Johnson is 72 years old. Hypertension is more common in older adults, and it is also more difficult to control hypertension in older adults.
Recommendations
I would recommend the following for Mrs. Johnson:
- Close monitoring of blood pressure: Mrs. Johnson should have her blood pressure checked regularly to ensure that it is under control.
- Education and support: Mrs. Johnson needs to be educated about the importance of taking her medications as prescribed and the risks of uncontrolled hypertension. She also needs to be provided with support to help her manage her stress and adhere to her medication regimen.
- Referral to other healthcare professionals: If Mrs. Johnson is struggling to adhere to her medication regimen or manage her stress, she may need to be referred to other healthcare professionals, such as a pharmacist, social worker, or psychologist.
I would also recommend the following for the practical nurse:
- Be empathetic and understanding: It is important for the practical nurse to be empathetic and understanding of Mrs. Johnson's situation. She is a 72-year-old woman who is caring for her husband with Alzheimer's disease. It is not surprising that she has missed doses of her medications lately.
- Be patient and supportive: It may take some time for Mrs. Johnson to make changes to her lifestyle and adhere to her medication regimen. The practical nurse should be patient and supportive and provide Mrs. Johnson with the resources she needs to be successful.
- Collaborate with other healthcare professionals: The practical nurse should collaborate with other healthcare professionals, such as Mrs. Johnson's doctor and pharmacist, to ensure that she is receiving the best possible care.