Hypertension Case Study

Hypertension Case Study

The patient is a 55 years old African American male. He explains about a two days history of a headache as well as chest pressure. He further provides a detailed report of his medical and social history. This case develops an evidence-based management plan for this patient in view of his medical, hereditary as well as social circumstances.

Diagnosis

Given the symptoms of the patient and the preliminary tests, the patient can be diagnosed with Hypertension. The B/P is 190/120 which is way above the normal 13/80). The patient’s lifestyle as explained by the patient equally points to the risk factors for hypertension. For instance, the patient takes several bottles of beer each day and smokes a packet of cigarette daily. He does not carry out physical exercise and is not keen on his weight gain.

The management plan for this condition will involve a scheduled time for physical exercise. The patient will be encouraged to undertake physical exercise each day. This will help in cutting down on body weight. A reduction in the weight of the body greatly contributes to the reduction of the blood pressure (Fujita, 2012).

Secondly, the patient will be advised on the appropriate diet to manage this condition.  The patient will be advised to adopt the DASH (Dietary Approach to Stop Hypertension). This is a diet that has been designing and proven to be effective in managing hypertension and is recommended by the American National Heart Lung and Blood Institute (NHLBI). This diet contains grains, fruits, vegetables, non-fat or low-fat dairy products, nuts and legumes (Zanchetti, 2014). This dietary approach will be effective in lowering the blood pressure and reducing the level of fats in the bloodstream. The patient should be advised to consume as little saturated fats as possible. Instead, the patient should eat a variety of vegetables as well as fruits. He should also consume fish that is rich in omega three at least two times a week (Zanchetti, 2015. The patients should further avoid animal fats, hydrogenated vegetable oils, and trans-fats. This dietary guide will be effective in reducing the blood pressure and consequently manage the condition of hypertension.

The reduction of consumption of alcohol will be of equal importance in the management of this condition. The patient said that he takes several bottles of alcohol each day. This not only increases the risk of hypertension and other cardiovascular diseases but also impairs the management of such conditions. Being a man, this patient should take a maximum of two bottles of alcohol as recommended by the American Heart Association.  This reduced consumption of alcohol will greatly reduce the blood pressure and hence help in the management of hypertension (Fujita, 2012). Moreover, the patient will require stopping smoking cigarette. Excessive smoking of cigarette is equally a risk factor for hypertension and compromises the management of the condition. 

The consumption of salt is another area to consider in the management of Hypertension. Salts have the effect of increasing the blood pressure. The increased intake of salt increased the concentration of sodium in the blood and consequently reduces the ability of the kidney to eliminate excess water. This results in increased blood fluid that increases the blood pressure. This patient has admitted that he consumes high quantities of salt. The patient should be advised to consume a maximum of 5 grams of salt daily. This will help in reducing the amount of salt admitted into the bloodstream and consequently increase the efficiency of the kidney in the elimination of excess water from the bloodstream. Consequently, the patient will be able to manage the blood fluid and the overall blood pressure.

The pertinent diagnostics involves the family history of the patient. The patient has admitted that his mother has hypertension as well as diabetes mellitus. Most importantly, his brother died of cystic fibrosis at the age of 20. It is important to note that CF is a hereditary condition (Zanchetti, 2014). This family history points to the fact that the patient in question has some has some hereditary and family history that led to his present conditions. Such family and hereditary history should be taken into account when outlining the diagnostic framework for the patient. The hereditary information and the history of hypertension within the family is a good diagnostic indicator that the patient is equally suffering from hypertension.

Lifespan Considerations

Several cultural and lifespan considerations must be acknowledged when developing this management plan. The patient is married and has two children. In crafting a schedule for physical exercise, the patient should be considered as the sole family provider (Nomie, 2014). As such, it should not coincide with the time scheduled for his employment or any other economic activity that he may be engaged in. moreover, religion is a strong cultural factor that affects African Americans (Swota, 2015). As such, this management plan is cognizant of this fact and should not contradict the religious beliefs of the patient. For instance, the diet should contain culturally compliant food as the patient prefers.

Education Plan

The patient should undergo training to manage their condition more effectively. First, the patient should undergo the diet education plan. Under this plan, the patient will be taught on proper eating plans and healthy foods. The patient will further be taught on the specific types of foods that he should avoid. The learning objective is to enable the patient to change his eating habits and consume foods that lower blood pressure (Nomie, 2014). The second educational plan is the physical exercise education. Next, the patient will be taken through a series of physical exercises that he can execute on a daily basis and which will be of great benefit in managing his condition. Moreover, the patient will be encouraged to undertake such exercises on a daily basis and equally be equipped with knowledge on the importance of such exercises particularly in relation to the management of his condition. Lastly, the patient will be taken through the educational plan that involves the breaking of harmful habits. Such habits include excessive smoking and excessive drinking of alcohol. The objectives of this education plan are to help the patient in breaking such habits and hence promoting the management of his condition.

Healthcare Promotion and Healthcare Maintenance Needs

Healthcare promotion involves initiatives that aim at promoting health in an individual. Such initiatives are preventive in nature and aim at reducing the chances of ill health. For this patient, the health promotion and health maintenance needs are those activities and initiatives that lower blood pressure. The maintenance needs and healthcare promotional activities include physical exercise and a healthy diet (Zanchetti, 2014). Such factors will tremendously help in creating good health and avoiding the ill health that the patient is currently experiencing.

Follow-Up and Referral for the Patient

The tests on this patient will be conducted after every one month to monitor the trends in his health. The follow-up will ensure that the patient is consistently on the right track in managing his conditions. The prior tests that were conducted on the patient will be repeated at each visit to monitors the trends in the outcome of the patient. In the event that the patient’s health deteriorates, the patient will be referred to a more specialized facility. During the follow-up sessions, the doctor will also keep checking for risk factors such as obesity and cholesterol. Subsequent screening should focus on damages associated with hypertension on body organs such as arteries, kidney, heart, and the brain (Zanchetti, 2015).

References

Fujita, T. (2012). 772 The kidney and hypertension-molecular mechanism of salt-sensitive hypertension. Journal of Hypertension, 30(12), 765-771.

Nomie, J. (2014). Cultural competency: A quantitative analysis of cultural awareness in U.S. Healthcare. Cultural Competence in Health Care, 4(12), 521-529.

Swota, A. H. (2015). Cultural and religious issues in healthcare. Guidance for Healthcare Ethics Committees, 7(3), 25-31.

Zanchetti, A. (2014). Challenges of hypertension and hypertension treatment. Journal of Hypertension, 32(10), 1917-1918.

Zanchetti, A. (2015). Dietary and metabolic aspects of hypertension and hypertension-related organ damage. Journal of Hypertension, 33(6), 1117-1118.

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