Nursing Grand Rounds Presentation

Nursing Grand Rounds Presentation

My Nursing Grand Rounds presentation is about Hypertension. Hypertension has intrinsic factors such as age, sex, ethnicity, and family history, as well as extrinsic factors such as unhealthy diet, physical inactivity, obesity, excessive alcohol intake, tobacco use, and stress (Centers for Disease Control and Prevention, 2020a). Hypertension is caused by the combination of cardiac output and peripheral resistance (Williams, 2015). Hypertension is most prevalent in low to mid-income level countries, in populations with lower education levels, and in lower socioeconomic groups (Mills, Stefanescu, & He, 2020). Men and women are affected equally, but older people are more affected than younger people due to increased rigidness of blood vessels (Williams, 2015). African Americans are most affected (Long, Ponder, & Bernard, 2017). Hypertension is the leading cause of premature death worldwide (Williams, 2015).

Some of the nursing interventions appropriate for Hypertension include blood pressure readings, daily weights, and labs (Vera, 2020). Labs that can assist in treating and monitoring Hypertension include CMP to monitor the effects of Hypertension and medications on kidney health and monitor sodium concentration in the blood and lipids to assist in assessing the possible blockages associated with hyperlipidemia that may increase blood pressure. Nurses generally administer and teach about several medications for Hypertension, including beta-blockers, calcium channel antagonists, diuretics, ACE inhibitors, and vasodilators (Vera, 2020). Nurses should assist in providing a relaxing environment to decrease stress. Nurses should also implement pain control measures when necessary, as pain can increase blood pressure.

Nurses should assist in lifestyle change education, including the DASH diet, limiting caffeine and alcohol intake, decreasing intake of processed foods, exercise, smoking cessation, weight reduction, and the importance of cardiology visits (Vera, 2020). Hypertension has many extrinsic factors that can be reduced with proper diet, weight reduction, and other behavioral modifications. This is what makes providing education on these topics so important. Patients should also be taught about self-monitoring their blood pressure, including techniques specified to use by the instruction manual in their blood pressure monitoring device (Drugs.com, 2020). Patients will need to know the parameters in which to not take their blood pressure medications so that their blood pressure doesn’t drop too low. Patients will also need to be taught about when to call 911, such as with chest pain, shortness of breath, or dizziness, and when to call the doctor, such as when there are increased blood pressure readings while taking medication as prescribed for multiple days per week (Drugs.com, 2020). Handouts to reference at home and the teach-back method are effective tools to assist nurses in providing education about Hypertension.

The interdisciplinary team for hypertension patients should include a cardiologist, a primary care physician, nurses, a pharmacist, laboratory technicians, a dietician, a social worker, and a family support system (Centers for Disease Control and Prevention, 2020b). Cardiologists and primary care physicians can work together to monitor and manage a patient’s blood pressure. Pharmacists can ensure that patient’s medications are appropriate and that multiple medications in the same class are not prescribed. Lab techs will assist in obtaining and reporting lab results of the necessary diagnostic and monitoring tests. Dieticians will assist the patient in a low sodium, low fat, DASH diet. Social workers will assist with obtaining home health assistance, medication financial support, and blood pressure monitoring equipment. Nurses assist in teaching ADLs monitoring and care of hypertensive patients in multiple healthcare settings. Finally, the patient’s family support system should be involved to assist the patient with lifestyle changes, respect dietary restrictions, especially at family meals and functions, and assist with hypertension monitoring and management as needed, like taking blood pressure or driving to cardiology appointments.

References

Centers for Disease Prevention. (2020, February 24). High blood pressure. https://www.cdc.gov/bloodpressure/index.htm

Centers for Disease Prevention. (2020, June 25). Promoting team-based care to improve high blood pressure control. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/team-based-care.htm

Drugs.com. (2020, February 3). Chronic Hypertension. https://www.drugs.com/cg/chronic-hypertension- discharge-care.html

Long, E., Ponder, M., & Bernard, S. (2017). Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States. Patient Education and Counseling, 100(5), 1000–1006. https://doi.org/10.1016/j.pec.2016.12.011

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of Hypertension. Nature reviews. Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2

Williams, H. (2015, February 11). Hypertension: Pathophysiology and diagnosis. Clinical Pharmacist. https://www.pharmaceutical-journal.com/cpd-and-learning/cpd-article/hypertension-pathophysiology- and-diagnosis/20067718.cpdarticle?firstPass=false

Vera, M. (2020, June 18). 6 Hypertension nursing care plans. Nurse Labs. https://nurseslabs.com/6- hypertension-htn-nursing-care-plans/

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Pathophysiology of the Disease Identifies the disease process. Consider the causes of the disease.

Nursing Grand Rounds Presentation

Such as infectious agents, chemicals, environmental influences, idiopathic causes, predisposing factors