Delivering Education to a Client Regarding Hypertension - Essay Example

Delivering Education to a Client Regarding Hypertension Educating individuals about hypertension is very important because if it goes untreated, theindividual can have many other difficulties including heart disease and damage to the arteries overtime (Mayo Clinic, 2010). When hypertension is not treated, it can also lead to heart attack or stroke. In many cases, the symptoms of hypertension can be present for many years before an individual is experiencing symptoms. In this clients case, it could be that he was having symptoms for many years but did not know that it was happening. Hypertension can be cause by obesity, and in this case at 152kg has a BMI of 45.9, which means they are considered "Morbidly Obese " (The Wittington Hospital, n.d.). This means that this client must lose weight in order to turn his health challenges around. The challenge for the community nurse will be to help the client understand the need to change their behaviours with eating and with exercise. In this scenario, the individual must start exercising daily and start eating meals at home instead of using take away food or restaurant food for most of his meals. He must also understand nutrition, how to read labels at the grocery store, and how to buy nutritious food for himself. In this situation it seems that the Trans Theoretical Model (TTM) is the best to use because this individual must learn self-care. Trans Theoretical Model Constructs Applied In the first phase of education, the nurse would encourage this client to understand more about hypertension. Most important would be to explain what hypertension does and the consequences of not treating it. The first step would be a general overview of hypertension and its symptoms. Once these were discussed, the nurse would provide the answers to any questions that the client may have about their own hypertension. The nurse would need to have information from the clients doctor about their hypertension. The objective of this education about hypertension would be to show the client the seriousness of the issue and help them make their own thoughts about what might happen if they go untreated. It would seem that in this scenario, this client may be moving into the pre-contemplation stage of the TTM. As he begins to understand the seriousness of hypertension, he should also be able to relate to some of the symptoms, though he may not have thought about them in the past. As an example, he may have experienced headaches, dizziness or nose bleeds at times when his blood pressure was high, but he would not have attributed these to hypertension. After education, he may be able to relate this information to the nurse. He would also gain information about how to have his blood pressure checked by the doctor or by some other means periodically. The client may at first think that this could not happen to him, but if he sees that it is already happening, he may be able to move forward into thinking about himself and how hypertension is affecting him. The next construct states that the individual will experience dramatic relief and will have some negative emotions about what he has found out about himself. The nurse would be there to guide him through the emotions, not as a therapist, but to allow him to understand that these types of feelings are normal when someone finds out about their health. In this situation, the client may need to have other community resources that may include support groups and/or a counsellor if they are having challenges dealing with these emotions. In order to help the client understand that they need to do a re-evaluation to show them they have more possibilities than they may have thought previously, it is important for the community nurse to give examples of how other people have changed their behaviour in order to promote health. In this stage, it would be a good idea to bring in another speaker or go on a field trip to a community group that talks about behaviour change. In this way, the client may be able to talk to someone who is very much like they were and gain understanding of someone else that changed. The environmental evaluation will be next. At this stage, it will be important for the nurse to help the client understand that his environment may have to change. As an example, instead of always eating at restaurants or getting take away food, he may have to learn to pack lunches from home. He may also need to balance his eating so that he is eating more nutritionally. Having a talk with a nutritionist who can show the value of eating healthy would be in order. The family will need to make adjustments also in their work with their father. Perhaps mom will create more nutritional meals for the entire family once they understand how to read packages in the grocery store. Also, there may need to be changes in the way that food is approached in the house. This skill would be a good idea for the entire family to learn. A set of goals should be developed by the client for self-care. In other words, by this stage, the client would be in the contemplation stage, which would help them think about goals for the next six months. Instead of looking towards a weight loss goal, it would be more appropriate to look for exercise goals or nutritional goals. As an example, eating at a restaurant once a week instead of every day would be a good goal. Also, making a goal to walk once or twice a week or to attend a fitness program once a week would be another goal to talk to the client about; of course, golf could also be instituted into the fitness program if they liked this as an activity. As the client begins to work through their fitness process, the TTM states that the client should come to a place of self-liberation where they decide to make the change. This is an important stage because behaviour change must happen not because the nurse says it must happen, but because the client sees the value of the change for themselves. By this point, they have a made a firm commitment to change and they have identified various friends and family who will support them in this change. The nurse will also help the client find substitutes for their negative behaviour. As an example, they can take a trip to the grocery store after the nutritionist appointment and find alternative to take away foods. They may also find low fat or sugar free snacks that are healthier but that have a good taste. These can be substituted for the higher fat or very sugary foods. It will be important for the client to remove any foods that stimulate them to eat a lot of it. As an example, if the client enjoys a lot of sandwiches, there may be able to find a low calorie bread to make sandwiches with or ones that are high in fibre and low in salt that would make them more appropriate to eat as they are attempting to eat a healthier diet. As a reward for the changes in habit, (reinforcement management), the client could decide on a vacation with the family that was fun for everyone. Since they have not been on a vacation for a very long time, it would help the entire family bond again, and would also help them understand their fathers choices. When an individual decides on a lifestyle change, it will affect the entire family. If this client is to get to the social liberation stage, they will need to understand their new life for themselves as well as their family. They will also need to be moving forward to get to the maintenance phase, the client will need to have the support for himself both internally and externally. Communication Skills The best way to do this presentation may be in the clients home, if they are amenable to this action. A community nurse could also do this presentation in a facility in the community. The hospital may or may not be a good place to present this type of program. This could also be done in a group format if there were more than one person who needed information on hypertension. Some of the basic information could be done in a group format and then individual education could be done that would depend on each individuals needs. Because people have different learning styles, the community nurse should use visuals such as posters, or other visuals and it may be a good idea for the individual to have a paper and pen so they can take their own notes. A community nurse would need public speaking skills. They would need to communicate easily, they would have a voice that was not too loud but not too soft and they would need to feel at ease with the subject matter (RN Central, 2010). The community nurse should also be very respectful of the client and patient with them. Lifestyle change is difficult for most people and the more patient and understanding the nurse can be about the situations that the individual is facing, the more they will feel supported. With in this process, the nurse must have good listening skills. Listening to the clients concerns (what they say and do not say) is important so that the client will fell heard. Also, a rule of thumb is to acknowledge the clients feelings and their way of life. Sometimes this means that the nurse will have to agree with what the individual is saying, and then give them information about how to change their information into a healthier choice. Conclusion The Trans Theoretical Model encourages a client to become self-sufficient and change their behaviour. They can do this with the gentle assistance from the nurse if the nurse continues to be understanding. Before starting this process in this scenario, it would be a good idea for the nurse to get to know the client and their family. It is often easier to work with a client when they know the nurse better. In presenting this information, the facts of hypertension would be the most information because the nurse would want to give accurate information to the client. Once they established a baseline for what needed to be done and why, the client should be involved in every step of their planning. Clients should also create some rewards for themselves along the way that would include going to a new place, purchasing a new piece of clothing or doing something special with the family. The challenge is to get them away from their old behaviours and begin new ones that are healthier choices. Word Count 1, 812 References Foster, J. (2010). Health education and chronic illness -- self management. Mayo Clinic Staff. (2010). High blood pressure (Hypertension). The MayoClinic.. Retrieved April 10, 2010 from http://www.mayoclinic.com/health/high-blood- pressure/DS00100 RN Central. (2010). 50 communication tips and techniques for caregivers. Retrieved April 10, 2010 from http://www.rncentral.com/nursing-library/careplans/ 50_communication_tips_for_caregivers The Wittington Hospital. (n.d.). Obesity surgery handbook. North London Obesity Surgery Service. Retrieved April 10, 2010 from http://www.whittington.nhs.uk/Documents/%28NLOSS%29%20Obesity%20boo k_6573.pdf Read More