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These patients are composed of middle aged adults living alone in suburban areas. Setting: Private Doctor’s Office Anticipated Client Outcomes: 1. Patient should be able to keep a record of two blood pressure readings a day. Blood pressure is checked through a digital sphygmomanometer once in the morning and in the afternoon. 2. Patient should be able to keep a monitoring sheet for daily intake of prescribed anti-hypertensive medication. Patients should also be able to verbalize understanding on the precautions in taking medications. 3. Patient should be able to eat a balanced diet with strict avoidance of foods rich in fat and salt.
This is measured through cholesterol determination and comparison with previously obtained results. Methodology: Patients will be divided into two groups with a minimum of five members each. Teaching classes are conducted every week. These patients are diagnosed with Stage 1 and Stage 2 Hypertension with systolic blood pressure of 140-179 and diastolic pressure of 90-109 (McGowan 6). They have been prescribed with a variety of anti-hypertensive medications, all of which are taken every morning.
Handouts will be distributed a day prior to discussion so that patients can do an advance reading and prepare questions, hence, fostering active participation. During class, basic information about blood pressure and hypertension will be provided through lecture discussion with the aid of power point and video presentations. The information presented primarily consists of definition, physiology, signs, symptoms, treatment modalities and complications of hypertension. All these information are discussed using mostly layman’s terms to facilitate better understanding among patients.
Patients will be taught on the proper use of digital sphygmomanometer. If there is unavailability of sphygmomanometer, it will be suggested to buy the cheapest but reliable ones. If it is unavailable due to financial constraints, patients who live in a neighborhood are encouraged to share the sphygmomanometer amongst them. Record books are provided for each patient. These log books are divided into four columns – the first column is for blood pressure reading in the morning, the second column is for the anti-hypertensive medication, the third is for blood pressure reading in the evening, and the fourth column is for additional remarks.
In the fourth column, patients can write their notes such as the symptoms experienced for that day. Proper use of digital sphygmomanometer is taught through demonstration. The nurse will show how to properly apply the BP cuff on a volunteer patient’s arm (5). Pointers will be provided so that patients can easily remember the location of the cuff. Most digital sphygmomanometers require one touch of a button to facilitate reading, so the nurse will focus on discussing the do’s and don’ts while the sphygmomanometer is reading.
The nurse will also discuss the normal range for blood pressure (8) and the importance of adherence to intake of prescribed medications. Alongside with this, the nurse will emphasize that blood pressure readings of 100/70 and below will require the patients not to take the medication temporarily to avoid sudden drop in blood pressure. In cases like this, close monitoring of blood pressure must be done to avoid sudden hypertensive episodes. Since these patients are living alone, they are also responsible for the preparation and selection of their foods.
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