Definition of hypertension and hyperlipidemia
Question:
Discuss about the Hyperlipidemia and Hypertension Problems.
Hypertension is a medical condition also referred to as high blood pressure in which the blood pressure within the arteries of an individual is elevated. It is possible to have this condition for years without any symptoms until it gets severe and starts attacking target organs (Harrison et al., 2011, p. 134). It is more prevalent among the elderly as is evident with Beryl’s case. In this essay, we will apply clinical reasoning cycle to plan and assess the patient care required. Additionally, we will talk about two priority problems for the patient and highlight nursing interventions for each of the priority problems. We will particularly talk about the hyperlipidemia and hypertension as the two priority problems.
Hyperlipidemia can be described as a high level of cholesterol or fat proteins in the bloodstream of an individual. The presence of high level of lipids in the bloodstream increases the risks of coronary heart disease (Eliopoulos, 2013). The two common abnormalities of lipids that are associated with hyperlipidemia are hypercholesterolemia which refers to high levels of blood cholesterols and hypertriglyceridemia which can be described as high levels of blood triglycerides. If the levels of cholesterol in the bloodstream get elevated, they can get deposited in the arterial walls and cause some heart-related conditions such as cardiovascular diseases (Nelson, 2013, p. 198).
This condition rarely has symptoms and it is normally diagnosed when a doctor performs a blood test known as lipid profile on the patient. The test is aimed at determining the levels of cholesterol in the blood. Normally, 0.05mmol/L for cholesterol is considered normal in the lipid profile test. Additionally, a high-density lipoprotein of 3.3mmol/L is okay under normal circumstances (Eliopoulos, 2013). High-density lipoprotein is considered as good cholesterol and therefore its quantity should be high. Furthermore, low-density lipoprotein should be in the region less than 5.5mmol/L. However, from the pathology results of Beryl, we notice that her cholesterol level is 6mmol/L which is extremely high. Her high-density lipoprotein level is 0.8mmol/L which is lower than the normal value. The range of her low-density lipoprotein, on the other hand, is 3.1mmol/L which can be considered as normal. These results indicate the presence of hyperlipidemia.
Classification of nursing interventions includes independent or collaborative, direct, and indirect. Independent nursing interventions are the interventions that are sanctioned by the acts of professional nurse practice and thus do not require directions from another healthcare professional. The following two are some of the nursing interventions for hyperlipidemia; nutrition education and encouraging the patient on increased physical activity.
Two priority problems for the patient
There are several dietary factors that influence the level of blood cholesterol. It is, however, important to note that reducing the consumption of saturated fats is the most beneficial strategy for lowering the levels of lipids in the blood (Last, Ference & Falleroni, 2011). It is crucial that nurses are educated on patient counseling, nutritional education, and techniques of dietary assessment so that they can effectively implement the strategies required to treat hyperlipidemia. The nurses are then required to educate the public on appropriate diets that are low in saturated fats to reduce the risks associated with hyperlipidemia (Tietge, 2014, p. 95). It is also important to note that nutrition education can inspire the patients and their families to reach for fruits and vegetables instead of already processed food. As a result, they are able to shape their perspectives of wellness and health (Baljani, Rahimi, Amanpour, Salimi & Parkhashjoo, 2011).
From the evidence-based literature provide, it is clear that Beryl never gets time to prepare healthy foods. She instead bus take away food for dinner and mostly takes a large muffin and full cream milk coffee for lunch. This kind of diet has led to elevated levels of cholesterol in her blood. The application of this intervention is therefore justified because will help to reduce the number of lipids in the body and maintain the cholesterol level at a normal range (Baljani et al, 2011).
Physical inactivity is a crucial risk factor for coronary heart disease there for consistent physical activity is essential in an individual’s daily routine. It is important to engage in regular aerobic exercises to help manage the levels of cholesterol (Gao et al., 2012, p. 55). Exercises are however effective if they are accompanied by a healthy diet. The recommended time for exercise is around 120-150 minutes every week. It is even more effective if every exercise session lasts around 40 minutes. It is important to note that physical activities help to enhance lipoprotein profiles (Tucker et al., 2013, p. 540). This is done through the reduction of triglyceride and the increase of high-density lipoprotein. It also helps to lower the LDL-to-HDL ratio.
There are several techniques an individual can use to incorporate physical activity into their routine. Some of these ways include cycling, running up and down the stairs, choosing to walk instead of taking a car or bus for short distances and dancing among others (Navar-Boggan et al., 2014, p. 455). The program of the physical activity should be designed in such a way that they will maximize the benefits with very minimal risks of aggravating the health or physical condition of a patient. It is therefore imperative that the nurse advises the patient on any specific concerns they might have regarding a particular physical activity (Wong et al., 2012, p. 567).
Nursing interventions for hyperlipidemia
We are informed that Beryl rarely engages in any form of exercise apart from occasionally walking to the local restaurant. This lack of exercise combined with her poor eating habit has put her at a risk of hyperlipidemia. Additionally, she drives to work and parks just next to her office and thus she rarely walks for longer distances. Increased physical activity is, therefore, necessary to help in reducing and maintaining the levels of blood cholesterol and a normal range. One challenge however to this intervention is that if an individual is using other medications to lower the lipid level then they might experience some muscle discomfort.
Hypertension is also known as high blood pressure and it can cause numerous health complications and even lead to heart attack, strong, and sometimes death. Hypertension, according to medical guidelines is defined as blood pressure that exceeds 130/80 mmHg. Blood pressure is defined by the amount of blood pumped by the heart and the amount of resistance offered by the walls of the arteries to the flow of blood. Blood pressure increases when the heart pumps more blood but the arterial walls are narrow (Harrison et al., 2011, p. 138). It is possible to have hypertension for many years without discovering any symptoms. It is, however, important to note that even in the absence of the symptoms, the damage to the vessels and the heart continues and can be detected in some instance. There are two types of hypertension that include primary hypertension that tends to develop gradually in an individual over the years. The other type is secondary hypertension that results from some underlying conditions that include kidney problems, thyroid problems and sleep apnea among others (Pedrosa et al., 2011, p. 813).
As mentioned above, the symptoms of this condition may not reveal themselves during the early stages. Blood pressure can, however, be measured using an inflatable arm cuff that is placed around the arm of a patient. Normally, the blood pressure should be 130/80 mmHg (Mitchel, 2014, p. 15). From the nursing assessment, Beryl’s blood pressure is revealed to be 160/95 mmHg. This value is extremely which is an indication of stage 2 hypertension.
The goals of the nursing interventions should be aimed at lowering the blood pressure of an individual and maintaining it at a normal range. The blood pressure should be reduced to below 140/90 mmHg. The interventions normally focus around lifestyle modification for all the patients suffering from prehypertension and hypertension (Hacihasano?lu & Gözüm, 2011, p. 695). Below we will discuss some nursing interventions for patients with hypertension.
Dietary factors influencing blood cholesterol
It is important to know the level of a patient’s blood pressure before you start treating the condition (Weber et al., 2014, p. 17). The assessment and monitoring of the blood pressure are important to aid in acquiring a baseline, analyzing the fluctuations in the blood pressure, diagnosing the disease, and to monitor medication among others (Li et al., 2012, p. 780). This assessment and monitoring of the blood pressure can be done in two ways that include invasive and non-invasive measurement.
Before commencing on this procedure, it is important that the nurse explains to the patient what they are about to do. This helps to ensure that the patient is relaxed and comfortable so that they are not distressed(Li et al., 2012, p. 782). It is also important to note if the patient takes any forms of medication that could raise their blood pressure.
This intervention is important because it helps in the treatment and prevention of blood pressure and any related diseases. Additionally, it helps in monitoring the cardiovascular hemostasis. It is also important to note that monitoring the blood pressure enables both the nurse and the patient to assess the possible treatment outcomes (Mirhosseini, Baradaran & Rafieian-Kopaei, 2014, p. 758). The nurse will effectively develop a treatment program that is appropriate for the patient and adjusts drugs and medication if necessary. Furthermore, assessing and monitoring the blood pressure enables a nurse to observe any complications and recommend emergency treatment.
From the nursing assessment form, it is indicated that Beryl’s blood pressure is 160/95 mmHg. This value is extremely elevated and if not monitored appropriately may cause a stroke or even worse, death. It is therefore important to assess this blood pressure and design a treatment plan that suits Beryl.
Lowering stress is very fundamental in reducing hypertension and preventing any blood pressure-related diseases (Lin et al., 2012, p. 8). Medical reports indicate that stressful situations are responsible for temporary spikes in blood pressure. It is also worth noting that stress may cause long-term hypertension (Grenard et al., 2011, p. 1177). Being depressed may lead to some self-destructive behaviors like failing to take your medications to control blood pressure like is the case with Beryl. It is therefore important to control and reduce stress to prevent blood pressure spikes and manage hypertension.
Decreasing stress may not necessarily reduce blood pressure directly but it is important to note that applying some stress reduction strategies can tremendously improve health (Persell, 2011, p. 1078). These stress management strategies can help a patient have some behavioral changes, some of which may help to manage hypertension and lower blood pressure.
Encouraging physical activity in patients
There are several ways that a nurse can propose to a patient to help in lowering stress and controlling blood pressure. The first strategy is simplifying one’s schedule (Parekh, J., Corley, D. A., & Feng, 2012, p. 2181). From Beryl’s assessment form, we realize that she has a very busy schedule that involves working daily from 8am-5pm. This is an indication that she rarely has time to relax and spend maybe some time with her three kids. She, therefore, needs to be advised on how she could simplify her schedule because her health should be her priority. Secondly, it is important to exercise because exercising helps in stress reduction. Additionally, she needs to have enough sleep if in any case, she is sleep deprived.
Conclusion
Hypertension and hyperlipidemia are life-threatening diseases that should be addressed with care and seriousness to prevent other conditions like stroke and cardiovascular disease. They are mostly caused by lifestyle choices like unhealthy eating habits. These conditions can, however, be controlled and managed by applying the appropriate nursing interventions. These nursing interventions help to improve health and educate the patients on how to handle these diseases.
References
Baljani, E., Rahimi, J. H., Amanpour, E., Salimi, S., & Parkhashjoo, M. (2011). Effects of a Nursing Intervention on Improving Self-Efficacy and Reducing Cardiovascular Risk Factors in Patients with Cardiovascular Diseases. Hayat, 17(1).
Eliopoulos, C. (2013). Gerontological nursing. Lippincott Williams & Wilkins.
Gao, W., He, H. W., Wang, Z. M., Zhao, H., Lian, X. Q., Wang, Y. S., … & Wang, L. S. (2012). Plasma levels of lipometabolism-related miR-122 and miR-370 are increased in patients with hyperlipidemia and associated with coronary artery disease. Lipids in health and disease, 11(1), 55.
Grenard, J. L., Munjas, B. A., Adams, J. L., Suttorp, M., Maglione, M., McGlynn, E. A., & Gellad, W. F. (2011). Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis. Journal of general internal medicine, 26(10), 1175-1182.
Hacihasano?lu, R., & Gözüm, S. (2011). The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. Journal of clinical nursing, 20(5?6), 692-705.
Harrison, D. G., Guzik, T. J., Lob, H. E., Madhur, M. S., Marvar, P. J., Thabet, S. R., … & Weyand, C. M. (2011). Inflammation, immunity, and hypertension. Hypertension, 57(2), 132-140.
Last, A. R., Ference, J. D., & Falleroni, J. (2011). Pharmacologic treatment of hyperlipidemia. American family physician, 84(5).
Li, P., McElligott, S., Bergquist, H., Schwartz, J. S., & Doshi, J. A. (2012). Effect of the Medicare Part D coverage gap on medication use among patients with hypertension and hyperlipidemia. Annals of internal medicine, 156(11), 776-784.
Lin, E. H., Von Korff, M., Ciechanowski, P., Peterson, D., Ludman, E. J., Rutter, C. M., … & McCulloch, D. K. (2012). Treatment adjustment and medication adherence for complex patients with diabetes, heart disease, and depression: a randomized controlled trial. The Annals of Family Medicine, 10(1), 6-14.
Mirhosseini, M., Baradaran, A., & Rafieian-Kopaei, M. (2014). Anethum graveolens and hyperlipidemia: A randomized clinical trial. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 19(8), 758.
Mitchell, G. F. (2014). Arterial stiffness and hypertension. Hypertension, 64(1), 13-18.
Navar-Boggan, A. M., Peterson, E. D., D’Agostino, R. B., Neely, B., Sniderman, A. D., & Pencina, M. J. (2015). Hyperlipidemia in Early Adulthood Increases Long-Term Risk of Coronary Heart DiseaseCLINICAL PERSPECTIVE. Circulation, 131(5), 451-458.
Nelson, R. H. (2013). Hyperlipidemia as a risk factor for cardiovascular disease. Primary Care: Clinics in Office Practice, 40(1), 195-211.
Parekh, J., Corley, D. A., & Feng, S. (2012). Diabetes, hypertension and hyperlipidemia: prevalence over time and impact on long?term survival after liver transplantation. American journal of transplantation, 12(8), 2181-2187.
Pedrosa, R. P., Drager, L. F., Gonzaga, C. C., Sousa, M. G., de Paula, L. K., Amaro, A. C., … & Lorenzi-Filho, G. (2011). Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension, 58(5), 811-817.
Persell, S. D. (2011). Prevalence of resistant hypertension in the United States, 2003–2008. Hypertension, 57(6), 1076-1080.
Tietge, U. J. (2014). Hyperlipidemia and cardiovascular disease: inflammation, dyslipidemia, and atherosclerosis. Current opinion in lipidology, 25(1), 94-95.
Tucker, S. J., Ytterberg, K. L., Lenoch, L. M., Schmit, T. L., Mucha, D. I., Wooten, J. A., … & Wahlen, K. J. M. (2013). Reducing pediatric overweight: nurse-delivered motivational interviewing in primary care. Journal of Pediatric Nursing: Nursing Care of Children and Families, 28(6), 536-547.
Weber, M. A., Schiffrin, E. L., White, W. B., Mann, S., Lindholm, L. H., Kenerson, J. G., … & Cohen, D. L. (2014). Clinical practice guidelines for the management of hypertension in the community. The journal of clinical hypertension, 16(1), 14-26.
Wong, J. M., Kendall, C. W., Marchie, A., Liu, Z., Vidgen, E., Holmes, C., … & Vuksan, V. (2012). Equol status and blood lipid profile in hyperlipidemia after consumption of diets containing soy foods–. The American journal of clinical nutrition, 95(3), 564-571.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
