Blood Pressure Management
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Transcript of Blood Pressure Management
Liz Rhodes, RNECU Student Nurse
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PROBLEM Uncontrolled blood pressures related to
medications, poor diet, and decreased physical activity
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GOALTo motivate a change in behavior patterns
and activities to control blood pressure for stroke prevention
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OBJECTIVESList four modifiable risk factors for strokesState the importance of controlling blood pressure.List different types of foods which are healthy and
not healthy.Verbalize the importance of a healthy lifestyle to
prevent a strokeInterpret BP results after participation in blood
pressure screening and document results if follow-up required
Complete the stroke risk factor form from using obtained knowledge of program
Be aware that there are others available for assistance
Desire a more positive healthy life styleIdentify reasons for not taking medications
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BLOOD PRESSUREHow can I tell if I have high blood
pressure?High blood pressure usually has no symptoms. Many people have high blood pressure for years
without knowing it. It's called the "silent killer."
Hypertension is the medical term for high blood pressure. It doesn't refer to being tense, nervous or
hyperactive. You can still have high blood pressure even if you are
a calm, relaxed person.
http://www.americanheart.org/presenter.jhtml?identifier=4473 5
Why is Blood Pressure Management Important?
There is a progressive increase in the risk of: stroke
Elevated BP one of the most common reasons Elevated BP places unnecessary stress on blood
vesselsCoronary (heart) disease (Kaplan & Rose, 2008).
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Factors related to High Blood Pressure
A family history of high blood pressureAge - The incidence of high blood
pressure rises in men after age 35 and in women after age 45
Gender - Men are more likely to have high blood pressure than women
Race - Approximately 33 percent of African-Americans have high blood pressure, compared to 25 percent of Caucasians
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Potential Reasons For Not Taking Medications
Poor eye sight Impairs ability to read prescription and understand labeling
on bottleLimited hearing
Critical communication from health care provider is diminished
Limited mobility Decreased mobility and dexterity can limit a person's ability to
have prescriptions filled to open and close childproof containers
Memory Loss Problem with recalling prescription instructions from
healthcare provider
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Potential Reasons For Not Taking Medications
Economic Condition Limited incomeIncrease in prescription costs
Depression Social and Health Beliefs
beliefs can be based on: misconceptions faulty information cultural conditioning
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Blood Pressure GuidelinesCategory Systolic BP (mm Hg) Diastolic BP (mm Hg) Treatment recommendations
Normal Less than 120 Less than 80 Lifestyle changes encouraged
Prehypertension 120–139 80–89Lifestyle changes necessaryDrugs for compelling indications*
Stage 1 hypertension 140–159 90–99
Lifestyle changes necessaryThiazide diuretic for most peopleMay also consider other blood pressure drugs alone or in combinationDrugs for compelling indications*
Stage 2 hypertension 160 or higher 100 or higherLifestyle changes necessaryTwo or more blood pressure drugs for most peopleDrugs for compelling indications*
*Compelling indications: diabetes, chronic kidney disease, previous heart attack, congestive heart failure, previous stroke, high cardiac risk
Note: When systolic and diastolic pressures fall into different categories, physicians rate overall blood pressure by the higher category. For example, 150/85 mm Hg is classified as stage 1 hypertension, not prehypertension.
Source: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, December 2003.
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Why is Blood Pressure ManagementFor Stroke Prevention Important?Strokes
Leading Cause of Disability in the U.S.3rd Leading Cause of Death in the U.S.
N.C. lies in the Stroke BeltThe Stroke Belt has the highest morbidity
and mortality from Stroke in the U.S.The Buckle of the Belt includes NC, SC and
Georgia
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TYPES OF STROKESHemorrhagic Stroke
Blood vessels in the brain ruptureIschemic Stroke
Blood clots or fatty deposits block vessels that supply the brain with blood.
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Modifiable Risk Factors of StrokesHigh cholesterolHypertension (high
blood pressure)ExerciseDietTobacco
Doubles stroke risk Increases blood
pressureObesity
Alcohol 4 oz. wine or
equivalent may be protective
DiabetesCardiac Disease
Atrial FibrillationTIA/Prior stroke
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PREVENTIONEating a well balanced dietExerciseCompliance with medicationsManagement of:
Diabetes HTN Heart disease
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STROKE RISK AWARENESS SURVEY Check all that applies to you. ***If you check two or more, please see a
healthcare professional and determine what you can do to lower your risk. AGE ____ You are a man over 45 or a woman over 55 years old. FAMILY HISTORY ____ Your father or brother had a heart attack before age 55 or your mother or
sister had one before age 65. MEDICAL HISTORY ____ You have coronary artery disease, or you have had a heart attack. ____You have had a stroke. ____You have an abnormal heartbeat. Tobacco SMOKE ____ You smoke, or live or work with people who smoke every day. Total CHOLESTEROL and HDL cholesterol ____ Your total cholesterol level is 240 mg/dL or higher. ____ Your HDL (“good”) cholesterol level is less than 40 mg/dL if
you’re a man or less than 50 mg/dL if you’re a woman. ____ You don’t know your total cholesterol or HDL levels.
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Risk assess cont.BLOOD PRESSURE ____ Your blood pressure is 140/90 mm Hg or higher, or you’ve been
told that your blood pressure is too high. ____ You don’t know what your blood pressure is. PHYSICAL INACTIVITY ____ You don’t accumulate at least 30 minutes of physical activity on
most days of the week. Excess BODY WEIGHT ____You are 20 pounds or more overweight. DIABETES ____ You have diabetes or take medicine to control your blood sugar.
American Heart Association. (2008). Personal risk assessment form. Accessed on September 12, 2008 at http://www.strokeassociation.org/presenter.jhtml?identifier=3034972
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Stroke is a Medical Emergency
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ABCs of Preventing Heart Disease, Stroke and Heart Attack
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http://www.strokeassociation.org/presenter.jhtml?identifier=3034972
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Heart-Healthy Cooking TipsEat less cholesterol, salt and saturated and trans
fats. Eating less saturated fat and trans fat helps to
lower blood cholesterol levels. Eating fewer calories will help you lose weight,
especially when you also enjoy regular physical activity.
Eating less salt and more potassium helps control blood pressure in most people.
Focusing your diet on foods such as fat-free and low-fat dairy fruits, vegetables and whole-grain, high-fiber foods is essential to good health.
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Here are some tips to help make your meals healthful:
FryingSteam, stir-fry, broil, or bake foods in olive oil or
canola instead of deep-frying in bacon grease or shortening.
SaltUse lemon juice, vinegar, garlic, hot red pepper flakes,
and onions or other low-salt spices instead of salt.Use little or no salt when you cook, spaghetti, noodles,
hot cereal or rice.
Salad DressingUse low-fat, low-calorie or fat-free salad dressings.
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TIPS continuedButter
Use soft tub margarine instead of butter, or use other spreads that are lower in trans fat, cholesterol, and saturated fat such as a stick of margarine.
Eggs Limit egg yolks to three or four per week, or eat egg whites
instead.
Meat Buy fresh lean cuts of meat and trim the fat before cooking. Eat chicken, turkey, and very lean pork or beef. Remove the skin from poultry before cooking except when
roasting a whole chicken. Roast, broil, or bake meats instead of frying them.
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TIPS continuedOils
Use olive, canola, corn, or safflower oil in cooking.
Use calorie-free, fat-free cooking spray to provide a non-stick surface for grills, bake ware, and wok-ware.
FatLimit saturated calories to less than 7 percent of
your total calories and trans-fat calories to less than 1 percent of your total calories.
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AREA DIETICIANSRenee L KemskeMPH RD LDNOrange County Health Dept2501 Homestead RdChapel Hill, NC 27514Phone: (919) 968-2022 x309Email: [email protected] of Practice:
Individual Counseling, Group Counseling, Programs/Workshops, Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness,
Gerontology, Weight Control
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AREA DIETICIANSAnne-Marie ScottUNC Wellness CenterHealth Education Dept100 Sprunt StChapel Hill, NC 27517Phone: (919) 843-2163Email: [email protected] of Practice: Individual Counseling, Group Counseling, Programs/Workshops Cardiovascular/Hypertension, General Nutrition/Wellness, Gerontology,
Weight Control
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AREA DIETICIANSElizabeth A WattRD LDNThe Wellness Center at MeadowMont100 Sprunt StChapel Hill, NC 27517-7811Phone: 919-843-2163Email: [email protected] of Practice:
Individual Counseling, Group Counseling, Programs/Workshops, Cardiovascular/Hypertension, General Nutrition/Wellness, Weight
Control
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AREA DIETICIANSKara M MitchellMS RD LDDuke Center for Living1300 Morreene RdDurham, NC 27710Phone: (919) 660-6818Email: [email protected] of Practice: Individual Counseling, Group Counseling, Programs/Workshops Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness,
Vegetarian, Weight Control
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FITNESS CENTERSCarolina Fitness
503-C West Main StCarrboro, NC 27510
phone (919) 960-9910
O2 FitnessView Website300 Market Street, #110 (Southern Village),
Chapel Hill, NC 27516 phone (919) 942-6002
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FITNESS CENTERSThe Wellness Center at Meadowmont
View Website100 Sprunt St
Chapel Hill, NC 27517 phone (919) 966-5500
World-Renowned Residential Program-- Duke
University Diet and Fitness Center 1-800-235-3853 http://www.dukehealth.org/Services/DietAndFit
ness/About/index/DFC%20Brochure%20Inside.pdf
Check with your physician be for starting any physical fitness program
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Prescription DrugsWALMART/SAM'S CLUB
$4 Prescription Drug Program Heart Health & Blood Pressure Medications
Target $4 Prescription Drug Program
UNC Hospital Program for free medications. An application needs to be filled out and submitted.
It does go by income.
**(Check with your physician for generic medication prescription for area programs)
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Things to RememberHelp decrease your risk for a stroke or
recurring stroke by:Maintaining a healthy dietExercise Program
Check with your physician before startingControl your blood pressure
Monitoring/keep tract of results Medications Medical follow-up
**If you think you are having a stroke, call 911 immediately! (See the following signs & symptoms)
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Signs & Symptoms of StrokesSudden numbness or weaknessSudden confusion, trouble speaking or understanding
Sudden trouble seeingSudden trouble walking, dizziness, or loss of balance or coordination
Sudden, severe headache32
Thank You
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Resources American Heart Association [AHA]. (2008). Diet and Nutrition. Site accessed on September 29, 2008 at
http://americanheart.org/presenter.jhtml?identifier=1200010
American Heart Association. (2008). Personal risk assessment form. Accessed on September 12, 2008 at http://www.strokeassociation.org/presenter.jhtml?identifier=3034972
American Heart Association [AHA], (2008). Stroke risk factors. Site accessed on September 29, 2008 at http://www.americanheart.org/presenter.jhtml?identifier=9217
American Heart Association [AHA]/American Stroke Association [ASA]. (2007). Let’s talk about lifestyle changes to prevent
stroke. Site accessed on September 29, 2008 at http://www.strokeassociation.org/downloadable/stroke/1219770019473Lifestyle%20Chgs%20to%20Prevent%20Stroke.pdf
American Stroke Association [ASA]. (2008). Converging risk factors. Site accessed on September 29, 2008 at
http://www.strokeassociation.org/presenter.jhtml?identifier=3027394
American Stroke Association [ASA]. (nd). Stroke risk awareness survey. Site accessed on September 29, 2008 at http://www.strokeassociation.org/downloadable/stroke/1130509929967PTES%20Risk%20Assessment%20Card.pdf
Dufresne, J. & Greene, V. (1990). Medication regimens: Causes of non-compliance. Department of Health and Human Services: Offices of Inspector General. Accessed on October 6, 2008 at http://www.oig.hhs.gov/oei/reports/oei-04-89-89121.pdf
Every Day Health Network. (2008). Stroke center: Blood pressure guidelines Accessed on October 27, 2008 at http://www.everydayhealth.com/publicsite/index.aspx?puid=1c66ebdb-25c5-4042-bd9b-051cb3f9e623&xid=gslp&s_kwcid=blood%20pressure|2525548814&gclid=CMyQ8Z6rzZYCFQS7sgodBWgGzQ
Kaplan, N. &Rose B. (2008). What is goal blood pressure in treatment of hypertension? Retrieved on October 19, 2008 from Up to date at UNC -Chapel Hill.
Sebastian, J. G. in M. Stanhope & J. Lancaster (2008). The nurse leader in the community. Public health nursing: Population-centered health care in the community. (7th ed.). St. Louis, MO: Mosby.
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