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Mrs. Johnson is a 72-year-old African American woman with primary hypertension diagnosed 22 years ago after she went through menopause. According to her family history, her father had high blood pressure and her grandfather died of a stroke at the age of 63. She worked at an insurance office for about 40 years until she retired 5 years ago. She states she feels “pretty overwhelmed” since her husband was diagnosed with Alzheimer’s disease 6 months ago. At this time, she takes hydrochlorothiazide (Microzide) 50 mg twice a day and amlodipine (Norvasc) 10 mg a day. She tells you that she has missed doses lately because she has been so busy with her husband.
- What are Mrs. Johnson’s risk factors for hypertension?
- What teaching should the practical nurse reinforce for Mrs. Johnson about her antihypertensive drugs?
- Please describe concerns you have as a practical nurse considering her history and assessment findings.
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- Professional organization, style, and mechanics in APA format
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- 2 References – must contain at least two professional references, published within the past 5 years
Title: Managing Hypertension in Mrs. Johnson: A Practical Nurse’s Perspective
Introduction
Hypertension, commonly known as high blood pressure, is a prevalent chronic condition that affects millions of individuals worldwide. Mrs. Johnson, a 72-year-old African American woman, has been living with primary hypertension for over two decades. This paper aims to assess Mrs. Johnson’s risk factors for hypertension, provide essential teaching points concerning her antihypertensive medications, and discuss concerns a practical nurse should consider based on her history and assessment findings.
Mrs. Johnson’s Risk Factors for Hypertension
- Family History: Mrs. Johnson’s family history is a significant risk factor for hypertension. Both her father and grandfather had high blood pressure, which suggests a genetic predisposition to the condition. This genetic influence increases her likelihood of developing hypertension.
- Age: At 72 years old, Mrs. Johnson falls into the older age group, which is at a higher risk of developing hypertension. Age-related changes in blood vessels and decreased elasticity contribute to elevated blood pressure in the elderly.
- Gender and Menopause: Being a woman, Mrs. Johnson’s risk factors are further exacerbated by her gender. Postmenopausal women are more prone to hypertension due to hormonal changes. Estrogen, which offers some protection against high blood pressure, decreases after menopause.
- Lifestyle Factors: While Mrs. Johnson’s occupation and retirement may not be direct risk factors, stress related to her career and the recent diagnosis of her husband with Alzheimer’s disease can contribute to hypertension. Chronic stress can elevate blood pressure over time.
- Medication Non-Adherence: Mrs. Johnson admits to missing doses of her antihypertensive medications due to her caregiver responsibilities. Medication non-adherence is a significant risk factor for uncontrolled hypertension and its complications.
Teaching Points for Mrs. Johnson
As a practical nurse, it is crucial to reinforce essential teaching points regarding Mrs. Johnson’s antihypertensive medications:
- Medication Adherence: Emphasize the importance of taking her medications consistently as prescribed. Missed doses can lead to uncontrolled blood pressure and increase the risk of cardiovascular events.
- Side Effects: Educate Mrs. Johnson about potential side effects of hydrochlorothiazide (Microzide) and amlodipine (Norvasc). Common side effects include dizziness, headache, and electrolyte imbalances. She should report any unusual symptoms promptly.
- Lifestyle Modifications: Encourage Mrs. Johnson to adopt a heart-healthy lifestyle, including a low-sodium diet, regular exercise, stress management techniques, and limiting alcohol intake. These measures can complement her medication regimen.
- Monitoring: Teach Mrs. Johnson to monitor her blood pressure at home using a reliable blood pressure monitor. Regular self-monitoring can help her track her progress and identify potential issues.
- Regular Follow-up: Stress the importance of attending regular follow-up appointments with her healthcare provider. These visits allow for medication adjustments and monitoring of her overall health.
Concerns as a Practical Nurse
Considering Mrs. Johnson’s history and assessment findings, several concerns must be addressed:
- Medication Adherence: Mrs. Johnson’s recent medication non-adherence due to caregiver responsibilities is a significant concern. The practical nurse should explore solutions to help her manage her husband’s condition while ensuring she adheres to her antihypertensive regimen.
- Psychological Well-being: Mrs. Johnson expressed feeling overwhelmed due to her husband’s Alzheimer’s disease diagnosis. This emotional stress can negatively impact her blood pressure control. The practical nurse should assess her mental health and provide resources for emotional support.
- Individualized Care: Mrs. Johnson’s unique situation requires a personalized care plan that accommodates her caregiving responsibilities and addresses her stressors. The practical nurse should collaborate with the healthcare team to create a tailored plan that optimizes her hypertension management.
- Education and Empowerment: Continual patient education is vital. The practical nurse should ensure Mrs. Johnson fully understands her condition, medications, and lifestyle modifications. Empowering her with knowledge can enhance her confidence in managing hypertension.
Conclusion
Mrs. Johnson’s case highlights the importance of addressing multiple risk factors for hypertension in older adults, including genetics, gender, age, and lifestyle factors. As a practical nurse, providing comprehensive education and support to Mrs. Johnson is essential for improving her hypertension management. Additionally, recognizing and addressing her unique caregiving situation and emotional stressors are crucial for her overall well-being and long-term health. A collaborative approach between healthcare professionals and Mrs. Johnson is essential in achieving optimal blood pressure control and preventing complications associated with hypertension.