Hypertension is a medical condition whereby the blood pressure in the arteries is elevated to very high levels. Hypertension may either be primary or secondary. In the primary type the cause of the condition cannot be attributed to any other medical condition while secondary hypertension is as a result of other medical conditions like tumor. Stress can also lead to the increase in the blood pressure. The client in this case is a male patient suffering from hypertension. From the outside the patient looks quite normal until his blood pressure is measured. This patient was chosen for the case because he has been receiving anti-hypertensive medication for the last three years and still his blood pressure kept on increasing.
SOCIAL BACKGROUND AND PRESENT STATUS
The patient is 42 years old and married to a 38 year old lady. The couple has two children (patient’s relatives). The eldest is a 10 year old boy and the other is a 6 year old girl. The couple lives in Michigan with the man’s parents. The patient is a second born child in their family and his father died because of a kidney failure. Two of his other siblings have never been diagnosed with any hypertension or any other related medical condition. The patient is of an American nationality and he says although he does not go to church regularly he belongs to the Catholic denomination because his parents belong to the same religion too. The patient is a graduate in mechanical engineering and works in a soft drinks manufacturing industry as the production supervisor. This indicates that the patient may be taking a lot of soft drinks which are a major cause of obesity and obesity may lead to hypertension. If the situation worsens the patient may be unable to carry out his duties which require him to be active most of the time (imaginary patient). The company will then have to assign him another task like office work to make him less active (social services). The patient feels that the condition may have a great impact on his family because the family depends mostly on his earnings. The patient does not have a broad knowledge of the condition although he has lived with it for three years. The patient’s wife is a high school graduate and works in a bank as a receptionist. The wife has had basic training in administering first aid.
MEDICAL AND HEALTH BACKGROUND
The patient was diagnosed with type two diabetes two years ago and he has a problem of obesity which he says he has been trying for a very long time to take care of but in vain. The patient also confesses that he had been into alcohol drinking for the larger part of his life but he quit two years ago after being diagnosed with type 2 diabetes. The patient has a systolic blood pressure of 168mm/hg which is a huge increase as compared to the normal blood pressure of 120mm/hg. The patient indicated a diastolic blood pressure of 92mm/hg, which is also high compared to the normal one of 80mm/hg. The patient’s blood pressure increased to even higher levels because of stress or incase of lack of sleep. The patient had earlier been prescribed to some medication to take care of his condition but there was no any indication of improvement (patient’s records). During the past 5 years the patient has been taking a lot of spicy food and he also likes sweets. In his childhood the patient suffered from regular tonsillitis and colds. He had also suffered from tuberculosis in the past but it was treated. On this day the patient reported with problems in moving his bowels and a lot of sweating. The patient also complained that his perspiration was offensive and this was greatly affecting his relationship with colleagues and family members. The patient also complained of lack of sleep and bad dreams when he slept. Conducting an assessment of his physical body revealed that he was 176cm tall and a weight of 96 kilograms which indicated a very huge weight compared to the height of the patient (medical professionals). When a stress test was conducted on the patient it indicated that it was within the normal limits. Prognosis of hypertension is based on genetics, feeding habits and choices in the lifestyle of the patient. Due to the fact that the patient’s father died of a kidney failure it is likely that the condition was genetically inherited by the patient.
HEALTHCARE THERAPY AND NURSING CARE
According to the tests carried out on the patient it is clear that the patient is not suffering from severe hypertension and therefore the patient should be encouraged to change his lifestyle without first opting for drugs to curb the condition. The patient is advised to engage in activities aimed at reducing his weight which include regular exercises like walking. Exercises improve the blood flow in the body and they also reduce the blood pressure by reducing the resting rate of the heart. The patient is also advised to reduce his amount of sugar intake and at the same time avoid eating very spicy food and sweets. The diet of this patient should have low amounts of salts as this decrease the blood pressure. The diet recommended to the patient should contain a lot of fruits and vegetables and it should be fat-free to take care of the increase in weight hence lowering chances of obesity. The patient is also advised to discontinue any use of tobacco as this can lower the blood pressure and it also reduces other outcomes of hypertension like heart attack. The patient is also advised not to take a lot of coffee as it has been noted to increase the blood pressure. Although the patient stopped using alcohol two years ago he is cautioned against use of alcohol because alcohol has been noted to increase the blood pressure significantly especially the systolic blood pressure. The patient was then advised to adopt ways of reducing stress. Some of the ways recommended to the patient to enable him reduce stress were meditation, avoiding areas of high noise levels and also avoiding areas of very high illumination. The doctor recommended some antihypertensive drugs to assist in lowering the blood pressure. Each of the drugs administered to the patient was aimed at lowering the blood pressure by a small range and therefore the doctor recommended multiple drugs so as to have an overall control of the blood pressure. Other treatments included administering diuretic drugs to help in the reduction of blood pressure although the patient was also briefed on the side effects that come with the various treatments (John and Guyton, 2006). The patient’s openness of the patient made my work simple because the patient talked about his past in an open manner and he even tells the me that he is not planning to get back to drinking.
PHYSIOLOGICAL EFFECTS UPON CLIENT AND FAMILY
The family of the patient largely depends on his income and therefore if the condition becomes worse and the patient has to be laid off by the employer, his family will encounter financial difficulties because the little income earned by the wife may not be enough to support the family. The patient has got to alter his lifestyle according to the recommendations given by the doctor, for example the patient has to set some time aside for moderate exercises and he has to make major adjustments on his diets. The patient also needs to avoid areas of loud noise, high illumination and instances that may lead to stress. The patient being a mechanical engineer will have to be reassigned and this may cause a reduction in the income and therefore forcing the patient and the family to have a change of their lifestyle. The developmental tasks of the patient were altered by the medical condition because he had to change his lifestyle and diet (Hetty, 1990). The relationship that the patient had with his workmates may also be affected by the condition.
The patient was taught on ways of reducing the occurrence of hypertension; this included avoiding intake of a lot of sugar and spices. Because the patient was diagnosed with obesity he was advised on taking foods with a lot of vegetables and fruits. I also noted that the patient worked in a soft drink industry meaning that he may be consuming a lot of carbonated soft drinks that lead to obesity. The patient was therefore discouraged from taking a lot of soft drinks. The patient should change his routine to include some time for moderate exercise to begin with. The patient is expected to be able to carry out the instructions given to him and therefore it is hoped that the patient will adjust with time to the new lifestyle. The patient has to have some changes in his workplace to ensure that he does not engage in very stressing activities that may worsen the condition. The family members need to avoid any situations that may make the patient stressful. According to the observations made during the teaching the patient looks quite interested and this means that he is probably going to follow the instructions.
During this exercise I learnt that medications should not be the first step in treating hypertension but the patient should first be advised to make a change of a change in their lifestyles if the condition is not chronic. Exercise and reducing stress are some of the measures that nurses should recommend to patients suffering from this condition. In cases of severe hypertension medications are administered and different medications have different side effects on the patient. The major difficult encountered in this exercise was convincing the patient to adopt a totally different diet. The patient could not easily accept to be feeding on foods that contained no spices and so i had to explain what a change of diet meant to the patient at this time.
Hetty Z., 1990, a psychology of ultimate concern: Erik H. Erickson’s contribution to the psychology of religion, Netherlands, Rodopi publishers, pp. 230-234
John E. and Guyton C, 2006, Textbook of medical physiology, St. Louis, Elsevier Saunders Publishers, pp.227-229
Professional staff- inside and outside the institution
Social service exchange