Assignment: Approaches to Disease Management: Hypertension

Approaches to Disease Management: Hypertension
Accurate diagnosis and treatment are important for the realization of optimum care outcomes in healthcare. Nurses and other healthcare providers utilize their knowledge and skills in nursing to develop patient-centered care plans that address actual and potential patient needs. Therefore, this essay examines a case study of a 3-year-old who has been diagnosed with hypertension. The essay focuses on topics, including workup, differential diagnoses, assessment, management, and risk factor counseling to be included.

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The 3-year-old child required different laboratory tests to determine the severity of the hypertension. The workouts also help identify underlying secondary conditions that could be contributing to hypertension. Genetic tests should be performed if one of the family members has a history of early-age hypertension or hypokalemia. Suppressed renin activity or altered renin-aldosterone ratio will also require genetic tests. Additional tests such as urinalysis, biochemical panel tests such as blood urea nitrogen and creatinine, and renal USG should also be performed. Should the patient be obese, hemoglobin A1C, ALT, AST, and fasting lipid panel tests should be performed. Optional tests should also be considered based on the patient’s health status. They include thyroid-stimulating hormone tests, fasting serum glucose, and sleep studies if the patient has a history of apnea (Göknar & Çalışkan, 2020). Some of the differential diagnoses that should be considered include secondary hypertension, coarctation of the aorta, chronic kidney disease, and renal artery stenosis.
The child should be assessed for causes or risk factors for hypertension. This includes obesity, overweight, renal diseases, aortic coarctation, pheochromocytoma, hyperthyroidism, Cushing syndrome, congenital adrenal hyperplasia, monogenic hypertension, and exposure to heavy metals such as lead and mercury. Treatment should be initiated to prevent end-organ damage and lower the risk of cardiovascular and hypertension disease in adulthood. Lifestyle and behavioral modifications are recommended alongside pharmacotherapy. The interventions include increased olive oil consumption, restricted dietary intake of salt, engaging in active physical activity, and increased intake of vegetables, fruits, low-fat milk products, chicken, lean meat, and fish (Göknar & Çalışkan, 2020).
Pharmacotherapy will be considered if lifestyle and behavioral modifications are unsuccessful; the patient is diagnosed with stage 2 hypertension in the absence of any modifiable risk factors, or if there is end-organ damage. Clinical evidence recommends prescribing children angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, long-acting calcium channel blockers, or thiazide diuretics as the initial therapy. The child should be started on a low dose of a single drug and monitored closely after every 2-4 weeks. A diuretic can be added if the child does not show favorable improvements in blood pressure control. The treatment would not change if the child were 10 years old (Göknar & Çalışkan, 2020; Iqbal & Jamal, 2024). This is because lifestyle and behavioral modifications alongside pharmacotherapy would still be the appropriate interventions for the patient.
The family should be counseled and educated on issues related to hypertension management and risk factors. Health education should focus on risk factors for hypertension such as obesity, overweight, increased dietary intake of salt, unhealthy diets, and physical inactivity. Genetic counseling should also be offered should the provider identify an increased risk of genetic predisposition in the family. The family should be educated on the importance of treatment adherence and blood pressure monitoring to determine treatment adherence (Göknar & Çalışkan, 2020). Health education should also increase the family’s awareness about the complications of hypertension and its signs to facilitate timely diagnosis and management.
Overall, different laboratory investigations will be performed on the client. The appropriate management includes pharmacotherapy and lifestyle with behavioral modification. The family should be educated and counseled on issues related to hypertension risks and management. Differential diagnoses should be ruled out for appropriate treatment and improved outcomes.
References
Göknar, N., & Çalışkan, S. (2020). New guidelines for the diagnosis, evaluation, and treatment of pediatric hypertension. Turkish Archives of Pediatrics/Türk Pediatri Arşivi, 55(1), 11–22. https://doi.org/10.14744/TurkPediatriArs.2020.92679
Iqbal, A. M., & Jamal, S. F. (2024). Essential Hypertension. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK539859/

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Approaches to Disease Management: Hypertension

After studying Module 6: Lecture Materials & Resources, discuss the following:

You see a 3-year-old with hypertension (documented on three different visits) in your primary care clinic.

Describe the workup, differential diagnoses, assessment, and management.

How would your plan of care be different if the child were 10 years old?

What risk factor counseling and advice would you include?

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources