NUR 518-Monitoring Blood Pressure in A Home Based Setting

ORDER NOW FOR AN ORIGINAL PAPER!!! NUR 518-Monitoring Blood Pressure in A Home Based Setting .

Create a PICOT Topic/Question (see PICOT Powerpoint: Students will brainstorm a problem or issue important in their practice area which they would like to see improved or learn more about. Each student will develop a PICOT question that includes: (POPULATION/PROBLEM, INTERVENTION/EXPOSURE, COMPARISON, OUTCOME) AND TIME (OPTIONAL). This question will establish your topic. Each student will write a 1-page narrative nothing the PICOT question, why you chose this question/problem/topic and why it is significant to your practice.

MY PRACTICE AREA IS South Florida.

1. When to Screen for High Blood Pressure:

The USPSTF recommends screening for high blood pressure in adults aged 18 years or older. The USPSTF recommends obtaining measurements outside of the clinical setting (at home) for diagnostic confirmation before starting treatment. Monitoring Blood Pressure in A Home Based Setting

2. American College of Cardiology (ACC) and the American Heart Association (AHA), now define blood pressures of as hypertensive: 130/80 or greater

How to diagnose HTN: at least two elevated measurements – five minutes apart, one in each arm – should be made on two or more visits. A patient cannot be diagnosed with hypertension if the patient is acutely ill or in acute pain at the time of the measurement.

4. What heart anomaly will cause differing BPs in upper and lower extremities?

Coarctation of the aorta

Technique for Taking Blood Pressure: Patient should be seated quietly for at least five minutes in a chair with their back supported, rather than on an examination table. The arm should be supported at heart level. Blood pressure should be auscultated with a stethoscope using a properly calibrated and validated instrument. The most important point is that an appropriately sized cuff be used to ensure accuracy. The length of the bladder of the cuff should be at least 80% of the arm circumference. A cuff that is too small will give you an erroneously high blood pressure Adults with obesity may require an extra large or “thigh-sized” cuff
What elevation of BP would you start two medications? More than 20/10
Initial medications for essential hypertension: thiazides, CCB, ACEIs/ARBs
Which electrolyte levels can be affected by thiazides? sodium –> hyponatremia potassium –> hypokalemia
Initial Testing for New Diagnosis of Hypertension: Lipid profile, Basic Metabolic Panel, Thyroid Stimulating Hormone, Urinalysis, Electrocardiogram, Measurement of urinary albumin excretion or albumin/creatinine ratio (optional)
Which lifestyle modification will decrease blood pressure the most? DASH eating plan (will drop it ~11 mmHg) (if a patient loses more than 11 kg then weight loss will lead to a more significant drop in BP)
When to Initiate Aspirin in Patients with Hypertension: The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years

ORDER NOW FOR AN ORIGINAL PAPER!!! NUR 518-Monitoring Blood Pressure in A Home Based Setting .
If thiazides don’t reach target BP what is next step? Add a different primary class BP med ACEI/ARB, CCB

13. Do not combine ARB and ACEI due to risk of what? Hypokalemia

Do not combine ARB and ACEI due to risk of what? Hyperkalemia
Stage 1 HTN range: 130-139/80-89 mm Hg
Stage 2 HTN range: 140 or higher systolic or 90 or higher diastolic