The nurse can encourage the patient to consult a dietitian to help develop a

The nurse can encourage the patient to consult a

This preview shows page 11 - 13 out of 29 pages.

than curing it. The nurse can encourage the patient to consult a dietitian to help develop a plan for improving nutrient intake or for weight loss. The program usually consists of restricting sodium and fat intake, increasing intake of fruits and vegetables, and implementing regular physical activity. Explaining that it takes 2 to 3 months for the taste buds to adapt to changes in salt intake may help
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the patient adjust to reduced salt intake. The patient should be advised to limit alcohol intake (see Table 31-2 for specific recommendations), and tobacco should be avoided because anyone with high blood pressure is already at increased risk for heart disease, and smoking amplifies this risk. Educating Patients About Self-Care. The therapeutic regimen is the responsibility of the patient in collaboration with the primary provider. The nurse can help the patient achieve blood pressure control through education about managing blood pressure (see earlier discussion), setting goal blood pressures, and providing assistance with social support. Involving family members in education programs enables them to support the patient’s efforts to control hypertension. The American Heart Association and the National Heart, Lung, and Blood Institute both provide printed and electronic patient education materials. Providing written information about the expected effects and side effects of medications is important. When side effects occur, patients need to understand the importance of reporting them and to whom they should be reported. Patients need to be informed that rebound hypertension (i.e., abnormally high blood pressure) can occur if antihypertensive medications are suddenly stopped. Thus, patients should be advised to have an adequate supply of medication, particularly when traveling and in case of emergencies such as natural disasters. If traveling by airplane, patients should pack the medication in their carry-on luggage. All patients should be informed that some medications, such as beta-blockers, might cause sexual dysfunction and that other medications are available if problems with sexual function or satisfaction occur. The nurse can encourage and educate patients to measure their blood pressure at home. This practice involves patients in their own care and emphasizes that failing to take medications may result in an identifiable rise in blood pressure. Patients need to know that blood pressure varies continuously and that the range within which their pressure varies should be monitored. TABLE 31-2 Lifestyle Modifications to Prevent and Manage Hypertensiona Modification Recommendation Goal of SBP Reduction (Range)b Weight reduction Maintain normal body weight (body mass index 18.5–24.9 kg/m2). 5–20 mm Hg/10 kg Adopt DASH eating plan Consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat.8–14 mm Hg Dietary sodium reduction Reduce dietary sodium intake to ≤2400 mg sodium daily.
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  • Fall '16
  • Denise Cauble
  • Nursing

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