Further reduction to no more than 1500 mg sodium daily is better, as it is associated with an even greater reduction in blood pressure. Reduce overall sodium intake from baseline by at least 1000 mg daily, even if goal of ≤2400 mg is not achievable; that reduction from baseline is associated with blood pressure reduction. 2–8 mm Hg Physical activity Engage in regular aerobic physical activity such as brisk walking (≥30 min/day, most days of the week). 4–9 mm Hg Moderation of alcohol consumption Limit consumption to ≤2 drinks (e.g., 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to ≤1 drink per day in women and lighter-weight people. 2–4 mm Hg TABLE 31-3 The DASH (Dietary Approaches to Stop Hypertension) Diet Food GroupNumber of Servings/Day Grains and grain products 7 or 8
Vegetables 4 or 5 Fruits 4 or 5 Low-fat or fat-free dairy foods 2 or 3 Lean meat, fish, and poultry≤2 Nuts, seeds, and dry beans 4 or 5 weekly 17. Nursing interventions o Focus on lowering and controlling the blood pressure without adverse events and without undue cost. o Education should include information on: treatment regimen, lifestyle changes, medications, follow-up appointments o Increasing Knowledge: o Pt. needs to understands disease process and how lifestyle changes and medications can control Blood pressure o Emphasize concept of controlling blood pressure rather than CURING it o Consult a dietitian for weight loss program Restricting sodium and fat intake Increase fruit and vegetables Increase physical activity Limit alcohol intake Avoid tobacco o Promoting adherence to treatment regimen o Active self-care- promotes greater sense of control Monitor blood pressure Diet o Lifestyle modification o Regularly prescribed medications o Behavior changes o Follow up at each visit to see how the patient has progressed with plans o Support groups o Promoting home, community based, and transitional care o Blood pressure screening Educate patient on what numbers mean o Educating pt. about Self Care o Provide written information about expected effects and side effects o Contact information on who to call if side effects o Education on rebound hypertension Abnormally high BP is medications are stopped abruptly o Medication Education o Beta blockers Can cause sexual dysfunction o Monitoring and managing potential complications o Review all body systems to ensure no vascular damage o Eye examination (Retinal blood vessel damage)
F&N: 18. IV fluids
19. Labs o Osmolality o Concentration of fluid that affects the movement of water between fluid compartments by osmosis. o Measures solute concentration per kilogram in blood and urine o Measure of a solutions ability to create osmotic pressure and affect the movement of water
o Serum Osmolality Concentration of sodium BUN and glucose play a role Normal- 275-290 o Urine Osmolality Determined by urea, creatinine, and uric acid Measures urine concentration Normal- 200-800 o TABLE 13-3 Factors Affecting Serum and Urine
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- Fall '16
- Denise Cauble