Treating Hypertension in R.S.
Added on 2020-05-16
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1Running head: NURSING Nursing Name of student:Name of university:Author note:
2NURSING List specific goals for treating R.S.’s hypertension.Management of hypertension is a comprehensive process in which several factors areto be addressed for achieving desired patient outcomes. For treating R.S’s hypertension, a setof nursing goals would be crucial considering the clinical conditions the patient is presenting.According to Siu (2015), high pressure is mainly caused due to obesity, lack of regularphysical exercise, increased consumption of tobacco and alcohol and chronic diseases such asdiabetes. With increased weight, the body requires more supply of nutrients and oxygen tothe tissues. This increases the pressure on the artery walls. Lack of regular physical activityincreases the chances of becoming overweight and thus increased blood pressure. Excessiveconsumption of alcohol and tobacco raises the blood pressure on a temporary basis anddamages the artery wall lining. Further, diabetes has been directly linked to elevated bloodpressure across the literature. In the present context, the primary goal of the patient’ treatmentwould be the maintenance of appropriate body weight, management of blood glucose level,increased physical activity and reduced consumption of alcohol and tobacco. The patient isoverweight with 90 kgs at the age of 65 years. His mobility is restricted due to gout which isa form of arthritis. Further, he is suffering from type 2 diabetes for the past one decade. Inaddition, he is a regular smoker and alcohol consumer. What drug therapy would you prescribe? Why?A number of therapeutic agents aid in the pharmacological management ofhypertension. The patient in the present case would be prescribed drug therapy of angiotensinconverting enzyme inhibitors (ACEIs). According to Ganesh and Viswanathan (2011) indiabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line inthe management of hypertension. Angiotensin converting enzyme inhibitors are effective inreducing morbidity and mortality rates in the patient. The inhibitors fundamentally act bysuppressing the rennin-angiotensinaldosterone system. The drugs cause prevention of the
3NURSING conversion of angiotensin I to angiotensin II and block the major pathway of bradykinindegradation by inhibition of ACE. The drug, therefore, reduces the activity of the rennin-angiotensin-aldosterone system (RAAS) as the main causal event in the development ofhypertension in patients suffering from diabetes. Some of the commonly used ACEI drug inthe US are Fosinopril, Captopril, Ramipril and Enalapril (Karch & Karch, 2016). What are the parameters for monitoring success of the therapy?According to Lehne and Rosenthal (2014) before commencing on the drug therapywith ACEI, patients must be monitored for renal function, urea, serum creatinine and serumpotassium level. These measurements are to be repeated on week after the commencement ofthe therapy and after one week after each increase in dosage. The lowest recommended doseof ACEI is to be used at the initial level, aiming for the target dose. ACE inhibitors lowerarterial resistance and increase venous capacity. As a result, there is a decrease in cardiacindex, cardiac output, stroke work and volume. These aspects are to be monitored adequatelyto for understanding the success of the therapy. Discuss specific patient education based on the prescribed therapy.Patient education is of prime importance when the ACEI drug therapy is in practice.The patient is to be advised to avoid engaging in strenuous physical activity until there are nosigns of dizziness. In addition, the patient is also to be educated that the therapy must not bestopped without medical consultation. Further, he is to be advised to rise slowly for avoidingpostural hypotension (Adams & Urban, 2015). List one or two adverse reactions for the selected agent that would cause you to changetherapy.While ACEI drug therapy is effective in addressing hypertension in diabetic patients,there is a risk of adverse effects. For patients who do not tolerate ACEI drugs well, adverse
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