Understanding Dyslipidemia and Hypertension

This assignment delves into the complex mechanisms driving dyslipidemia and hypertension. Students are tasked with analyzing a set of research articles focusing on the pathophysiology of these conditions, considering factors like obesity, genetics, and chronic kidney disease. The goal is to develop a comprehensive understanding of how these interrelated disorders manifest and progress.

NURSING'S CASE
STUDY

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Identification of priority problem - Hypertension.......................................................................1
Pathophysiology of Hypertension...............................................................................................1
Nursing interventions to treat hypertension................................................................................2
Priority problem 2: Dyslipidaemia..............................................................................................4
Pathophysiology of Dyslipidaemia.............................................................................................4
Nursing interventions to treat Dyslipidaem................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Nursing plays an important role in health care services. These are those practitioners
which helps patients with their entire medication and care services. The report will outline the
case of study of Simmons, Beryl who is 50 year old lady suffering from Hyper tension. To
reduce health issue she attends Healthy heart Workshop at local community Centre. The report
will focus on her two priority problems that is Blood pressure and Dyslipidaemia. As per the
analysis it has been discovered that despite of high cholesterol and tension she regularly intakes
two or three glasses of wine. She hardly exercises due to lack of time as she is mother of three
children and she always ahas to look after their studies and education. Thus, the report will
outline pathophysiology to analyse relationship between priority problem and Beryl signs and
symptoms. Also, it will identify nursing intervention to prevent her form high cholesterol and
increasing blood pressure.
MAIN BODY
Identification of priority problem - Hypertension
From the analysis of case study of Beryl Simmons, it was identified that she was
suffering with hypertension due to higher blood pressure. The blood pressure of Beryl recorded
was 160/90. The normal blood pressure according to healthcare professionals in human beings
would be 120/80 to 140/90 (DeMarco, Aroor and Sowers, 2014). Thus, she was suffering from
high blood pressure. Blood pressure is the pressure that the blood gives against the vascular
system as it moves through the body. If the blood pressure is too low then blood can't reach
periphery or brain and if the blood pressure is too high, it will start damaging organs and vessels.
Higher blood pressure can be because of activation of sympathetic nervous system. The
activation could activate alpha receptor which cause blood vessels to constrict and activate beta
receptor which increases heart rate and force of contraction. Blood pressure can be increased due
to smoking, overweight, higher cholesterol or from medications and supplements. Hypertension
is considered as one of the most chronic diseases which affect the life of many people living
worldwide. It is also one of the major risk factors for cardiovascular disease which affected 8
million Australians aged 18 years and above. Prevalence of hypertension increased with age and
without proper care and support, it has become life threatening.
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Pathophysiology of Hypertension
Pathophysiology is a division of medicine which elaborates the functions of body as it
relates to disease and conditions. The elevation of blood pressure refers to hypertension and
pathophysiology of hypertension elaborates mechanistically the causes of hypertension. In order
to maintain cardiovascular homeostasis through pressure, volume and chemoreceptor signals, the
autonomic nervous system play an essential role. This can be done by controlling peripheral
vasculature, kidney function which in turn affect cardiac output, vascular resistance and fluid
retention (Yannoutsos and et.al., 2014). Excessive activities in the sympathetic nervous system
enlarge blood pressure and thus, contributes to hypertension. From the analysis of case study, it
was identified that Beryl spends most of her day in stress and her recent divorce further increases
her stress. Excessive exposure to stress enhances sympathetic outflow and repeated stress-
induced vasoconstriction that may result in vascular hypertrophy which leads to increase in
peripheral resistance and thus, increase blood pressure. Blood pressure could also increase
through higher cholesterol level (Wirix and et.al., 2015).
It was identified that Beryl was identified with higher cholesterol level. Her eating
practices was also not healthy which increases her cholesterol level. Too much cholesterol in
blood may increase risk of cardiovascular disease such as heart attack and stroke. If hypertension
remains untreated then patient may observe stroke, cerebral haemorrhage, Myocardial Infarction,
angina, heart failure, renal failure and Peripheral Vascular Disease. In order to reduce the effects
of hypertension and minimise higher blood pressure, it is important for the healthcare
professionals to implement precise interventions. As hypertension is considered as one of the
most common chronic diseases, it is essential for individuals suffering from hypertension to
contact healthcare professionals immediately so that the issue can be effectually resolved or
minimised.
Nursing interventions to treat hypertension
To reduce or resolve the issue of hypertension in patient, it is important for nurses and
healthcare professionals to devise effective and efficient strategies which can help the patient to
eliminate the problem of hypertension (Di Giosia and et.al., 2018). From the analysis of case of
Beryl, it was identified that her eating practices were not healthy as she drinks two or three
glasses of wine per night and eats a lot of take away foods which contains high calories which
increases the cholesterol. Furthermore, it was identified that she often forgot to take her
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medications on time. This negatively impacted on her present conditions. In this context, the
nursing intervention and care plan in accordance with the case study to treat hypertension are
formulated as below: Assessing risk or presence of conditions associated with obesity: In order to prepare the
care plan, it is important for nurses to assess the risk of conditions associated with obesity
as it is an added risk with high blood pressure. Assessing patient understanding: Here, nurses provide patient’s knowledge regarding
direct relation of hypertension and obesity (Griffin, Polichnowski and Bidani, 2016).
Reduction in weight may obviate the need for drug therapy or decrease the amount of
medication needed for control of BP. Preparing diet plan for patient: Here, nurses ensure that patient reduces his or her
calorie intake and minimise salt, fats and sugar in food. Excessive salt intake expands the
intravascular fluid volume which can increase hypertension. Determining patient desire to lose fat: Nurses have to make sure that patient is
determined to lose weight. From the analysis of height and weight of Beryl, it was
identified that her body mass index was 46.7 which is considered as obese. Thus, nurses
have to ensure that Beryl is determined to lose extra fat in order to stabilise her condition. Reviewing caloric intake and dietary choices: Nurses need to identify the strengths and
weaknesses of the current dietary programs through proper evaluations and needs to
make necessary improvements in order to improve the diet intake of Beryl. This is done
in order to reduce the rate of blood pressure from hypertension to normal Providing medication time schedule for patient: Nurses as a part of their intervention
needs to produce a medication time schedule for patient which can help the patient to
know the time for taking medicines. This will help in lowering her blood pressure
effectively and efficiently.
 Refer to dietician: If the diet plan is not working as expected then nurses need to
communicate to dietician in order make the diet plan more robust and effective.
Thus, the above nursing intervention is made by analysing the case of Beryl. As it was
identified that she was having high cholesterol which impacts on her blood pressure and
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hypertension. This nursing intervention will help in lowering her blood pressure and eventually
hypertension.
Priority problem 2: Dyslipidaemia
Dyslipidaemia is fats in blood or raised cholesterol. This is developed in body when due
to obesity, eating disorders, lack of exercise and routine mismanagement like in case of Beryl,
who is focused on managing children and despite of hypertension she lacks exercising (Taskinen
and Borén, 2015). Moreover, it is caused when lipids are overproduced in blood and the
increasing impact of these diseases are abnormal. Dyslipidaemia is common problem in modern
era and it occurs due to unhealthy lifestyle of individuals. Increasing blood pressure which is
160/95 and increasing weight which is 105kg, helped in identifying that is suffering from high
cholesterol which can be due to hypertension, and unusual daily routine. Further, it is caused due
to cigarette smoking, Elevated Lipoprotein, high blood pressure, family history. It can be sad
that if Beryl keep on ignoring exercising and drinking wine than there is probability that
Dyslipidaemia turns into diabetes. Basically, disorder of lipids is categorized into two that is
Phenotype and Etiolog where Phenotype occurs due to increase of fatty lipids in blood whereas
Etiology occurs when person suffers form Dyslipidaemia due to family history. Atherogenic
dyslipidemia is identified by high low-density lipoprotein (LDL) particle number, low levels of
high-density lipoprotein (HDL) and high levels of triglycerides. Dyslipidaemia can lead to
cardiovascular disease, can be evidence. High LDL cholesterol levels are connected with
coronary artery disease (CAD), that is blockage in the arteries of heart and peripheral artery
disease (PAD), that is blockage in the arteries of your legs. The main indication of PAD is leg
hurting when walking. Thus, CAD denotes chest pain and cardiac arrest.
Pathophysiology of Dyslipidaemia
Dyslipidaemia starts from damaged Atheerosclerotic Plaque is in Epicardial Coronory
Artery section. This level of lipid disorder starts dangerous for both men and women., This is the
stage which is curable and can be cured by proper medication and therapy. Further, the problem
increases to Atherosclerotic Plaques where fatty streaks turns into lipid rich plaque, lipid core
that turns into fibrous cap and lastly it takes place of Thrombus. Increasing impact of
Dyslipidaemia further turns into Occluded Coronary Artery, in this lipid retention occurs in
vessel which leads to Necrotic atherosclerotic lesion. The lesion are converts into plaques which
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are highly risk to trigger acute lumenal thrombosis and it ultimately leads to molecular
cardiology (Yin and et.al., 2012). It occurs to person who has been suffering from high blood
pressure, hyper tension. In addition, it can be said that hyper tension and Dyslipidaemia to Beryl
can lead to diabetes and cardiovascular Mortality if she continues suffering from Hypertension
also taking wine every day. Thus, low density of lipopropteins reflects cholesterol from liver to
peripheral tissues. Excess of peripheral tissues increases the chance of atherosclerosis. However,
cholesterol from vascular tissues to liver for removal minimizes chance of atherosclerosis
(Rotondo and Davidson, 2010). Cardiovascular Mortality is the situation which can be easily
cured and is life threatening. This can lead to cardiac arrest, strokes etc. Thus, it is important for
Beryl to follow suggested nursing intervention to prevent further dangerous
Nursing interventions to treat Dyslipidaem
Nursing intervention plays an important role in preventing diseases. Like it helps the
person in understanding about their problem and measure to overcome them. In case of Beryl,
Dyslipidaemia is life threatening diseases and can said that it is cause due to her high blood
pressure and daily drinking habits (Yannoutsos, and et.al., 2014). Pathophysiology of
hypertension: interactions between macro and microvascular alteration. However, the
intervention can assist her in making proper routines and diet follow ups to reduce cholesterol
and to norm high blood pressure. The intervention in case of Dyslipidaemia of Beryl will be as
follows:
Dietary n modification: Diet is the common is the routine which plays an important role
in preventing diseases. For Beryl the modification will be based on reducing trans and saturated
fats. This will help in replacing polyunsaturated and mono-unsaturated fat (Arnaldi and et.al.,
2010). The diet will be consist of soluble fibre, enriched milk, margarine and no alcohol. All the
edibles will be focused on less of cholesterol and reducing weight.
Proper and regular medication: This intervention will be focused on medication on
right time which comprise HMG CoA Reductase, which helps in body in limiting excess to
cholesterol. Apart from this, medicines will be imvastatin
, atorvastatin
, rosuvastatin.
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Physical exercises: In case of hyper tension and high cholesterol, it is important for the
individual to exercise regularly. It assists the person in managing diet and physical working is bet
strategy which helps the person is distracting mind and reducing intake of unhealthy diet.
Regular check: Regular check up on health and diagnosing is the best practice which
helps in reducing chance of increasing health problems. Like in case of Cholesterol it is
important for Beryl to regularly visit for diagnosis in order to know about body changes with
change in diet.
Health programs: Visiting healthy programs for understanding about different solution
which can assist in Beryl in developing understanding over the diet plans and habits which can
help her in preventing causes of increasing cholesterol ((Saland, Ginsberg and Fisher, 2002).
Hence, following these interventions are based on basic routine which aims at proper
food and regular habits like check-up and physical exercises. It can help the lady in minimizing
cholesterol and risk of life.
CONCLUSION
The report summarized about tow priority problems of 5 year old lady Beryl. She is
suffering from Hyper tension and Dyslipidaemia. Despite of health problems he never quits in-
taking three glass of wine every day. Moreover, she does not exercise as according to her, she
has very packed routine. The report outline pathophysiology of her two priority problems and
suggested nursing intervention to it. The pathophysiology of hyper tension comprise about
excessive activities in nervous system blow up blood pressure and leads to life threats like,
Myocardial Infarction, angina, heart failure, Renal failure and Peripheral Vascular etc. However,
from Pathophysiology of Dyslipidaemia is lipid disorder which leads to Cardiovascular
Mortality. Also, report outlined nursing intervention of hypertensions OF beryl are, proper
dietary habits, medication, reviewing caloric intake and diet plans etc. Thus, the report concluded
by stating nursing intervention for Dyslipidaemia which comprise physical exercise, regular
check up, involving in health programs etc.
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REFERENCES
Books and Journals
Arnaldi, G., Scandali, V. M., Trementino, L., Cardinaletti, M., Appolloni, G., & Boscaro, M.
(2010). Pathophysiology of dyslipidemia in Cushing’s syndrome. Neuroendocrinology.
92(Suppl. 1). 86-90.
DeMarco, V. G., Aroor, A. R., & Sowers, J. R. (2014). The pathophysiology of hypertension in
patients with obesity. Nature Reviews Endocrinology, 10(6), 364.
Di Giosia, P., Giorgini, P., Stamerra, C. A., Petrarca, M., Ferri, C., & Sahebkar, A. (2018).
Gender Differences in Epidemiology, Pathophysiology, and Treatment of
Hypertension. Current atherosclerosis reports, 20(3), 13.
Griffin, K. A., Polichnowski, A. J., & Bidani, A. K. (2016). Pathophysiology of Hypertension in
Chronic Kidney Disease and Dialysis. In Core Concepts in Hypertension in Kidney
Disease (pp. 35-61). Springer, New York, NY.
Rotondo, D., & Davidson, J. (2010). Genetics and molecular biology: identification of
dyslipidemia genes. Current opinion in lipidology. 21(6). 548-549.
Saland, J. M., Ginsberg, H., & Fisher, E. A. (2002). Dyslipidemia in pediatric renal disease:
epidemiology, pathophysiology, and management. Current opinion in pediatrics. 14(2).
197-204.
Taskinen, M. R., & Borén, J. (2015). New insights into the pathophysiology of dyslipidemia in
type 2 diabetes. Atherosclerosis, 239(2), 483-495.
Wirix, A. J. G., Kaspers, P. J., Nauta, J., Chinapaw, M. J. M., & Kist‐van Holthe, J. E. (2015).
Pathophysiology of hypertension in obese children: a systematic review. Obesity
reviews. 16(10). 831-842.
Yannoutsos, A., Levy, B. I., Safar, M. E., Slama, G., & Blacher, J. (2014). Pathophysiology of
hypertension: interactions between macro and microvascular alterations through
endothelial dysfunction. Journal of hypertension. 32(2). 216-224.
Yin, W., Carballo-Jane, E., McLaren, D. G., Mendoza, V. H., Gagen, K., Geoghagen, N. S., ... &
Wolff, M. (2012). Plasma lipid profiling across species for the identification of optimal
animal models of human dyslipidemia. Journal of lipid research. 53(1). 51-65.
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