Hypertension
What is the definition of hypertension?
Abnormal elevation in diastolic pressure (>90 mmHg) and/or systolic pressure (>140 mmHg)
Name 2 of the 3 things patients should avoid 30 mins prior to taking their blood pressure reading?
1. Caffeine
2. Exercise
3. Smoking
Where is the home blood pressure log located to give to patients prior to their 2 week nurse visit?
Document Library
At what age should women start getting mammograms?
50 years old
Wants a baby elephant
Who is Tiffaney Gatewood
Define systolic and diastolic blood pressure
1. Systolic blood pressure is the force that the blood exerts on the walls of the arteries when the heart contracts to pump blood throughout the body.
2. Diastolic blood pressure is the pressure of the walls of the arteries when the heart relaxes and refills.
Describe proper cuff position/placement?
1. Bare upper arm
2. Positioned with the middle of the cuff bladder over the brachial artery.
3. Cuff at heart level
4. Snug fit
When should a patient return for a nurse visit to have BP rechecked?
2 weeks
Based on the USPSTF- how often should a women get a screening mammogram if they are
1. between 50-74 years old?
2. between 40-49 years old?
3. 75 and older?
1. Biennial- Every two years.
2. individual decision
3. screen only if life expectancy is at least 10 years
First girl in 2 generations, has 2 human sons, and 1 furbaby son who is almost 1 year old.
Who is Samantha Murphy
Blood pressure that is less than the 90th percentile for that age.
Describe 1 of the 2 ways to ensure proper cuff size?
1. The length of the bladder should cover 80% of the patients bare arm.
2. The width of the cuff should cover at least 40% of the arms circumference
If the initial blood pressure is elevated, what should a patient do before you recheck it again?
Sit quietly for 5 minutes, then remeasure the bp.
What do you do for a patient that had a prior abnormal mammogram with clear recommendations for a repeat study?
Per the standing order the clinical staff may order the recommended follow up study for the patient, and task to provider once done.
Has 3 dogs, 2 cats and a tiny human who just turned 1
Who is Heather Madry
What is masked hypertension?
Office readings underestimate BP readings which leads to underdiagnosis and undertreatment.
10% of all hypertensive patients.
List 3 of the 5 proper positioning techniques.
2. Legs and ankles uncrossed
3.Patient's arm supported
4. No talking or distractions
5. Do blood pressure last when rooming a patient.
What should you do with the second blood pressure reading when you recheck it during a visit?
1. Document BOTH in the vital signs section.
2. Make provider aware of both readings.
What diagnosis code do you use to order a screening mammogram?
Z12.31
Order the screening digital breast tomosynthesis bilateral 77063
Spent Valentines day in the NICU with her baby boys 2 years ago
Who is Victoria Lodato
What is hypertensive urgency and what should be done if a patient has this in clinic?
Severe elevation in BP (>180/120) WITHOUT severe symptoms
NOTIFY provider
Managed with oral medications and outpatient follow up in 24-72 hours.
List 5 of the 7 "Simple Tips to Get An Accurate Blood Pressure Reading" (as seen on the red laminated poster from the Target BP program)
1. Don't have a conversation
2. Empty bladder
3. Support Back/Feet
4. Keep legs/uncrossed
5. Support arm at heart level
6. Put cuff on bare arm
7. Use correct cuff size
What do you do at the nurse visit for the following patients-
Patient A's blood pressure is 138/78.
Patient B- 142/90
Patient C- 162/101
Patient A- document the nurse visit
Patient B- recheck blood pressure, document both, and schedule an appointment for PCP follow up as soon as possible.
Patient C- recheck blood pressure, notify provider to determine next actions and document both readings.
If a patient refuses a mammogram, what are 2 of the 4 things you should do?
1. Discuss reasons for refusal
2. Offer education about breast cancer screening
3. Note refusal in NextGen
4. Add Alert to patient's chart
Can be found at the gym most days at 0400 and once did a 30 min wall sit
Who is Samantha Murphy