Confirm Eligibility
Age requirement for referral?
18+
What is the best diet for a patient with High Blood pressure?
DASH diet
fruits, vegetables, low fat dairy, low sodium
What is the stage of CKD excluded from protocol?
Stage 4
What labs are needed after starting algorithm meds
mg +
BMP
what vital signs need to be completed during every HTN visit
blood pressure, HR, oxygen sat. RR, weight, and pain score
what Dx is needed
Primary HTN
BP goal for HTN management?
130/80 or less
What heart rate measurement should a provider be notified?
greater than 110 or less than 50
when would you schedule labs after starting algorithm med?
1-4 weeks
initial visit and then annually
Once the referral is placed, when does it expire?
12 months
Home BP monitoring encouraged? (Yes/No)
Best ways for accurate reading?
yes
Use a validated upper-arm cuff
Sit quietly 5 minutes before measuring
Feet flat, back supported, arm at heart level
No caffeine, exercise, or smoking 30 minutes prior
Take 2 readings, 1 minute apart
Measure morning and evening
What percentage of weight change should we notify provider?
greater than 10%
When does the patient get scheduled to see nurse after starting algorithm medication?
4 weeks
What if the patient shows up for the visit and provider has not reviewed labs first can we still see patient?
yes, we can not titrate medication without speaking to provider first.
What blood pressure is needed to qualify for protocol?
greater or equal to 130/80
What is the limit in mg of sodium one should intake in a day
1500-2300 mg/day
What oxygen saturation would we notify provider?
less than 90%
What needs to be reviewed before nurse visit is scheduled?
provider needs to be review labs
Can we manage patient if the labs were completed the same week of starting meds?
No, we would have to cancel referral and send back for provider management.
What medication options does the patient need to be placed on prior to the referral?
Lotrel or Azor
what type of exercises are most effective for HTN patients?
moderate aerobic exercise/walking
what category of patients are we not able to treat in the HTN protocol?
pregnant patients
Dx of secondary HTN
Dx of CAD
Dx of heart failure
nursing home residents
home care patients
What specific flowsheets need completed during initial patient visit?
RN HTN MGMT- AVERAGE PT REPORTED BP
RN HTN MGMT-BP TECHNIQUE VERIFIED
EPWORTH SLEEPSTUDY/STOP BANG ASSESSMENT
Who is responsible for placing the referral and ordering initial medication?
the provider