What is Hypertension
How is Hypertension Diagnosed?
Based on 3 high blood pressure readings taken on separate occasions.
Name 3 modifiable risk factors of high blood pressure.
Lack of physical activity
Unhealthy diet, especially high in sodium
Overweight or obese
Too much alcohol
Sleep Apnea
High Cholesterol
Diabetes
Smoking
Stress
What is normal blood pressure range
less than 120/80
What can cause our bodies to go into high gear on and off for days and can cause our body to release stress hormones into the blood causing the blood pressure to rise.
Chronic Stress
Which is the Change Talk and which is the Sustain Talk in your patient's remark: "I want to lower my sodium intake, but frozen meals are so convenient".
Change Talk: "I want to lower my sodium"
Sustain Talk: "Frozen meals are so convenient"
Explain the difference between Systolic and Diastolic
Systolic blood pressure is the force on artery walls when heart beats. Top number
Diastolic blood pressure is the force on artery walls when heart muscle rests between beats. Bottom number
What percent of weight loss can lead to improved health outcomes?
5-10%
What are 5 most common medication classes used to treat high blood pressure?
Beta Blocker
ACE Inhibitors
ARBs
Calcium Channel Blockers
Diuretics
What are hidden sources of sodium?
Dining out and pre-packaged foods (canned, frozen, snacks).
What are 4 skills used in MI?
Open-ended questions
Affirmations
Reflection
Summarizing
What is the range for Stage 1 Hypertension?
Systolic 130-139
OR
Diastolic 80-89
Explain the acronym used to help remember and recognize stroke symtoms.
Face dropping
Arm weakness
Speech difficulties
Time to call
What class of medications are used to lower LDL cholesterol?
Statins
What are food sources of saturated fats?
high fat meats (animal fats)
high fat dairy (cheese, milk, butter)
Pastries (cakes, cookies)
You patient says "I know it would be good for me, but it’s just too hard to exercise regularly. I’m too busy."
Give a reflective response.
You're too busy to exercise.
What is the treatment target range for someone with hypertension?
Less than 130/80
What are 5 common warning signs of a heart attack?
Pain or discomfort in chest
Lightheadedness, nausea, or vomiting
Jaw, neck or back pain
Discomfort or pain in arm or shoulder
Shortness of breath
What 4 steps should you follow before taking your blood pressure?
Avoid smoking, eating, caffeine, and exercise for 30 minutes prior to taking
Sit calmly for at least 5 minutes
Sit back in your chair with both feet on the floor
Roll up your sleeve above your upper arm
Explain how saturated fat can impact your health.
Saturated fats raise LDL (bad) cholesterol and increases risk of cardiovascular disease.
What is a question to ask your patient when assessing motivation for lifestyle changes using MI style.
How ready do you feel to change your eating patterns and/or lifestyle behaviors?
How is your current weight affecting your life right now?
What kinds of things have you done in the past to change your eating?
What strategies have worked for you in the past?
How do you feel about changing your eating or exercise behaviors?
How would you like your health to be different?
What steps do you feel ready to take to improve your health?
Explain what hypertension is.
The heart has to pump harder than normal.
A heart that has to work harder than normal for a long time gets larger and weaker.
What is the impact of High Blood Pressure?
Can lead to multi-systems harms
Complications include stroke, heart attack, heart failure, vision loss, kidney disease, sexual dysfunction
Explain how to conduct a medication reconciliation.
Review the list of current medication prescribed by the doctor.
Review the medication that the patient is taking by reviewing the bottles and asking how the patient takes them.
Confirm the medication is not expired.
Confirm the # of refills left.
Escalate any differences to your NP.
What are the lifestyle modifications to help control blood pressure?
salt restriction
health weight
increased consumption of fruits, vegetables, low-fat dairy
Physical Activity
Avoid smoking
Limit alcohol
Manage stress levels
What are the 4 processes of Motivation Interviewing?
Engage
Focus
Evoke
Plan