NR511 ESTES.K CPG HYPERTENSION RATED A+ DOWNLOAD TO SCORE A WITH REFERENCES, Exams of Nursing

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CLINICAL PRACTICE

GUIDELINES:

Kimar Estes October 2019

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HYPERTENSION

NR 511: Differential Diagnosis and Primary Care

OBJECTIVESNR511 ESTES.K CPG HYPERTENSION RATED A+ DOWNLOAD TO SCORE A WITH

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1. Define clinical practice guidelines.

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2. Discuss the pathophysiology, incidence and prevalence of hypertension.
3. Discuss relevant recommendations and the evidence to support the recommendation for patients with hypertension.
4. Provide an example of a case of a patient with hypertension and how the patient was evaluated and treated while comparing to the clinical practice guidelines.

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What are Clinical Practice

Guidelines (CPG)?

• Recommendations
• Diagnosis and treatment

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• Health care providers
• Appropriate care and treatment
• Current medical knowledge
• Risks and benefits National Center for Biotechnology Information (2016). What are clinical practice guidelines?. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK 390308 /

PathophysiologyNR511 ESTES.K CPG HYPERTENSION of Hypertension RATED A+ DOWNLOAD TO SCORE A WITH

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Figure 1: Texas Department of Health Services Website

Incidence of Hypertension NR511 ESTES.K CPG HYPERTENSION RATED A+ DOWNLOAD TO SCORE A WITH REFERENCES

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Figure 2: American Heart Association Home Page (AHA, 2019)

PrevalenceNR511 ESTES.K CPG HYPERTENSION of Hypertension RATED A+ DOWNLOAD TO SCORE A WITH

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Figure 3: Centers for Disease Control

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and Prevention Home Page (CDC, 2019)

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Clinical

Presentation of

Hypertension

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• Dizziness
• Blurred vision or double vision
• Nausea
• Headache
• Drowsiness
• Flushed Face
• Shortness of Breath
• Nosebleeds

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Clinical Practice

Guideline Publication

• 2017 Guidelines for the Prevention, Detection, and Management of High Blood Pressure in Adults developed by

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✓ American College of Cardiology and the American Heart Association ✓ Authors are the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines ✓ Original Publication 1977 ✓ National Heart, Lung and Blood Institute ➢ Official in 2003 ✓ Joint Committee on Prevention, Detection and Treatment of High Blood Pressure

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CPG – Hypertension

Applicability to the

Primary Care Setting

• Gap bridging tool: policy, best practice, patient choice
• Variations in practice

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• Accuracy of diagnosis
• High-quality care
• Cost containment
• Mistakes and adverse events

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Clinical Practice Guideline Statements

for Hypertension

• Blood Pressure (BP) should be categorized (Class of recommendation I – STRONG).

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• Accurate Measurement of Blood Pressure in the Office (Class of recommendation I – STRONG).
• Out-of-Office and self monitoring (Class of recommendation I – STRONG).
• Secondary Forms of Hypertension (Class of recommendation I – STRONG).
• Non-pharmacological Interventions (Class of recommendation I – STRONG)

Patient NR511 ESTES.K CPG HYPERTENSION Presentation – Clinical RATED A+ DOWNLOAD TO SCORE A WITH Rotation

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• 57 year old Hispanic male – 5 feet 7 inches and 210 lbs – 32.8 BMI
• No PMH

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• No allergies, no current medications
• No Surgical History
• Mother and Father were both diagnosed with HBP by age 48 and 52 respectively
• No smoking, no drinking, no drugs
• No physical activity
• 9/5/2019 BP was 138/82 … … 10/3/2019 BP was 140/80

Diagnosis NR511 ESTES.K CPG HYPERTENSION and Treatment of RATED A+ DOWNLOAD TO SCORE A WITH Patient

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What was done: • Diagnosis: Primary Hypertension

• Logging of blood pressure at

home and work.

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• Treatment
  • Diet
  • Exercise
• No medications prescribed What was recommended: As per the CPG for high blood pressure recommendations:
  • The patient’s blood pressure readings in the office and out of the office.
  • Hypertension stage 1 and 2