Hypertension Crisis

Hypertension Crisis
[Name]
[Institution Affiliation]
[Date]

Hypertension Crisis
A presentation of hypertension combined with diabetes mellitus can be difficult to manage although not impossible. The responsibility of a nurse in such a case should be to motivate willingness for adherence to the formula that is chosen. In most cases, persistence in taking the medication is the most important part of the disease management. The two diseases can be controlled by a particular set of drugs combined with lifestyle changes. (Song et al., 2016) Prescriptions that can be used for hypertension control include thiazide diuretics, beta-blockers, angiotensin converting enzymes, calcium channel blockers and renin inhibitors. Of these drugs, it is indicated that C.J has been taking Lisinopril. This is one of angiotensin converting enzyme that works through the relaxation of blood vessels. It is possible that C.J additionally received a prescription for calcium channel blockers. This medicine has been shown to perform very well in black older men. They are a proper replacement for beta blockers which do not work efficiently on older black men. For diabetes mellitus, conventional medication involves insulin therapy. (Song et al., 2016)
Luckily, both diseases have very similar lifestyle requirements. One of the requirements is the maintenance of a healthy body weight management. Alt 797lbs, C.J is grossly overweight and should focus on weight reduction techniques. Both conditions recommend an increase in physical activity such as walking and swimming.

(Fiona White, 2016) Such activity will contribute to weight reduction. In addition to this maintaining, a healthy diet will reduce weight and help in the maintenance of blood sugar levels and hypertension. Recommended dietary intake in C.J cases includes an increase in fruit and vegetable consumption, eating whole grain food, increasing potassium intake (which can be found in such foods as bananas) and reducing salt consumption a low-fat diet is beneficial in these conditions.
The healthcare team that should be engaged in C.J’s health management should include a doctor, nutritionist, a nurse and family members. The crisis in hypertension has resulted due to neglect in care and treatment. While one of the recommendations for the management of hypertension is to stop smoking, C.J continues to smoke heavily. In addition to this, he skips the lisinopril prescriptions because he cannot afford the daily dose indicated. Also, he ignores the insulin therapy altogether just because he does not want to prick his body. (Fiona White, 2016) It seems that C.J has very little will to achieve a better health status. The initial role of the nurse is to form a relationship with the family. The genesis of a productive relationship is to establish a mutual friendship. The nurse must engage C.J in a relationship that esteems him and emphasizes his value despite his illness. She should also educate the family and local community on how to relate to him so that he can feel loved and appreciated. This will increase his motivation to life and increase his willingness to take drugs. The doctor will be useful in prescribing alternative medicines that are affordable to C.J. he will also be consulted at regular intervals to check his progress.
Physiological plan of care
This is care that will involve the evaluation of processes that affect the physical functioning of the body. (Chan, 2012)
Priority nursing diagnosis
One short and one long-term goal
Three to five nursing interventions with rationale statements
Three to five evaluative statements based on interventions
A minimum of three potential patient education needs for consideration
Acute Hypertension and diabetes mellitus
Supporting Data
heart rate 105; resp. rate 18; BP 208/130; O2 98% on room air. weight 297 lbs; glucose level 295
Patients history and former prescription Short term: Client will report 4/10 reduction in headache, increased vision and bleeding stops due to stabilized hypertension and diabetes.
Long-term: Client will report 8/10 reduction in headache, increased vision and bleeding stops due to lower blood pressure and sugar levels in addition to reduced weight and reduction in smoking Check laboratory data for the patient. Rationale: to identify underlying factors
Monitor arm and thigh blood pressure at rest. Rationale: To get a comprehensive picture of vascular activity.
Observe the skin for its color, moisture, temperature, and capillary refill time. Rationale: Access Patient peripheral’s vasoconstriction and therefore access cardiac activity. Checking the laboratory results will inform the nurse of possible underlying conditions and therefore assist in developing comprehensive care
Monitoring arm and thigh blood pressure will alert the nurse in case of worsening condition
Observing the skin characteristics will alert the nurse of excessive heart load and possible failure. Educate patient on proper dosage
Educate patient in the importance of loosing weight.
Education patient of need to quit smoking
Psychosocial plan of care
Psychosocial diagnosis and cares involve self-perception and perceptions from the entire community. (Chan, 2012)
Priority nursing diagnosis
One short and one long-term goal
Three to five nursing interventions with rationale statements
Three to five evaluative statements based on interventions
A minimum of three potential patient education needs for consideration
Social Isolation Short-patient will be able to relate freely with the nurse
Long- Patient will relate the rest of the community Access client for medical symptoms of depression. Rationale: investigate underlying cause for personal negligence
Listen to the client. Rationale: understand patients general life attitude
Stay with the patient. Rationale: understand different trends in patients mood Helped establish whether a patient has undetermined depression
Helps nurse understand why the patient skips drugs and continue to smoke.
Assess self-worth which is essential in recovery. Train community in the importance of participation.
Educate individual in the importance of self-care
Education on alternative care procedures

References
Chan, S. (2012). Welcome to the Journal of Nursing Interventions. International Journal Of Nursing Practice, 18, 1-2. http://dx.doi.org/10.1111/j.1440-172x.2012.02005.x
Fiona White, H. (2016). Management of hypertension in patients with diabetes mellitus. Experimental & Clinical Cardiology, 15(1), 5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907884/
Song, J., Sheng, C., Huang, Q., Li, L., Ma, C., & Guo, X. et al. (2016). Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians. Journal Of Hypertension, 34(8), 1648-1653. http://dx.doi.org/10.1097/hjh.0000000000000994