Running head: Hypertension – HSNS 263

Name: Pavithra Asangani Samaranayake

Student No: 220194999
University of New England

Due Date: 09/05/2019

Unit Coordinator: Rikki Jones
Word count: 1093 (without references)
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Hypertension is a most common disease in every part of the world. The Australian population
at 2015 was 23,781,200 (Australian Bureau of Statistics, 2016). According to Australian
health Survey 2014/15 which has done by Australian Bureau of Statistics, nearly 6 million
Australians who are 18 years and over had hypertension or taking treatments for
hypertension. Among them, 68% are not with a regular treatments or a follow up care. In the
above year, men were more prone to get untreated hypertension than women and in addition,
the statistic shows this amount increased dramatically with age. Moreover the statistics shows
that highest incidences of untreated high blood pressure found in Tasmania (25.2%) and the
lowest incidences have reported in Western Australia (20.4%).

According to National Heart Foundation of Australia HeartWatch Survey (2016) Australians

living in remote areas had a high prevalence (33.9%) of high blood pressure than people live
in metropolitan areas (32.0%). Furthermore, Hypertension is common in Australian people
with lower incomes rather than people with higher income.

According to National Heart Foundation of Australia (2016), high blood pressure among
adults can be classify into the categories namely optimal (systolic < 120 & Diastolic <80),
Normal (Systolic 120- 129mmHg &/or Diastolic 80-84mmHg), High-normal (Systolic 130-
139mmHg & Diastolic 85-89mmHg), Grade 1(mild) hypertension (Systolic 140- 159mmHg
&/or Diastolic 90-99mmHg) Grade 2 (moderate) hypertension (Systolic 160- 179 mmHg
&/or Diastolic 100-109mmHg) , Grade 3 (severe) hypertension (Systolic ≥ 180mmHg &/ or
Diastolic ≥ 110mmHg) and eventually, Isolated systolic hypertension (if Systolic > 140 and
Diastolic < 90).

According to Health Direct (2018) the un-modifiable risk factors affect with hypertension are
family history, age, gender, race and chronic kidney disease. The modifiable risk factors are
sedentary life style, unhealthy diet, excessive sodium consumption, obesity, excessive alcohol
consumption, dyslipidemia, diabetes, smoking and stress.

Change in standard of living is the most vital first-line treatment plan for hypertension and
this include dietary habits namely reduction of salt consumption, moderate alcohol drinking,
and weight reduction. Moreover the changes in life style such as cease with smoking, engage
with physical exercise, and stress management also play a vital role with maintaining a
normal blood pressure level. (Gupta, R., & Guptha, S., 2010).
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According to Australian Heart Foundation (2018), the uncomplicated hypertension patients

that not accompany any other disease can treat with ACE inhibitors or angiotensin-receptor
blockers (ARBs), calcium channel blockers and thiazide diuretics as first-line
antihypertensive therapy. Patients with low cardiovascular disease risk with blood pressure
(BP) ≥ 160/100 mmHg, patients at moderate cardiovascular disease threat with systolic BP ≥
140 mmHg and/or diastolic ≥ 90 mmHg, and patients with uncomplicated hypertension who
should maintain a target of < 140/90 mmHg or lower need to initiate with antihypertensive
therapy. Moreover Australian Heart Foundation (2018) explained patients with a history of
transient ischemic attacks or stroke are recommended to take antihypertensive medications to
minimize cardiovascular risk. Hypertension patients with chronic kidney disease and diabetes
are recommended to get any of the first-line antihypertensive medications that efficiently
decrease blood pressure level. Hypertensive patients with peripheral arterial disease are
recommended with any of the first-line antihypertensive drugs that effectively reduce blood
pressure. With older hypertension patients, any of the first-line antihypertensive drugs that
effectively diminish BP can be used with a small starting dose.

In conclusion, high blood pressure has become one of the most common disease conditions in
Australia. There are various risk factors that grounds for high blood pressure namely
sedentary lifestyle, smoking, obesity, excessive salt consumption, high cholesterol level,
excessive alcohol consumption and diabetes. Hypertension can be classified according its
severity and it effects with the initial management of hypertension.
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Appendix

Education Plan

Mr Trevor with cardiac failure, Diabetes Mellitus & hypertension

Education topic Evidence Goals Experts/resources/multidisciplinar referenc

of y team members e
health
and
educati
on
1. Enhance Activity Introdu  Refer the patient to a Araujo,
activity intolerance ce & physiotherapist. A. A.,
tolerance due to the train Nobrega
disease the  Registered Nurse , M. M.,
condition patient Teach to the patient easy &
evidenced by with exercises that he can tolerate Garcia,
the patient’s easy & T. R.
wife’s tolerabl (2013)
statement e
that patient exercis
becomes es
fatigue and
out of breath
easily.
2. Maintain Altered Reduce 1. Doctor Araujo,
tissue tissue the A. A.,
 Order Diuretics
perfusion perfusion oedem Nobrega
(Frusemide)
evidenced by atous , M. M.,
the leg 2. Registered Nurse &
oedematous Garcia,
 Aware the patient and
noticed at the T. R.
family members about
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physical indications & adverse (2013)

examination effects of diuretics

 Encourage to take a low

salt diet

3. Maintain Difficulty in Mainta 1. Doctor Araujo,

airway breathing due in A. A.,
2. Registered Nurse
to disease oxygen Nobrega
condition Saturat  Administer oxygen via , M. M.,
evidenced by ion face mask &
low oxygen level Garcia,
 Prop up the bed to make
saturation above T. R.
patient more comfort
level (89%) 95% (2013)
& chest X-  Administer diuretic
ray medications (Frusemide)
to lose accumulated fluid

3. Physiotherapy

 Teach breathing exercises

4. Maintain Blood Mainta 1. Doctor America

Blood pressure in BP n Heart
 To aware about risk
pressure 143/87 120/80 Associat
factors
within mmHg on mmHg ion(2017
normal first  Order Enalapril & )
range admission Metapralol

2. Registered Nurse

 aware about adverse

effects of medications &
hypertension risk factors

3. Nutritionist
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 aware about low salt diet

5. Maintain BGL Mainta 1.Doctor 1. (Americ

Blood 12.4mmol/L in BGL an
2.Registered Nurse
glucose 5.6 to Diabetes
HbA1C Aware about complications of Associat
level within 6.9
7.2%A diabetes, diet plan, exercises & ion,
normal mmol/
range L follow up care 2015)

3. Nutritionist
Aware about diet plan

6. Maintain serum Reduce 1.Doctor Departm

the cholesterol the risk ent of
Order Atorvastatin 20mg
cholesterol level of heart Health
level within 9.1mmol/L disease 2.Registered Nurse &
normal s Human
Aware about adverse effects of
range Services
medication, impact of high
. (2014)
cholesterol & diet plan

3. Nutritionist
Aware about diet plan
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Katrina with Rheumatic fever

Education topic Evidence Goals Experts/resources/multidisciplinar referenc

of y team members e
health
and
educati
on
Relieve pain sore throat & Reduce 1. Doctor Rheumat
headache inflam Prescribe anti- ic heart
evidenced by matory inflammatory medications disease,
patient’s signs (oral cortisone) Australi
complaint and 2. Nurse a(n.d)
pain Encourage rest
Reduce body Temperature Reduce 1. Doctor Cilliers
temperature found as body 2. Nurse A. M.
40oC in temper (2006)
physical ature
examination
Prevention of echocardiogr 1. Doctor Cilliers
Rhumatic Heart am showed Prescribe Amoxcillin & A. M.
Disease pericardial penicillin as antibiotics (2006)
thickening & Aware about importance
fluid build up of antibiotic therapy

2. Nurse
Aware the parents about
signs of endocarditis , the
importance of antibiotic
therapy & importance of
rest
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References

American Diabetes Association. (2015, January 01). 13. Diabetes Care in the Hospital,
Nursing Home, and Skilled Nursing Facility. Retrieved from
http://care.diabetesjournals.org/content/38/Supplement_1/S80

American Heart Association. (2017). Know Your Risk Factors for High Blood Pressure.
Retrieved from https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-
pressure-is-a-silent-killer/know-your-risk-factors-for-high-blood-pressure

Araújo, A. A., Nóbrega, M. M., & Garcia, T. R. (2013). Nursing diagnoses and interventions
for patients with congestive heart failure using the ICNP. Retrieved from
http://www.scielo.br/pdf/reeusp/v47n2/en_16.pdf

Australian Bureau of Statistics. (2016, March 23). 3101.0 - Australian Demographic

Statistics, Jun 2015. Retrieved from
http://www.abs.gov.au/AUSSTATS/[email protected]/allprimarymainfeatures/6CBA90A25BAC951
DCA257F7F001CC559

Cilliers A. M. (2006). Rheumatic fever and its management. BMJ (Clinical research
ed.), 333(7579), 1153–1156. doi:10.1136/bmj.39031.420637.BE

Department of Health & Human Services. (2014, February 28). Better Health
Channel.Cholesterol. Retrieved from
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cholesterol

Gupta, R., & Guptha, S. (2010). Strategies for initial management of hypertension. The
Indian journal of medical research, 132(5), 531–542.
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Healthdirect. (2018). High blood pressure (hypertension). Retrieved from

https://www.healthdirect.gov.au/high-blood-pressure-hypertension

National Heart Foundation of Australia. (2016). High blood pressure statistics. Retrieved
from https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-
australia/high-blood-pressure-statistics

Rheumatic Heart Disease, Australia. (2017, July 18). How is it prevented? Retrieved from
https://www.rhdaustralia.org.au/how-it-prevented

The National Heart Foundation of Australia. (2016, July 18). Guideline for the diagnosis and
management of hypertension in adults 2016. Retrieved from
https://www.heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-
guideline-2016_WEB.pdf