Liz Rhodes, RN ECU Student Nurse PROBLEM Uncontrolled blood pressures related to medications, poor diet, and decreased physical activity.
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Transcript Liz Rhodes, RN ECU Student Nurse PROBLEM Uncontrolled blood pressures related to medications, poor diet, and decreased physical activity.
Liz Rhodes, RN
ECU Student Nurse
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PROBLEM
Uncontrolled blood pressures related to medications,
poor diet, and decreased physical activity
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GOAL
To motivate a change in behavior patterns and
activities to control blood pressure for stroke
prevention
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OBJECTIVES
List four modifiable risk factors for strokes
State the importance of controlling blood pressure.
List different types of foods which are healthy and not
healthy.
Verbalize the importance of a healthy lifestyle to prevent a
stroke
Interpret BP results after participation in blood pressure
screening and document results if follow-up required
Complete the stroke risk factor form from using obtained
knowledge of program
Be aware that there are others available for assistance
Desire a more positive healthy life style
Identify reasons for not taking medications
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BLOOD PRESSURE
How can I tell if I have high blood pressure?
High blood pressure usually has no symptoms.
Many people have high blood pressure for years without
knowing it.
It's called the "silent killer."
Hypertension is the medical term for high blood
pressure.
It doesn't refer to being tense, nervous or hyperactive.
You can still have high blood pressure even if you are a calm,
relaxed person.
http://www.americanheart.org/presenter.jhtml?identifier=44
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Why is Blood Pressure
Management Important?
There is a progressive increase in the risk of:
stroke
Elevated BP one of the most common reasons
Elevated BP places unnecessary stress on blood vessels
Coronary (heart) disease (Kaplan & Rose, 2008).
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Factors related to
High Blood Pressure
A family history of high blood pressure
Age - The incidence of high blood pressure
rises in men after age 35 and in women after
age 45
Gender - Men are more likely to have high
blood pressure than women
Race - Approximately 33 percent of AfricanAmericans have high blood pressure,
compared to 25 percent of Caucasians
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Potential Reasons For
Not Taking Medications
Poor eye sight
Impairs ability to read prescription and understand labeling on
bottle
Limited hearing
Critical communication from health care provider is diminished
Limited mobility
Decreased mobility and dexterity can limit a person's ability to
have prescriptions filled
to open and close childproof containers
Memory Loss
Problem with recalling prescription instructions from healthcare
provider
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Potential Reasons For
Not Taking Medications
Economic Condition
Limited income
Increase in prescription costs
Depression
Social and Health Beliefs
beliefs can be based on:
misconceptions
faulty information
cultural conditioning
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Blood Pressure Guidelines
Category
Systolic BP (mm Hg)
Diastolic BP (mm Hg)
Treatment recommendations
Normal
Less than 120
Less than 80
Lifestyle changes encouraged
Prehypertension
120–139
80–89
Lifestyle changes necessary
Drugs for compelling indications*
Stage 1 hypertension
140–159
90–99
Lifestyle changes necessary
Thiazide diuretic for most people
May also consider other blood pressure drugs alone or in
combination
Drugs for compelling indications*
Stage 2 hypertension
160 or higher
100 or higher
Lifestyle changes necessary
Two or more blood pressure drugs for most people
Drugs for compelling indications*
*Compelling indications: diabetes, chronic kidney disease, previous heart attack, congestive heart failure, previous stroke, high cardiac risk
Note: When systolic and diastolic pressures fall into different categories, physicians rate overall blood pressure by the higher category. For example,
150/85 mm Hg is classified as stage 1 hypertension, not prehypertension.
Source: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, December 2003.
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Why is Blood Pressure Management
For Stroke Prevention Important?
Strokes
Leading Cause of Disability in the U.S.
3rd Leading Cause of Death in the U.S.
N.C. lies in the Stroke Belt
The Stroke Belt has the highest morbidity and
mortality from Stroke in the U.S.
The Buckle of the Belt includes NC, SC and Georgia
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TYPES OF STROKES
Hemorrhagic Stroke
Blood vessels in the brain rupture
Ischemic Stroke
Blood clots or fatty deposits block vessels that supply the
brain with blood.
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Modifiable Risk Factors of Strokes
High cholesterol
Alcohol
Hypertension (high blood
4 oz. wine or equivalent
may be protective
Diabetes
pressure)
Exercise
Diet
Tobacco
Doubles stroke risk
Increases blood pressure
Obesity
Cardiac Disease
Atrial Fibrillation
TIA/Prior stroke
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PREVENTION
Eating a well balanced diet
Exercise
Compliance with medications
Management of:
Diabetes
HTN
Heart disease
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STROKE RISK AWARENESS SURVEY
Check all that applies to you. ***If you check two or more, please see a
healthcare professional and determine what you can do to lower your risk.
AGE
____ You are a man over 45 or a woman over 55 years old.
FAMILY HISTORY
____ Your father or brother had a heart attack before age 55 or your mother or sister had one
before age 65.
MEDICAL HISTORY
____ You have coronary artery disease, or you have had a heart attack.
____You have had a stroke.
____You have an abnormal heartbeat.
Tobacco SMOKE
____ You smoke, or live or work with people who smoke every day.
Total CHOLESTEROL and HDL cholesterol
____ Your total cholesterol level is 240 mg/dL or higher.
____ Your HDL (“good”) cholesterol level is less than 40 mg/dL if you’re a man
or less than 50 mg/dL if you’re a woman.
____ You don’t know your total cholesterol or HDL levels.
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Risk assess cont.
BLOOD PRESSURE
____ Your blood pressure is 140/90 mm Hg or higher, or you’ve been told that
your blood pressure is too high.
____ You don’t know what your blood pressure is.
PHYSICAL INACTIVITY
____ You don’t accumulate at least 30 minutes of physical activity on most days of
the week.
Excess BODY WEIGHT
____You are 20 pounds or more overweight.
DIABETES
____ You have diabetes or take medicine to control your blood sugar.
American Heart Association. (2008). Personal risk assessment form. Accessed on
September 12, 2008 at
http://www.strokeassociation.org/presenter.jhtml?identifier=3034972
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Stroke is a Medical Emergency
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ABCs of Preventing Heart
Disease, Stroke and Heart Attack
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http://www.strokeassociation.org/presenter.jhtml?ide
ntifier=3034972
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Heart-Healthy Cooking Tips
Eat less cholesterol, salt and saturated and trans fats.
Eating less saturated fat and trans fat helps to lower
blood cholesterol levels.
Eating fewer calories will help you lose weight,
especially when you also enjoy regular physical activity.
Eating less salt and more potassium helps control
blood pressure in most people.
Focusing your diet on foods such as fat-free and lowfat dairy fruits, vegetables and whole-grain, high-fiber
foods is essential to good health.
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Here are some tips to help make
your meals healthful:
Frying
Steam, stir-fry, broil, or bake foods in olive oil or canola
instead of deep-frying in bacon grease or shortening.
Salt
Use lemon juice, vinegar, garlic, hot red pepper flakes, and
onions or other low-salt spices instead of salt.
Use little or no salt when you cook, spaghetti, noodles, hot
cereal or rice.
Salad Dressing
Use low-fat, low-calorie or fat-free salad dressings.
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TIPS continued
Butter
Use soft tub margarine instead of butter, or use other spreads that are
lower in trans fat, cholesterol, and saturated fat such as a stick of
margarine.
Eggs
Limit egg yolks to three or four per week, or eat egg whites instead.
Meat
Buy fresh lean cuts of meat and trim the fat before cooking.
Eat chicken, turkey, and very lean pork or beef.
Remove the skin from poultry before cooking except when roasting a
whole chicken.
Roast, broil, or bake meats instead of frying them.
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TIPS continued
Oils
Use olive, canola, corn, or safflower oil in cooking.
Use calorie-free, fat-free cooking spray to provide a nonstick surface for grills, bake ware, and wok-ware.
Fat
Limit saturated calories to less than 7 percent of your
total calories and trans-fat calories to less than 1 percent
of your total calories.
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AREA DIETICIANS
Renee L Kemske
MPH RD LDN
Orange County Health Dept
2501 Homestead Rd
Chapel Hill, NC 27514
Phone: (919) 968-2022 x309
Email: [email protected]
Areas of Practice:
Individual Counseling, Group Counseling, Programs/Workshops,
Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness, Gerontology, Weight
Control
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AREA DIETICIANS
Anne-Marie Scott
UNC Wellness Center
Health Education Dept
100 Sprunt St
Chapel Hill, NC 27517
Phone: (919) 843-2163
Email: [email protected]
Areas of Practice:
Individual Counseling, Group Counseling, Programs/Workshops
Cardiovascular/Hypertension, General Nutrition/Wellness, Gerontology, Weight
Control
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AREA DIETICIANS
Elizabeth A Watt
RD LDN
The Wellness Center at MeadowMont
100 Sprunt St
Chapel Hill, NC 27517-7811
Phone: 919-843-2163
Email: [email protected]
Areas of Practice:
Individual Counseling, Group Counseling, Programs/Workshops,
Cardiovascular/Hypertension, General Nutrition/Wellness, Weight Control
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AREA DIETICIANS
Kara M Mitchell
MS RD LD
Duke Center for Living
1300 Morreene Rd
Durham, NC 27710
Phone: (919) 660-6818
Email: [email protected]
Areas of Practice:
Individual Counseling, Group Counseling, Programs/Workshops
Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness, Vegetarian, Weight
Control
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FITNESS CENTERS
Carolina Fitness
503-C West Main St
Carrboro, NC 27510
phone (919) 960-9910
O2 Fitness
View Website
300 Market Street, #110 (Southern Village),
Chapel Hill, NC 27516
phone (919) 942-6002
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FITNESS CENTERS
The Wellness Center at Meadowmont
View Website
100 Sprunt St
Chapel Hill, NC 27517
phone (919) 966-5500
World-Renowned Residential Program-- Duke
University Diet and Fitness Center
1-800-235-3853
http://www.dukehealth.org/Services/DietAndFitness/A
bout/index/DFC%20Brochure%20Inside.pdf
Check with your physician be for starting any physical fitness program
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Prescription Drugs
WALMART/SAM'S CLUB
$4 Prescription Drug Program
Heart Health & Blood Pressure Medications
Target
$4 Prescription Drug Program
UNC Hospital
Program for free medications.
An application needs to be filled out and submitted.
It does go by income.
**(Check with your physician for generic medication
prescription for area programs)
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Things to Remember
Help decrease your risk for a stroke or recurring stroke
by:
Maintaining a healthy diet
Exercise Program
Check with your physician before starting
Control your blood pressure
Monitoring/keep tract of results
Medications
Medical follow-up
**If you think you are having a stroke, call
immediately!
911
(See the following signs & symptoms)
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Signs & Symptoms of Strokes
Sudden numbness or weakness
Sudden confusion, trouble speaking or
understanding
Sudden trouble seeing
Sudden trouble walking, dizziness, or
loss of balance or coordination
Sudden, severe headache
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Thank You
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Resources
American Heart Association [AHA]. (2008). Diet and Nutrition. Site accessed on September 29, 2008 at
http://americanheart.org/presenter.jhtml?identifier=1200010
American Heart Association. (2008). Personal risk assessment form. Accessed on September 12, 2008 at
http://www.strokeassociation.org/presenter.jhtml?identifier=3034972
American Heart Association [AHA], (2008). Stroke risk factors. Site accessed on September 29, 2008 at
http://www.americanheart.org/presenter.jhtml?identifier=9217
American Heart Association [AHA]/American Stroke Association [ASA]. (2007). Let’s talk about lifestyle changes to prevent stroke. Site accessed on
September 29, 2008 at http://www.strokeassociation.org/downloadable/stroke/1219770019473Lifestyle%20Chgs%20to%20Prevent%20Stroke.pdf
American Stroke Association [ASA]. (2008). Converging risk factors. Site accessed on September 29, 2008 at
http://www.strokeassociation.org/presenter.jhtml?identifier=3027394
American Stroke Association [ASA]. (nd). Stroke risk awareness survey. Site accessed on September 29, 2008 at
http://www.strokeassociation.org/downloadable/stroke/1130509929967PTES%20Risk%20Assessment%20Card.pdf
Dufresne, J. & Greene, V. (1990). Medication regimens: Causes of non-compliance. Department of Health and Human Services: Offices of Inspector
General. Accessed on October 6, 2008 at http://www.oig.hhs.gov/oei/reports/oei-04-89-89121.pdf
Every Day Health Network. (2008). Stroke center: Blood pressure guidelines Accessed on October 27, 2008 at
http://www.everydayhealth.com/publicsite/index.aspx?puid=1c66ebdb-25c5-4042-bd9b051cb3f9e623&xid=gslp&s_kwcid=blood%20pressure|2525548814&gclid=CMyQ8Z6rzZYCFQS7sgodBWgGzQ
Kaplan, N. &Rose B. (2008). What is goal blood pressure in treatment of hypertension? Retrieved on October 19, 2008 from Up to date at
-Chapel Hill.
UNC
Sebastian, J. G. in M. Stanhope & J. Lancaster (2008). The nurse leader in the community. Public health nursing: Population-centered health
in the community. (7th ed.). St. Louis, MO: Mosby.
care
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