Answer:
**Case Study: Managing Chronic Hypertension**
**Introduction:**
This case study follows Ms. Johnson, a 58-year-old female diagnosed with chronic hypertension. She has a history of hypertension for the past 10 years and has been under medication and regular check-ups with her healthcare provider. Ms. Johnson lives an active lifestyle and works as a schoolteacher. She presents with complaints of occasional dizziness, headaches, and difficulty concentrating. The nursing team aims to provide comprehensive care to manage her chronic condition and improve her overall quality of life.
**Health History:**
- Age: 58
- Gender: Female
- Medical History: Chronic hypertension for the past 10 years.
- Family History: Father had hypertension and mother had type 2 diabetes.
- Lifestyle: Active lifestyle, follows a balanced diet, and practices stress-relief techniques.
**Medications:**
- Lisinopril 10 mg once daily for hypertension.
**Nursing Assessment:**
- Blood Pressure (BP): Elevated BP readings, ranging from 140/90 to 160/100 mmHg during office visits.
- Heart Rate (HR): Regular, within normal limits.
- Respiratory Rate (RR): Within normal limits.
- General Appearance: Alert and oriented, cooperative, no signs of distress.
- Neurological Assessment: Occasional complaints of headaches and dizziness, otherwise normal.
**Nursing Care Plan:**
- Monitor BP regularly, at least twice daily during morning and evening, and document readings.
- Assess for signs of complications related to hypertension, such as chest pain, shortness of breath, or visual disturbances.
- Educate the patient about the importance of adhering to medication and lifestyle modifications.
- Encourage Ms. Johnson to maintain a low-sodium, heart-healthy diet rich in fruits, vegetables, and whole grains.
- Emphasize the significance of stress management and relaxation techniques, such as deep breathing exercises and mindfulness.
- Monitor for potential medication side effects, such as cough or angioedema, and report them to the healthcare provider promptly.
**Goals and Desired Outcomes:**
- Achieve and maintain target blood pressure levels within the normal range (< 130/80 mmHg for patients with hypertension).
- Improve symptom management, reducing the frequency of headaches and dizziness.
- Enhance patient knowledge about hypertension and the importance of medication adherence, diet, and lifestyle modifications.
- Empower the patient to manage stress effectively to reduce the risk of hypertension-related complications.
**What stage of chronic hypertension:**
Ms. Johnson is likely in the stage of **Stage 2 chronic hypertension** based on her elevated blood pressure readings during office visits (ranging from 140/90 to 160/100 mmHg). Further assessment and continuous monitoring will be essential to determine the exact stage and develop an effective management plan.
**Conclusion:**
Ms. Johnson's case highlights the importance of consistent monitoring, adherence to medication, lifestyle modifications, and patient education in managing chronic hypertension effectively. By working collaboratively with the healthcare team, Ms. Johnson can improve her blood pressure control and overall well-being, reducing the risk of hypertension-related complications. Regular follow-ups and ongoing support will be crucial in achieving the desired outcomes and improving her quality of life.
