A community organization has decided to launch a campaign that aims to eradicate high blood pressure through a comprehensive program of primary, secondary, and tertiary prevention
a. How might statistical reports on the incidence, prevalence, morbidity, and mortality of high blood pressure in the target community be helpful in planning a comprehensive prevention program? What are the potential limitations of using such reports for assessing and addressing the health care needs of a community?
b. Outline a plan that includes possible activities that could be included in the primary, secondary, and tertiary prevention arms of this program.
- Assuming that sound epidemiological methods were used, statistical reports will be helpful in determining whether high blood pressure is a problem in this community. Such reports could provide the following information:
o Incidence of high blood pressure, that is, number of people newly diagnosed with high blood pressure in the past year
o Prevalence of high blood pressure, that is, number of people who currently have high blood pressure
o Factors, such as age or sex, that might affect an individual's susceptibility to high blood pressure or response to treatment
o Factors, such as average educational or income level in the target community, that would be helpful for program planners to know as they develop educational and treatment strategies
- Limitations of such reports include potential inaccuracies due to faulty methods of data collection. Also, epidemiological data provide information about groups, but health care providers must consider the unique needs of the individual.
b.
- Primary Prevention--preventing the development of high blood pressure in patients with normal blood pressure by reducing or eliminating risk factors. Activities might include but are not limited to
o Blood pressure screening for healthy adults or children
o Educational programs about identifying and reducing risk factors for high blood pressure
o Programs to promote healthy lifestyles--such as heart healthy diet, exercise, stress reduction
- Secondary Prevention--preventing disease progression in asymptomatic individuals who have high blood pressure. Activities might include but are not limited to
o Weight reduction, smoking cessation, and exercise programs
o Referral to health care provider to evaluate need for high blood pressure medications
- Tertiary Prevention--preventing complications and deterioration in patients who have symptoms or disease conditions (such as heart attack or stroke) due to their high blood pressure. Activities include but are not limited to
o Educational programs about early signs and symptoms of heart disease, stroke, and other possible complications of high blood pressure
o Medications or treatments that offset the increased cardiac workload caused by high blood pressure
o Development of an individualized nutritional and exercise program
o Financial counseling for the economic consequences of high blood pressure
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A nurse is preparing to administer a first dose of meperidine for a postoperative patient. Prior to administering the drug, the nurse should assess for which of the following?
A) The patient's electrolyte values B) The patient's blood pressure C) The patient's allergies to any medications D) The patient's hydration status
A rule of delegation is:
1. choose only the best person for the job. 2. determine if the person is qualified to perform the task. 3. follow the procedure in your policy manual. 4. delegate only to other nurses.
A patient comes to the clinic for a follow-up appointment after being released from the hospital for angina. The nurse is discussing his medication, nitroglycerin
The nurse is correct to state that the principal way this medication relieves the pain of stable angina is by a. strengthening blood pressure. b. reducing cardiac oxygen demand. c. promoting vagal stimulation. d. increasing sympathetic stimulation to the heart.
Which of the following statements made by the client prescribed to take sublingual nitrogly-cerin for chest pain indicates a need for further discussion regarding this therapy?
A. "I keep my medicine in a clear plastic bag in my purse so that I can get to it easily if I have chest pain." B. "Even if I have not used any of the nitroglycerin from one refill, I get another re-fill every 3 months." C. "If I still have chest pain after I have taken three nitroglycerin tablets, I will go to the hospital." D. "When my nitroglycerin tablet tingles under my tongue, I know that it is strong enough to work."