Primary Hypertension 1) What are specific cultural considerations


Primary Hypertension

What are specific cultural considerations in the
United States for hypertension?

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Specific criteria in cultural considerations for
hypertension include medication adherence, patient education, eating practices,
and finances. “Ethnic variations account for some differences in the prevalence
of hypertension and blood pressure control rates among Hispanics, including the
need for culturally appropriate management models.” (Patel, 2011) It has been
noted, that in the United States, socioeconomic and racial factors detrimentally
influence ones’ health. Education, modernization, and structural assimilation
directly relate to favorable blood pressure profiles. Being proficient
linguistically significantly impacts one’s ability to fully comprehend and
execute a medical professionals’ explanation and orders related to
hypertension. (Patel, 2001) When language is no longer a barrier, the patient
education process is smoother and medication adherence is more likely to occur since
the patient more fully understands what they are taking and why they are taking
a certain medication. Eating practices greatly impact hypertension as well. African-Americans
have what is referred to as “soul food”; while it may contain healthy foods
such as collard greens, legumes, and potatoes, other parts of their diet are
often not healthy. Low fiber, calcium and potassium deficient, and foods high in
fat, contribute directly to hypertension. (Ewing, 2016) Economically
disadvantaged families may not have the ability to afford healthier foods, they
may rely more heavily on low nutrient prepackaged foods, raising their likelihood
of hypertension based on poor health.

What are some common nursing diagnoses for
clients with hypertension?

Nursing diagnoses for hypertension could include decreased
cardiac output. An inadequate amount of blood pumped by the heart would not
meet the metabolic needs of the body. Activity intolerance would produce
insufficient energy, both physiological and psychological, to sustain daily
activities. Acute pain ranging from moderate to severe. Imbalanced nutrition
because ones’ nutrient intake is not sufficient for their metabolic needs. And Deficient
knowledge, the patients level of knowledge and understanding to the topic is
insufficient. (Hypertension, 2013)

After the diagnosis of essential hypertension is
confirmed with initial studies, what further evaluations are necessary?

After the initial
diagnosis of hypertension, further evaluations include careful

measurements and recordings of blood
pressure are important. Ambulatory blood pressure monitoring should be
conducted in addition to what the doctor conducts in the office because it
gives a larger picture and more correct view of one’s blood pressure. It
establishes a pattern that can be reviewed and activities to be revised.
Laboratory tests could also include an electrocardiogram, urinalysis, blood glucose
and hematocrit. Serum potassium, creatinine, or corresponding estimated
glomerular filtration rate, calcium would also be measured. Lipid profiles
following a nine to 12 hour fast that included high and low density lipoprotein
cholesterol and triglycerides and a measurement of urinary albumin excretion or
albumin/creatinine ratio would most likely also be conducted. (Rafey, 2013)

What is the purpose of the registered dietitian
in the multidisciplinary team conference with the client who is diagnosed with
essential hypertension?

The registered dietitian
will help the patient to recogonize healthy and unhealthy

decisions about food. Their role is
to provide Medical Nutrition Therapy to patients and to help educate their
support system such as family members, who will be involved in the patients
care. They advocate for and educate about adequate resources that are available
to the patient. They will complete a nutritional evaluation on the entire diet.
This would include foods, drinks, supplements, and medications. Eating patterns
may be evaluated, allergies and other dietary adjustments possibly related to
religious practices will be taken into account. The Dietitian would then create
a care plan as part of the guided treatment of hypertension. (The Role, 2018)
It is important that they meet the patient and be present so the patient has
ample opportunity to ask questions and fully understand the new dietary requirements. 


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