...Dev Patel What is the Effect of Post Cardiovascular Treatment through Medication Therapy Management (MTM)? An Annotated Bibliography Critical Preface Hypertension is a major risk of cardiovascular disease and stroke. Hypertension can have primary and secondary causes. There are a series of diagnostic procedure needs to occur to avoid and diagnose hypertension; they involve repeated blood pressure measurements, family histories, laboratory procedures and physical examinations. Patients with established hypertension blood pressure and heart rate should be measured repeatedly with a proper size cuff. In regards to the management of hypertension, lifestyle modifications may need to take place that includes a decrease in salt intake as well as high fat foods, the cessation of smoking, limited alcohol consumption, weight management and a diet high in vegetables and fruits. Although I know the treatment strategies involved within hypertension, for this research project, I set out to discover how Medication Therapy Management (MTM) to figure out if this would be beneficial for the patient and pharmacist stand point. I posted several questions that I hope my research could help me answer and gain a greater understanding of (1) What is Medication Therapy Management and their role of helping the patient? (2) How patients perform after MTM relating to health and lifestyles?...
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...Renal hypertension is an elevated blood pressure caused by kidney disease. It is caused by a narrowing in the artery that delivers blood to the kidney. Renal hypertension usually causes no symptoms. The narrowing in the arteries can't be felt. Unless it's dangerously high, high blood pressure causes no symptoms either. Symptoms of severely elevated blood pressure include: • Headache • Confusion • Blurry or double vision • Bloody (pink-colored) urine • Nosebleed The vast majority of people with renal hypertension never experience these (or any) symptoms. High blood pressure is dangerous partly because there are no symptoms, so organ damage can occur slowly without being recognized.Renal hypertension can cause chronic kidney disease. This is a slow decline in kidney function. Until the condition is well advanced, chronic kidney disease also causes no symptoms.Because there are usually no symptoms, a doctor may suspect renal hypertension when someone has uncontrolled high blood pressure despite multiple medications or has unexplained chronic kidney disease. With Renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day cannot adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys can often help. Possible procedures include the following: Angioplasty, Stenting...
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...Hypertension or High blood pressure is a prevalent cardiovascular disease in the United States and other nations around the world. It is estimated that 1 billion is affected with the disease and about 7.1 million hypertension related mortalities annually. It is a condition in which the long-term force of blood against artery walls is high enough to ultimately cause heart attack, aneurysm, stroke or left ventricular hypertrophy leading to congestive heart failure. Many people with hypertension do not realize they have because the symptoms are subtle and that it generally develops over a long period of time. Most often, vital organs like the kidneys and eyes may damage or other diseases may occur before it is detected; for this reason, it is often called the "silent killer (American Heart Association, 2014). According to Woo & Wynne (2012), a report from the World Health Organization indicates that suboptimal blood pressure higher than 115mm Hg (systolic) is liable for 62% of all cardiovascular disease and 49% of all ischemic heart disease. A normal blood pressure level is systolic reading of blood pressure (SBP) less than 120mmHg with diastolic level (DBP) less than 80mmHg. Hypertension disease has the following stages. A pre-hypertensive level is SBP 120-139, and DBP 80-89. Hypertension stage 1 is SBP 140-159, with DBP of 90-99. Hypertension stage 2 is SBP greater than or equal to 160 with DBP of 100 or more. Stress and emotional tension may temporarily increase blood pressure;...
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...labeled graphic, then that is acceptable as well. Hypothetical Case (basic details only): A 23 year old female presents today with hypothyroidism. She is obese with a BMI of 50, has hypertension, and diabetes. She is concerned about how this affects her weight, hypertension and diabetes. There is a family history of hypertension and diabetes on both the maternal and paternal side. Her maternal grandmother died of a stroke at the age of 45. Medical Model: In diagnosing hypothyroidism, your doctor will take into account both your symptoms and the results of a thyroid stimulating hormone (TSH) test. Hypothyroidism is the result of diminished levels of thyroid hormones—known as T3 and T4. Today's TSH tests are very accurate and sensitive; they can help diagnose even the mildest cases of hypothyroidism. Your doctor may measure the level of free T4 (the portion of total T4 thyroid hormone that is available to your tissues) in your bloodstream. A third hypothyroid test is for anti-thyroid microsomal antibodies—anti-thyroid peroxidase (anti-TPO). The physician may prescribe medication to replace the hormones that the body isn’t producing. Synthroid and Levothyroxine are two such drugs that are used. Treatment for hypertension comes in many forms -- from lifestyle changes to medication. Besides taking your blood pressure, your doctor will do a physical exam and medical history. Your doctor may...
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...Pennsylvania School of Nursing Medication Tracking Sheet Tracking Medications Across the Curriculum Major Drug Classification (s): beta blocker Generic drug name: Metoprolol Trade (Brand) name: Lopressor Normal dosage range:______25-50mg Safe dosage range: Route(s) of administration: PO once a day Drug action (s): Blocks simulation of beta1 adrenergic receptors. * Uses: * Hypertension. * Angina pectoris. * Prevention of MI and decreased mortality in patients with recent MI. * Management of stable, symptomatic (class II or III) heart failure due to ischemic, hypertensive or cardiomyopathc origin (may be used with ACE inhibitors, diuretics and/or digoxin; Toprol XL only). * * * Significant side effects: fatigue, weakness * Significant adverse reactions: CV- bradycardia, tachycardia, pulmonary edema, hypotension Significant drug/drug interactions: Drug-Drug * General anesthesia, IVphenytoin, and verapamil may cause ↑ myocardial depression. * ↑ risk of bradycardia when used with digoxin, verapamil, diltiazem, or clonidine . * ↑ hypotension may occur with other antihypertensives, acute ingestion of alcohol, or nitrates . * Concurrent use with amphetamines, cocaine, ephedrine, epinephrine, norepinephrine, phenylephrine, or pseudoephedrine may result in unopposed alpha-adrenergic stimulation (excessive hypertension, bradycardia). * ...
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...Hypertension Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Hypertension is the consistent elevation of systemic arterial blood pressure. It is also the most common primary diagnosis in the United States (Brashers, 2010). It is one of the most common worldwide diseases afflicting humans. Because of the associated morbidity and mortality and the cost to society, hypertension is an important public health challenge. Over the past several decades, extensive research, widespread patient education, and a concerted effort on the part of health care professionals have led to decreased mortality and morbidity rates from the multiple organ damage arising from years of untreated hypertension. I. Prevalence of disease (in US) and risk factors Hypertension is a major U.S. health problem affecting some 50 million individuals. Approximately 65% of Americans older than age 60 have hypertension. Of those diagnosed with hypertension, over 30% do not have their hypertension adequately treated and controlled. Ninety to ninety-five percent of hypertension is idiopathic and called primary hypertension. Five to ten percent of hypertension is the result of an identifiable etiologic cause and is called secondary hypertension. According to Center of Disease Control (CDC) the prevalence of hypertension, 45.3% had been treated...
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...Care Plan Elements of Hypertension Susan Salby American Sentinel University Care Plan Elements of Hypertension Worldwide, hypertension is the most common contributor to death of any medical risk factor. HTN contributes to the development of heart disease, heart failure, chronic renal failure requiring dialysis, stroke, peripheral vascular disease and cognitive decline. The risk of cardiovascular events doubles for every 20/10mmHg rise in blood pressure above 115/70mmHg. Untreated HTN causes progressive renal and vascular damage, eventually leading to a treatment resistant state. Hypertension is usually diagnosed and treated in the community. As this is largely an asymptomatic disease, particularly in its initial stages, compliance with treatment regimens can be problematic. Successful treatment of HTN relies on the patient establishing an ongoing therapeutic relationship with a trusted and knowledgeable health professional (Casey, 2011). Tools to manage care, such as clinical pathways, practice guidelines, and best practices have increased as the health care insurance industry has put more pressure on health care providers to improve care and provide more cost-effective care. These tools offer health care providers the opportunity to determine the best approaches to clinical problems based on current research and expertise (Finkleman, 2011). Best Practices Best practices are those treatments, procedures, tests, therapies and interventions that have consistently...
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...also available in separate programs (Redman, 2007). This patient education plan will identify and determine how to fulfill the gaps in education regarding Larry Garcia’s newly diagnosis of hypertension. Assessment of Larry Garcia Larry Garcia is a 45 year-old male newly diagnosed with hypertension during a physical examination due to the change in his company’s healthcare and wellness policy. He has been married to his wife, Monica, for 18 years; together they have 3 children, a 15 year-old son, Mark; a 12 year-old daughter, Kelly; and another daughter Andrea who is 8 years-old. Mr. Garcia has been employed as a sales representative for the past 10 years with the same company, which is considered a high pressure position that requires meeting a monthly sales quota. In addition to his immediate family responsibilities, Mr. Garcia also claims responsibilities for his parents who are aging and need assistance on a daily basis. Physical assessment reveals a middle-aged male who is 12 pounds over ideal body weight (height= 5’9”; weight=157 pounds; blood pressure=156/84; pulse=80 beats per minute; respirations=14 per minute). He does not exercise regularly because “he does not have time”. His last physical examination was over 6 years ago. Mr. Garcia does not take any daily medications other than a multi-vitamin and states he “would prefer to use homeopathic...
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...Women and Heart Disease Coppin State University Abstract Heart disease is a leading cause of death for women and men worldwide. Women are more vulnerable to myocardial infarction because of the size of their coronary arteries. They have unique risk factors such as a high level of cholesterol, hypertension, and smoking that cause heart disease, which leads to the high mortality rate. To reduce the high mortality rate among women, nurses must play their roles as educators because they interact frequently with patient, moreso than any other health care workers. Nurses must educate their patients on how to prevent the risk factors of heart disease. In order to reduce the high mortality rate due to MI in women, the Obama administration implemented the Patient Protection and Affordable Care Act (PPACA), popularly called t "Obama Care". This policy has mandated that insurance companies cover important preventive care at no cost, which will help eliminate the expensive bills that would have been incurred. As a future nurse, I would address the issue of heart disease by providing qualitative education and creating awareness of the causes and preventive measures of heart diseases. Keywords: Affordable Care Act, Heart Disease, Myocardial Infarction, "Obama Care", and Women's Health. Introduction Although both men and women have increased mortality rates due to heart disease in the United States, women have the higher rate and carry a heavier cardiovascular burden...
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...------------------------------------------------- Hypertensive emergency From Wikipedia, the free encyclopedia A hypertensive emergency is severe hypertension (high blood pressure) with acute impairment of an organ system (especially the central nervous system, cardiovascular system and/or the renal system) and the possibility of irreversible organ-damage. In case of a hypertensive emergency, the blood pressure should be substantially lowered over minutes to hours with an antihypertensive agent. Contents [hide] * 1 Treatment * 2 Incidence * 3 Definition * 3.1 Hypertensive emergency as a generic term * 4 Pathophysiology * 5 Mortality * 6 Clinical history * 7 References * 8 See also | ------------------------------------------------- [edit]Treatment Several classes of antihypertensive agents are recommended and the choice for the antihypertensive agent depends on the cause for the hypertensive crisis, the severity of elevated blood pressure and the patient's usual blood pressure before the hypertensive crisis. In most cases, the administration of an intravenous sodium nitroprusside injection which has an almost immediate antihypertensiveeffect is suitable but in many cases not readily available. In less urgent cases, oral agents like captopril, clonidine, labetalol, prazosin, which all have a delayed onset of action by several minutes compared to sodium nitroprusside, can also be used. It is also important that the blood pressure is lowered not too...
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...When we spoke to the members of the stein center we were able to discover that many of them were eager to learn about hypertension, the reasons for their medications, and effects. They were very interested and just needed some clarification on the subject. There is a knowledge deficit in the community related to hypertension as evidence of personal communication. They voiced that their knowledge on the subject was very limited and needed more understanding. So by the end of the presentation that was given regarding hypertension they will be able to demonstrate understanding of what hypertension is and how to prevent or manage hypertension. We will measure the success of the education by handing the members pre and post exams as well as verbal surveys. The style of teaching will be visual, as well as audio. The members voiced that they learned best when there are visuals. They expressed that too much talking can bore them but if they are engaged there is a greater chance that they will grasp the concept. On June 19th 2012 at 11:25 am, my colleagues and I conducted a fifteen minute presentation on high blood pressure management for the members at the Senior Stein Center. Sixteen members participated in the teaching session, the member’s age range from 60 and up, male and female both participated, the race and ethnicities consisted of African American, Caucasian, Hispanic, and Asian. To determine the learning needs of that particular group, we provided a pretest prior to the teaching...
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...produced a duodenal ulcer. This ulcer then produced a bloody diarrhea stool. C.W. Was brought to the emergency room with by his wife for having bloody diarrhea for three days and was presenting signs of weakness and hypotension. C.W. underwent surgery for his gastrointestinal bleed and then was admitted to the hospital for having a fluid volume deficit, due to his diarrhea and bleed. C.W. being volume deficit made his fluid, electrolyte and blood levels become very abnormal. His medication that he was on for prior health history was causing some of his levels to rise and drop. He has a past medical history of cardiovascular problems, which were described and attributed to his current admitting problems. While at the hospital he went into sinus tachycardia and was placed on a Swan-Ganz catheter. One of the main goals for treating C.W. is to control his tachycardia and control his levels. He has some serious cardiovascular conditions that can not be healed but medical professionals, using education and medication , can better his quality of the life he has left. Patient C.W., a 70-year-old male, was admitted to the hospital at 0430 with a 25-X15-mm duodenal ulcer causing a gastrointestinal bleed, which was presented by “ dark red “ bloody diarrhea. His wife states that he has had diarrhea for 3 days with “dark red” stool starting the night before. She states that when he became “very dizzy, disoriented and weak” in the morning she decided to bring him to the hospital. He went through...
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...Hypertension John Smith, age 63 was recently diagnosed with hypertension. His family will be accompanying him today to speak with me about his treatment options. To prepare for my discussion with Mr. Smith and his family, I want to gather some simplistic information about hypertension. Hypertension is an abnormal rise in blood pressure. Blood pressure is the blood that is pumped into and out of the heart. The systolic pressure, also known as the blood leaving the heart, is what occurs when the heart contracts (or squeezes). The diastolic pressure is found in the arteries when the heart is resting. Your physician typically displays your blood pressure results as 130/70 or systolic/diastolic. Hypertension involves major parts of the body, like your heart, kidneys, and the brain. Each plays an essential part of the body function like blood pressure. When hypertension occurs, it puts stress on these parts of your body. It can cause coronary heart disease that leads to heart attacks, strokes, kidney failure, and even premature death. Things like cigarette smoking, eating fatty foods, little to no physical activity and even consuming too much salt and sodium can cause a rise in blood pressure leading to hypertension. Hypertension is not the result of one or two blood pressure test coming back elevated. It is the result of several repeated blood pressure test over a span of time coming back in an above normal range. Normal ranges under 120/80 are typically where your physician would...
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...study of Mr. J; he has been exhibiting dyspnea upon exertion and fatigue. His blood pressure was 170/95 mmHg. After reviewing his labs; his LDL level was 200 mg/dl. Upon physical examination, he was found to have peripheral edema and jugular vein distention. A chest X-ray revealed cardiomegaly and pleural effusion. An echogram has also been scheduled. Based on his signs and symptoms, the physician suspects Mr. J has new onset Stage C heart failure. Mr. J has multiple prescribed drugs for Hypertension, Hyperlipidemia, Parkinson’s, Gout and Depression. After careful reviewing Mr. J’s medications there is concerns ineffective pharmacological management. Ineffective pharmacological management refers to medication therapy prescribed that does not take into account the patient’s age, diagnoses and comorbidities; therefore leading to complications of existing health problems. Side effects, adverse reactions and drug to drug interactions have to also be considered when reviewing a patient’s medication regimen. The drug categories most commonly involved in adverse reaction are cardiovascular agents, antibiotic, diuretics, anticoagulants, hypoglycemic, steroids, opioids, anticholinergic, benzodiazepines, and non-steroidal anti-inflammatory drugs. Nurses have the unique opportunity to help identify patients at risk for ineffective pharmacological management and educate patients and families about risk reduction. In this case study I will explore potential problems related to ineffective...
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...related to hypertension and the lack of awareness of the disease. Hypertension is a chronic disease. Chronic illness is a condition that last six months. It can be managed but not cure. The CDC stated (2014) “As of 2012, about half of all adults- 117 million people have one or more chronic diseases. Seven of the 10 causes of death in 2010 were chronic disease. Heart disease and cancer together accounted for nearly 48% of all deaths.” The objectives of this case study are to review the history and physical, describe the disease process, and formulate a patient- centered education plan. Disease process Mr. Larry Garcia is a 45 year old Hispanic male. He was newly diagnosed with hypertension during a physical exam for his employment. He does not consult his primary physician regularly. His previous physical exam was six years ago. Larry is overweight and lack of physical activity. He does not smoke but drinks alcohol occasionally on the weekend. He complains of shortness of breath, dizziness, headache and blurry vision occasionally. However, he stated “I feel fine.” Mr. Garcia refused prescribe medication for his hypertension. He takes only one multivitamin daily. Larry is married and has three children. He has a stressful job as a sale representative. He is the only child. He assists both of his parents with their financial. Larry’s family medical history revealed his father had congestive heart failure and macular degeneration. His mother refused medication for hypertension...
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