A DASH to Stop Hypertension

By Krystle Banzuela

DASH stands for Dietary Approaches to Stop Hypertension. Hypertension is blood pressure greater than 140/90 mmHg. Studies have shown that following a DASH eating plan can prevent and control hypertension. It can lower the systolic blood pressure (SBP) 8-14 mmHg, lower weight and lower LDL or the bad cholesterol, which all together will reduce the risk of getting heart and renal diseases.
A DASH eating plan is low in saturated fat, cholesterol, and total fat. It emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products. It also includes whole grain products, fish, poultry, and nuts. It is reduced in lean red meat, sweets, added sugars, and sugar containing beverages. It is rich in potassium, magnesium and calcium, as well as protein and fiber. It contains less salt and sodium. 1500-2300 milligrams of sodium per day is recommended.
To make a DASH for life, start now and go slowly. Gradually increase the amount of fiber-rich foods you eat over several weeks to prevent bloating and diarrhea. Don’t stop taking prescribed blood pressure medications. Continue taking them and let your primary health care provider know that you are now eating the DASH way.

To learn and get more information, visit: http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm.
To download the Guide to lowering blood pressure with DASH, visit: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

References:

Mauk, K.L. (2006). Gerontological nursing: Competencies for care. Masachusetts: Jones and Bartlett Publishes.

National Heart, Lung, and Blood Institute. (n.d.). Your guide to lowering your blood pressure with DASH. Retrieved February 05, 2009, from http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

Smeltzer, S. C., Bare, B. G., Hinkle, J. L. & Cheever, K. H. (2008). Brunner & Suddarth’s textbook of medical-surgical nursing (11th ed., Vol. 2). Philadelphia: Lippincott Williams & Wilkins.

Notes: This blog post reflects the work of Krystle Banzuela RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The cont of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Healthy Living

Healthy Living as You Age

By: Zondra Davis, Rn.

An ounce of prevention is worth a pound of cure! Early detection and management of disease is worth its weight in gold! Effectively treating existing disease -PRICELESS! Individuals who have the privilege to enjoy a long, healthy life also have the responsibility LIVE WELL. The following steps are sure to add quality to your life.

Laugh often. If you feel a loss of pleasure and interest for 2 or more weeks, this is not normal aging. Ask your primary health care provider for a depression screening. You deserve to feel better.

Immunizations offer protection against influenza and pneumonia. Get your flu vaccine every year and the pneumonia vaccine once (repeat after five years if recommended by your primary health care provider).

Verify your medications and their side effects with each visit to your primary health care provider and keep an updated list with you.

Eat a balanced diet with daily exercise under the supervision of your primary health care provider. Regular exercise improves balance and strength, and is your best protection against falls.

Weigh-in with friends and family. Regular interaction within a positive social network improves well being.

Engage in diagnostic screening test to screen for cancer, hypertension, hearing, and vision problems. Talk to your primary health care provider about other screening test, early detection of disease improves treatment options.

Leisure that stimulates the mind provides recreation and has cognitive benefits. Puzzles, bingo, reading, writing, and nature walks are examples of activities that benefit well-being.

List important numbers and appointments, this helps you stay organized and keep important medical appointments. Live your best life!!!

References

1. Mauk, K.L. (2006). Gerontological nursing: Competencies for care. Masachusetts: Jones and Bartlett Publishes.

2. www.cdc.gov/ncipc/duip/spotlite/falls

3. www.cancer.gov/cancertopics/screening

4. www.cdc.gov/vaccines/

5. www.mentalhelp.net/

Notes: This blog post reflects the work of Zondra Davis RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

By: Janella Schroeder RN

Natural Herbs and Vitamins Interact With Medications and Medical Conditions,
Elderly at Highest Risk

The concept of health promotion and primary disease prevention are growing trends in health care. With health awareness come more frequent doctor visits, more attention to lifestyle and diet choices and becoming more common is types of alternative medicine. Among the most common alternative medicine are natural herbal supplements and vitamins. The elderly have been quick to take part in this growing trend of “natural” medicine for varying reasons. Most are looking to supplement their diets and use herbs for health promotion and disease prevention. Unfortunately, some older adults turn to herbal supplements and vitamins due the high cost of prescription medication. Some are also looking for a more natural way to cure some aliment without going on another “medicine”.
It is extremely important to realize that herbal supplements and vitamins as natural as they may seem are still considered medication. The elderly are at higher risk for the side effect and drug interactions that herbal supplements and vitamins possess due to the increased multiple medications they are on and the decrease in kidney and liver function that comes with age. It is also vital that all consumers of herbal supplements and vitamins be aware that the evaluation of safeness and effectiveness of these substances is in the hands of the manufactures. The Food and Drug Administration (FDA) does not test the actual substances sold nor does it test the claims the manufactures of the supplements make.
There are many health benefits to supplements, but it is essential to discuss the supplement choice and dose with your doctor or pharmacist. Dosing can mean the difference between beneficial results and detrimental side effects and vitamin toxicity that are more common among elderly partakers. The some common supplements that can cause fatal vitamin toxicity in the elderly are vitamin D, vitamin A, and vitamin B6. So many herbal supplements and even plain vitamins can have detrimental interactions with prescription medications. One of the most common vitamin supplements taken is calcium which can interact with antibiotics, diuretics, thyroid medications and many more. It cannot be stressed enough that just because a medication is over the counter does not mean it does not come with side effects and potential interactions and your doctor still needs to know that you take it even though it is not a “medication”.
If your doctor is unwilling to work with you in finding the right supplements and vitamins to work for your symptoms and current medications, either find a doctor who will or visit a pharmacist. There are many great resources that offer nonbiased online information on all medications including vitamins and supplements. Most importantly the source discusses possible side effects and potential drug interactions.
Supplements and vitamins can have great benefits and most are considered safe however it is not safe to self-diagnosis and self-medicate, no matter what your age. Unfortunately with age comes more complications in taking these natural substances, so before you try them, please discuss them with a health care professional. Most importantly, consider every pill, cream, tea, or solution you ingest a medication and tell your doctor you are on it.


References

Drug Digest: http://www.drugdigest.org/wps/portal/ddigest

Beatty, E. (2007). Herbal Supplements and the Elderly. Retrieved 2 5, 2009, from Resources For Seniors: www.resourcesforseniors.com/pharm_essays/herbal%20supplements.doc

Mauk, K. (2006). Gerontological Nursing. Sudbury: Jones and Bartlett.

T. B. (2002). Vitamin toxicity. Retrieved 2 5, 2009, from Life Steps: http://www.lifesteps.com/gm/Atoz/ency/vitamin_toxicity.jsp

Notes: This blog post reflects the work of Janella Schroeder RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Addressing Childhood Obesity

By: Ruth Young RN

Obesity is a growing concern in our community that is affecting children at alarming rates. According to the CDC, more than half of the adults in the U.S. are overweight, and the number of overweight children and teens has doubled in the past decade. An estimated 17% of children and adolescents age 2-19 are overweight. (National Health and Nutrition Examination Survey)
The cause of obesity may be genetically linked or lifestyle behaviors and this may put you at risk for developing other medical conditions such as diabetes, high cholesterol and cardiovascular disease. (CDC) Other problems that may also develop are depression, anxiety, low self-esteem & poor body image.
With the help of the parents and the Community Health Nurse, this problem can be managed successfully with diet modifications, an exercise regimen, and maybe counseling for some individuals.
First there is a need to assess the family’s willingness to change; secondly we need to focus on healthy behaviors, its not just about losing weight. Education on fresh fruits and vegetable consumption, incorporation of 3 balanced meals a day, limiting highly processed foods, and comparison shopping may be beneficial for those families who aren’t able to buy healthy foods due to the cost.
The nurse needs to place an emphasis on getting the children back to being active instead of watching television, playing video games, and surfing the internet. The parents need to be educated on providing physical activity for their children which helps keep them healthy.

References
http://www.cdc.gov/nchs/about/major/nhanes/DataAccomp.htm http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm

Note: This blog post reflects the work of Ruth Young RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Congestive Heart Failure

By: Michael Lane RN
Congestive Heart Failure (CHF) is a condition that impairs the pumping of the heart (Lewis, Heitkemper, and Dirksen 2004). The heart is unable to pump enough blood to meet the body’s needs. Any number of underlying heart conditions can lead to heart failure (http://www.mayoclinic.com). Its called “congestive” from the fact that one or both of the heart's lower chambers fail. This failure causes blood to back up into,or congests, the liver, abdomen, lower extremities, and lungs, causing symptoms such as shortness of breath, fatigue, and leg swelling (www.mayoclinic.com).
Currently over 5 million people in the United States have CHF. It is the most rapidly increasing form of Cardiovascular Disease. The American heart association estimates that close to 500,000 new cases are diagnosed a year. CHF increases with advancing age. Approximately 1 in 100 older adults have some form of CHF. The incidence is the same in both women and men. The annual cost of the disease exceeds $57 billion dollars (Lewis, Heitkemper, and Dirksen 2004).
The care is multi-faceted and the community nurse is essential in educating this community. Lifestyle changes are critical brcause CHF is a progressive disease. Transplants are a possible option for younger sufferers of CHF but are not often offered to most older adults with CHF. The key is slowing the progression of the disease and improving the overall heart function. Some people can live for years with CHF if managed properly.
Severe cases will require closer monitoring. The use of oxygen and BiPap machines to aid in breathing and combating dypsnea and apnea while sleeping will help improve quality of life. Medication therapy is essential to keep heart working efficiently and keep fluids from accumulating. Diet and weight management is critical to the patient. Salt and water must be measured on a daily basis. Abstinence from smoking and alcohol consumption should be strictly adhered to. Daily weights should be done to detect complications of fluid retention early.
Patient teaching should include the family and support structure. Everyone needs to know that this disease is progressive and requires strict guidelines to ensure medication is taken properly. Patients needs to be aware of early signs of exacerbations and side affects of medicines.
Patients must learn the importance of frequent blood test and doctor visits. Encourage patients to write down questions so they can remembered them when calling the doctor. Home health and counseling should be in place for monitoring and psychological problems stemming from the disease.
Prognosis is good with proper management. The future holds promise with things like ventricular devices, balloon pumps, and new medications in research as we speak management will become much easier

Note: This blog post reflects the work of Michael Lane RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Protecting Children from lead poisoning

By Tracey Jackson RN

Keeping children safe from lead poisoning requires attention from everyone in a child's life. Lead is harmful to children because if they get enough of it in their bodies, it can limit their physical development; cause irreversible neurological damage as well as renal disease; cardiovascular effects and reproductive toxicity.
Childhood lead poisoning can be addressed by the community health nurse in the home. Community health nurse (CHN) works with the family to identify possible sources of contamination and to educate families on ways to reduce the risk of lead contamination. In cases where the child's blood lead level is 10 micrograms per deciliter or greater, a CHN contacts the family either by phone or letter to provide education to prevent further lead poisoning. In cases where the blood lead level is 20 micrograms per deciliter or greater, a CHN and a Registered Environmental Health Specialist visit the home of the child to provide education to prevent further poisoning and to attempt to identify the source of the lead poisoning.
The CHN helps client to self manage their disease process by decreasing exposure to lead. From January through June 2008, there have been more than 50 recalls of over a million products due to high lead content. The vast majority of these recalled products are children's products (http://service.mattel.com/us/recall/39054_IVR.asp?prod=).
CHN role is to ensure abatement of the lead source and provide education to the family and patient.To prevent further hospitalization of lead poisoning the plan of care consists of prescribing treatment of chelating therapy which reduce existing blood lead levels. Reducing the hazards lead poisioning requires both individual actions and public policy regulations. CDC’s Childhood Lead Poisoning Prevention Program is committed to the Healthy People 2010 (http://www.healthypeople.gov/) goal of eliminating elevated blood lead levels in children by 2010.

Note: This blog post reflects the work of Tracey Jackson RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Preventing seizure related injuries

By Stacy Hall RN

According to the Epilepsy Foundation (2005) each year approximately 300,000 people experience a first convulsion. More than one third of them (120,000) are children under eighteen years of age, and 75,000 to 100,000 are children under five years of age who experience febrile seizures. Many of those who experience a first seizure however go on to develop chronic seizure disorder without any known cause (Clark 410).
Caring for children and adolescent with seizure disorder can be quite a scary situation when you don’t know what is going on with your child. A seizure is a sudden change in consciousness or behavior caused by abnormal brain activity. It also involves assisting them to cope with the perceived or real stigma attached to the disease as well as encouraging compliance with medical therapy (http://www.yourtotalhealth.village.com/). Medication is highly effective in the treatment of epilepsy, with approximately 70% of those treated remaining seizure-free for 5 or more years, at which time three fourths of them can discontinue medication without a return of a seizures. With Adolescent the need is different than with children, with adolescent in particular may need to be referred for counseling if their condition contributes to a poor self image or difficulty with interpersonal interactions especially in school setting. Under certain circumstance anyone can experience a seizure, but a seizure can occur at any age although children are at greater risk for seizure than any other age groups. There are different medical conditions that may produce a seizure such as (Diabetes and etc).
The community health nurse can educate them about the inadvisability of swimming alone or help adolescent cope with their inability to obtain a drivers license. Both the children and parents may need to be helped to cope with the fear and uncertainty caused by uncontrolled seizures. School nurse in particular, may be in a position to educate others about seizures disorder and advocate for fair treatment of those affected, and also medication management. Educate on keeping an emergency kit for seizure disorder with them at all times, educate on the pre seizure activity to family and client, and Safety measure such as (helmet wearing for protection of head, and etc.)

References

1. Retrieved July 21, 2008 from http://www.yourtotalhealth.village.com /html
2. Clark, J.M., (2008) Community Health Nurse Meeting the Health Needs of Children and Adolescent (pp. 410) Pearson Education, Inc., New Jersey.

Note: This blog post reflects the work of Stacey Hall RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.