Health Education on prevention of hypertension

Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The

1. SHIMLA NURSING COLLEGE SHURALA,SHIMLA


HEALTH EDUCATION

ON

PREVENTION OF HYPERTENSION

SUBJECT: MEDICAL SURGICAL NURSING

SUBMITTED TO: SUBMITTED BY:
DR.PALLAVI PATHANIA RADHIKA KULVI
ASSOCIATE PROFESSOR M.Sc.1
ST
YEAR
MEDICAL SURGICAL NURSING. ROLL NO:2

SUBMITTED ON:
03/05/2022

2. IDENTIFICATION DATA


 Name of student teacher : Radhika Kulvi

 Class : M.Sc. Nursing 1
st
year

 Name of the subject : Medical Surgical Nursing

 Name of the topic : Prevention of hypertension

 Group : Patients admitted in ICU

 Venue : BLK Hospital, New Delhi

 Name of the evaluator : Dr.Pallavi Pathania

 Duration of teaching : 30-35 min.

 Method of teaching : Lecture cum discussion

 AV-aids : Chart, pamphlets, leaflets, handouts.

 Previous knowledge of the group : Patients have some knowledge regarding prevention of hypertension

3. LEARNING OBJECTIVES


General objectives:
At the end of the health education patients will be able to understand and explain about prevention of hypertension.

Specific objectives:
At the end patients will be able:
 To define hypertension.
 To explain about classification of hypertension.
 To discuss about the modifiable and non-modifiable risk factors of hypertension.
 To enlist the sign and symptoms of hypertension.
 To discuss about diagnostic evaluation of hypertension
 To explain about prevention of hypertension.
 To conclude the topic.
 To summarize the topic.
 To recaptulize the topic.

4. Sr.
no.
TIME SPECIFIC
OBJECTIVE
CONTENT MATTER TEACHER
LEARNER
ACTIVITY
A.V. AIDS EVALUATION
1 10 sec. To introduce
myself
SELF INTRODUCTION: Good morning to all I am Radhika kulvi
student of MSc. Nursing 1
st
year. Today I am here to give health
education on prevention of hypertension.
Lecture
method
Verbal
explanation

2 I min. To introduce
the topic
INTRODUCTION
Hypertension is a chronic condition of concern due to its role in the
causation of coronary heart diseases. Hypertension is a worldwide
epidemic and important risk factor for coronary artery disease, stroke and
renal diseases. Blood pressure is the force exerted by the blood against
the walls of the blood vessels and is sufficient to maintain tissue
perfusion during activity and rest. Hypertension is sustained elevation of
BP. In adults, HTN exists when systolic blood pressure is equal to or
greater than 140mmHg or diastolic BP is equal to or greater than
90mmHg. The
diagnosis of HTN requires that elevated BP at least in 3 occasions in
several weeks.
Lecture
cum
discussion
method.
Verbal
explanation
Define
hypertension.
3 2 min. To enlist the
classification
of
hypertension.

CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS








CLASSIFICATION OF HYPERTENSION
According to the etiology of hypertension it can be classified as:
 Primary (essential) Hypertension: When BP elevated without any
identified cause it is termed as essential hypertension. It
Lecture
cum
discussion
method.
Verbal
explanation
Discuss the
types of
hypertension. CATEGORY SYSTOLIC DIASTOLIC
Optimal <120 <80
Normal <130 <85
High normal 130-139 85-89
HYPERTENSION
Stage 1 140-159 90-99
Stage 2 160-179 100-109
Stage 3 >180 >110

5. accounts 90 to 95% of all hypertension. The exact cause is unknown but
some contributing factors like increased sodium intake, increased sodium
retaining hormone, etc.
 Secondary Hypertension: When BP is elevated due to some identified
cause like endocrine disorder like hyperaldosteronism, renal disease,
etc. it accounts 5 to 10% in adults and 80% in among children. Once
the causative factor is eliminated/ corrected BP
become normalized.

4 5 min. To explain
about the risk
factors of
hypertension.
RISK FACTORS
Hypertension is not only one of the major risk factors for most forms of
cardiovascular disease, but that it is a condition with its own risk factors.
A WHO Scientific Group has recently reviewed the risk factors for
essential hypertension. These may be classified as:

Non-modifiable risk factors
 Age: BP rises progressively with age in both sexes. Elevated BP is
present in approximately 50% people above 60yr of age.
 Gender: HTN is more prevalent in male in young adulthood and early
middle age. After 55 yrs hypertension is more prevalent among
female.
 Ethnicity: Incidence of HTN is twice high among African American.
Black Americans of Africans origin have been demonstrated to have
higher blood pressure levels than whites.
 Family history: Risk of HTN is increases for those with a close
relative having hypertension. Study shows that 3% risk among
normotensive parent whereas 45% among children of two hypertensive
parent.

Modifiable risk factors
 Obesity: The greater the weight gain, the greater the risk of high blood
pressure. “Central obesity” indicated by an increased waist
Lecture
cum
discussion
method.
Pamphlets Explain the
modifiable
and non-
modifiable
risk factors
of
hypertension.

6. to hip ratio, has been positively correlated with high blood pressure in
several populations.
 Salt intake: There is an increasing body of evidence to the effect that a
high salt intake (i.e. 7- 8gm per day) increases proportionately.
 Saturated fat: The evidences suggest that saturated fat raises blood
pressure as well as serum cholesterol.
 Alcohol: High alcohol intake is associated with an increased risk of
high blood pressure. It appears that alcohol consumption raises systolic
pressure more than the diastolic.
 Dietary fibre: Several studies indicate that the risk of CHD and
hypertension is inversely related to the consumption of dietary fibre.
Most fibres reduce plasma total and LDL cholesterol.
 Physical activity: Reduced physical activity causes increase weight
gain and can increases the chances of hypertension.
 Environmental stress: The term hypertension itself implies a disorder
initiated by tension or stress. The more the stress increases the chances
of blood pressure.
 Socio-ecnomic: A higher prevalence of hypertension have been noted
in upper socio- economic groups.

5 3 min. To discuss
about the sign
and symptoms
of
hypertension.
SIGN AND SYMPTOMS OF HYPERTENSION:
If the blood pressure is high the following sign and symptoms can be seen
in the client:
 Severe headache
 Fatigue or confusion
 Vision problems
 Chest pain
 Difficulty in breathing
 Irregular heartbeat
 Blood in urine
Lecture
cum
discussion
method.
Leaflets Enlist the
sign and
symptoms of
hypertension

7.  Pounding in chest, neck or ears
 Anxiety
 Decrease alertness and concentration
 Weakness or numbness in limbs, face or other areas
 Restlessness and sleepiness
 Nose bleed
 Oedema

6 2 min. To explain the
diagnosis of
hypertension.
DIAGNOSIS OF HYPERTENSION
To diagnose the hypertension one high reading does not mean you have
high blood pressure. It is necessary to measure the BP at different times,
while resting comfortably for at least 5min. to make diagnosis of
hypertension, at least three readings that are elevated are usually required.

Other factors for diagnosis includes all risk factors:
 Family history of hypertension
 Dietary factors
 Heart problems
 Obesity
 Life style, etc
Lecture
cum
discussion
method.
Verbal
explanation
Explain the
diagnostic
criteria for
hypertension.
7 15 min. To explain
about
prevention of
hypertension.
PREVENTION OF HYPERTENSION
The WHO has recommended the following approaches in the prevention
of hypertension:

PRIMARY PREVENTION
a) Population strategy
b) High- risk strategy

SECONDARY PREVENTION

PRIMARY PREVENTION: Primary prevention has been defined as “all
measures to reduce the incidence of disease in a population by reducing
Lecture
cum
discussion
method.
Chart Explain the
prevention of
hypertension.

8. the risk onset”. The goal of the population approach is to shift the
community distribution of blood pressure towards lower levels .This
involves a multifactorial approach , based on the following interventions:

NUTRITION: Dietary changes are of paramount importance. The DASH
(Dietary Approaches to Stop Hypertension) diet emphasizes vegetables,
fruits and low- fat dairy foods- and moderate amounts of whole grains,
fish, poultry and nuts.These comprise:
 Reduction of salt intake to an average of not more than 5gm per
day.
 Moderate fat intake (by avoiding fried food items and extra milk
products)
 The avoidance of a high alcohol intake (a maximum of 2 drinks a
day for men and one for women)
 Restriction of energy intake appropriate to body needs.

Grains include bread, cereals, rice and pasta. Focus on whole grains
because they have more fiber and nutrients than do refined grains. For
instance, use brown rice instead of white rice, whole wheat pasta instead
of regular pasta and whole grain bread instead of white bread. Grains are
naturally low in fat. Keep them this way by avoiding butter, cream and
cheese sauces.
Vegetables and fruits includes tomatoes, carrots, broccoli. Sweet
potatoes, greens and other vegetables are full of fiber, vitamins and such
minerals as potassium and magnesium. Fresh and frozen vegetables are
both good choices but should labelled as low sodium or without added
salt. Have a piece of fruit with meals and one as a snack. Leave on edible
peels whenever possible. The peels of apple, pears and most fruits with
pits contain healthy nutrients and fiber. For citrus fruits like grapes consult
physician.
Dairy products should low in fat content or should be fat free. It includes
milk, yogurt, cheese and other dairy products are major sources of



Explain the
dietary
management
of
hypertension.

9. calcium, vitamin D and protein.
Lean meat, poultry and fishes can be taken. Meat can be a rich source of
protein. B vitamins, iron and zinc. Trim away skin and fat from poultry
and meat and then bake, grill or roast instead of frying in fat. Eat heart-
healthy fish such as salmon, herring and tuna. These types of fish bare
high in omega- 3 fatty acids, which can help lower the cholesterol.
Nuts, seeds and legumes like almonds, sunflower seeds, kidney beans,
peas, lentils and other foods in this family are good sources of magnesium,
potassium and protein . They are also full of fiber and phytochemicals,
which are plant compounds that may protect against some cancers and
cardiovascular disease.

WEIGHT REDUCTION:
The prevention and correction of overweight/ obesity ( Body Mass Index
greater than 25) is a prudent way of reducing the risk of hypertension and
indirectly heart diseases, it goes with the dietary changes.

EXERCISE PROMOTION:
The evidence that regular physical activity leads to a fall in body weight,
blood lipids and blood pressure goes to suggest that regular physical
activity should be encouraged as part of the strategy for risk factor control.
Engage in regular aerobic physical activity such as brisk walking, jogging,
cycling or swimming at least 30minutes per day, most days of the week.

BEHAVIOURAL CHANGES:
Certain behavioural changes are involved to maintain the blood pressure at
normal levels:
 Reduction of stress
 Avoid smoking
 Limit alcohol intake to no more than two drinks per day.
 Yoga
 Meditation

10. SELF- CARE:
An important element in community – based health programmes is patient
participation. The patient is taught self-care, i.e. to take his own blood
pressure and keep a log book of his readings. Log books can also be useful
for statistical purposes and for the long term follow up of cases.

HIGH- RISK STRATEGY:
This is also part of primary prevention. The aim of this approach is “ to
prevent the attainment of levels of blood pressure at which the institution
of treatment would be considered”. Detection of high risk subjects should
be encouraged by the optimum use of clinical methods. Tracking of blood
pressure from childhood may be used to identify individuals at risk.

SECONDARY PREVENTION:
The goal of secondary prevention is to detect and control high blood
pressure in affected individuals. Modern anti- hypertensive drug therapy
can effectively reduce high blood pressure and consequently risk of
cardiovascular and kidney diseases. The control measures comprise:

 Early case detection: Early detection is a major problem. This is
because high blood pressure rarely causes symptoms until organic
damage has already occurred, and our aim should be to control it before
this happens. The only effective method of diagnosis of hypertension is
to screen the population.
 Treatment: The aim of the treatment should be to obtain a blood
pressure below 140/90mmHg and ideally a blood pressure of
120/80mmHg. Control of hypertension has been shown to reduce the
incidence of stroke and other complications.
 Patient compliance: The treatment of high blood pressure must
normally be life-long and this presents problems of patient
compliance, which is defines as “the extent to which patient
behaviour (in terms of taking medicines, following diets or

11. executing other life style changes) coincides with clinical
prescription”. The compliance rates can be improved through
education directed to patients, families and community.

8 2 min. To conclude
the topic.
CONCLUSION:
Hypertension is a worldwide epidemic and important risk factor for
coronary artery disease, stroke and renal diseases. Hypertension is the
most important risk factors for chronic disease burden in India. Studies
from various parts of India have reported high prevalence of hypertension.
Lecture
cum
discussion
method.
Verbal
explanation
.

9 2 min. To summarize
the topic.
SUMMARIZATION:
Today we have discussed about
 Hypertension
 Classification of hypertension
 Causes of hypertension
 Risk factors of hypertension
 Sign and symptom of hypertension
 Diagnostic evaluations of hypertension
 Management of hypertension
 Prevention of hypertension
 Dietary management of hypertension.
Lecture
cum
discussion
method.
Verbal
explanation

10 3 min. To recaptulize
the topic
RECAPTULATION:
 Define hypertension.
 What are the causes of hypertension?
 Enlist the sign and symptoms of hypertension.
 Explain the prevention of hypertension.
 Explain dietary management of patient with hypertension.
Discussion
method
-

12. BIBLIOGRAPHY


BOOK REFERENCES:
1. Dash Bijayalaskhmi; A Comprehensive Textbook of Community Health Nursing; Jaypee The Health Sciences Publisher; viewed on:01/05/2022
2. Park K; Textbook of Preventive and Social Medicine; 22
nd
Edition; BanarsidasBhanot Publishers; viewed on:01/05/2022
3. Brunner and Sudharth’s “Textbook of Medical Surgical Nursing” 11
th
edition Lippincott Williams and Wilkins a Wolter kluwerbussiness; viewed
on:01/05/2022
4. Black M Joyce ‘Medical Surgical Nursing’ 6
th
edition, W.B. Saunders Company Philadelphia, Pennsylvania 19106; viewed on:01/05/2022
5. Chintamani “Levi’s Medical Surgical Nursing” 2013 published by Elsevier, a division of Reed Elsevier India private limited 305, Rohit house,
3 Tolstoy Marg, New Delhi 110001; viewed on:01/05/2022

INTERNET REFERENCES:

1. https://uihc.org/health-topics/prevention-and-treatment-high-blood-pressure-hypertension.viewed on:01/05/2022
2. https://pubmed.ncbi.nlm.nih.gov/12357131/. viewed on:01/05/2022
3. https://www.sciencedirect.com/science/article/pii/S0735109718354676 .viewed on:01/05/2022
4. https://www.everydayhealth.com/hypertension/preventing.aspx.viewed on:01/05/2022