Introduction
In the United States of America and the rest of the globe, high blood pressure (HBP) poses a significant threat to public health due to its prevalence and association with cardiovascular disease. Hypertension increases the risk of cardiovascular illnesses, heart difficulties, stroke, and renal ailments, among the major causes of mortality in the United States. Hypertension has a wide range of causes, and most individuals have more than one. 56% of non-Hispanic black adults have hypertension, compared to 48% of non-Hispanic white adults, 46% of non-Hispanic Asian adults, and 39% of Hispanic people (Centers for Disease Control and Prevention, 2023, para. 3). In the United States, more than 670,000 fatalities in 2020 had hypertension as a major or underlying cause (Centers for Disease Control and Prevention, 2023, para. 2). Controlling hypertension may be challenging, and many individuals struggle with illness management.
There are several variables that contribute to the development of hypertension, including genetic disposition, environmental risk factors, and social determinants of health. In people with hypertension, lowering blood pressure to non-hypertensive values with pharmacological and nonpharmacological therapy reduces the risk of further cardiovascular illnesses. Over the last fifty years, high blood pressure (HBP) has become more prevalent in the United States. Several projects have been established to increase hypertension awareness. Most of these efforts focus on populations with a larger likelihood of having HBP, like blacks and those with low socioeconomic status (Centers for Disease Control and Prevention, 2023). When a diagnosis of hypertension has been made, the next step is to manage blood pressure (BP) and limit the risk of subsequent complications, such as different forms of cardiovascular incidents.
Physicians and several other medical care specialists, such as primary care practitioners, psychologists, nutritionists, and caseworkers, are multidisciplinary in offering assistance and share hypertensive roles. Clinical inertia is the theory that poor blood pressure regulation results from incompetent management and inappropriate practice structure (Milman et al., 2018). Numerous health researchers have largely recognized this theory. Patients suffering from hypertensive crises typically occupy the intensive care unit (ICU). Hence, as a registered nurse in the ICU, blood pressure is an intriguing and compelling subject of conversation. In most cases, uncontrolled blood pressure is the cause of stroke among this unit’s patients. Several individuals have experienced multiple strokes in various body parts due to hypertension. Healthcare practitioners may enhance hypertensive patients’ comprehension, compliance, and medication management. Individuals with elevated blood pressure can benefit from medication; however, nurses are obligated to develop less invasive and more patient-oriented options.
Analysis of Evidence from the Literature and Professional Sources
Lifestyle modification, supported by the establishment of patient-centered care, may enhance hypertension management. Nurses are best positioned to actively interact with patients on optimum blood pressure management, lifestyle risk reduction, and compliance with evidence-based standards due to their long-term involvement and ongoing relationships with patients. After hypertension is identified in an individual, the registered nurse conducts a review with the patient, during which a baseline blood pressure (BP) is determined, biometric measures are taken, and lifestyle factors are discussed.
Eating healthily, managing stress, engaging in regular exercise, quitting smoking, and managing weight frequently contribute to realizing one’s health objectives. Belozo et al. (2018) discovered that obese hypertensives who did rigorous aerobic exercise three times a week for 30 minutes at 70%–80% of their MHR (maximum heart rate) had decreased blood pressure. Research has shown that aerobic exercise at 50%–75% of the MHR improved metabolic markers such as blood pressure in persons with type 2 diabetes (Belozo et al., 2018). The research found no significant variations in the HR (Heart Rate) and BP values of hypertensive obese persons before and after training. However, following the twenty-fourth session, the association between BP and HR was examined and determined to be statistically significant. The findings validated the literature’s conclusion that a greater HR is related to higher BP and may increase the likelihood of hypertension and cardiovascular disease. In addition, it is essential to note that lowering HR, even to a small degree, is regarded as a therapeutic approach and clinically significant in hypertensive individuals.
Modifying lifestyles for hypertensive patients involves adopting dietary intake practices such as limiting salt intake, increasing vegetable and fruit consumption, and decreasing alcohol use. In one research, 12 individuals enrolled in a randomized crossover trial comparing the effects of low and high-salt diets over the course of seven days (Ozemek et al., 2020). The low sodium diet lowered office systolic blood pressure and diastolic blood pressure by 22.7 and 9.1 mmHg, accordingly, relative to baseline office BP, whereas the high sodium diet did not substantially differ (Ozemek et al., 2020). The scientists concluded that dietary salt consumption might be a substantial factor in anti-hypertensive drug resistance in this cohort (Ozemek et al., 2020). Applying these techniques in a clinical context has been a fruitful endeavor. If a nurse instructs patients on regulating their blood pressure, they must remember that many individuals find it challenging to adhere to a healthy lifestyle, observe their physicians’ instructions, and visit a doctor as recommended (McManus et al., 2021). The neglect of evidence-based nursing practice has made it difficult for nurse practitioners to overcome the obstacles preventing its broad adoption.
State Board Nursing Practice Standards and Governmental Policies
As a result of the establishment of state nursing boards, the American Nurses Association implements and enforces a range of policy provisions. Nursing systems are government agencies that supervise and guarantee safe patient care by establishing guiding principles for issuing licenses and taking measures against nursing staff who have participated in harmful nursing care (NursingExplorer, 2018). On the other hand, all nursing organizations emphasize the safety and health of the public by ensuring that doctors are qualified to perform the responsibilities associated with being registered doctors in a specific state. In New York, RN licenses are valid for three years, and to preserve their licenses, doctors must maintain a positive reputation among the licensing boards and the company for which they work (Tailleart, 2022). The standards for nursing licensure and continuing education vary by county, and doctors must adhere to the guidelines established by their board of nursing to be in excellent condition while working conscientiously and responsibly.
As the Education Law outlines, candidates for a nursing license in New York must complete specific criteria, including education, assessment, and ethical character standards. The state department is accountable for verifying that license candidates satisfy certain State requirements (NursingExplorer, 2018). Moreover, the Department investigates complaints and prosecutes professional malpractice such as gross negligence. The Department has devised a risk-based approach for prioritizing investigations, and it also has time frame targets to ensure that investigations are done on time. For instance, priority one investigations (containing allegations that represent a significant threat to public health and safety) must be concluded within six weeks.
The Department separately examines academic requirements, test scores, and out-of-state licenses; however, it fails to take equivalent proactive procedures to verify applicants’ moral conduct. Rather, the Department depends only on applicants to report previous transgressions and convictions entirely and accurately. While New York does not need fingerprints or background checks for nursing licenses, the state does not employ additional techniques that may reduce the probability that applicants do not disclose all relevant information.
Leadership Strategies to Improve Outcomes
Along with other medical teams, Registered Nurses (RN) are crucial in delivering patient care and enhancing the quality of life and outcomes. Nurses play a critical role in treating several chronic conditions, particularly hypertension. Nursing personnel is the most vital element of the care team when it involves patient education and training, communication, and outreach. Communication is essential when providing treatment since it helps them to feel that they have a partner in their primary care and that all healthcare staff meets their needs (Ozaras & Abaan, 2018). To improve patient outcomes, training must include the deployment of self-care practices to recognize better and respond to worsening symptoms and manage potential adverse drug reactions. While managing hypertensive patients, advocacy is a crucial factor for nurses to undertake. As it relates to the ideas of morality, governance, ethics, and coordinated care, advocacy is believed to be the intellectual foundation and goal of nursing. In addition to preserving patients’ autonomy, rights, and interests, assuring patients’ access to readily available resources, and respecting patients’ desires and requirements, nurses are held to rigorous standards as caretakers.
Part 2 Of the Assignment
Mrs. Eve is my aunt, who has been battling hypertension for the last two years. On a successive follow-up appointment with her primary care physician, she observed that her blood pressure had increased in conjunction with her body mass index. When her doctor inquired whether she had adjusted her current lifestyle, she said it was unnecessary since she was using her prescriptions. After assessing Mrs. Eve’s knowledge of high blood pressure, it was evident that she needed additional information regarding the necessary lifestyle adjustments. For the sake of this research, Mrs. Eve’s primary care nurse was contacted about hypertensive treatment. For Mrs. Eve, the most important part of nursing is education.
Patients are likely to feel vulnerable when they receive a new diagnosis. Nurses must provide these patients with appropriate information to manage the disease. Yet, education does not cease after the initial diagnosis; it is vital to give continuing education to ensure that patients are supported in their efforts to control their hypertension. The middle-range nursing concepts for hypertension therapy would be an excellent strategy to ensure the effectiveness of Mrs. Eve’s illness-preventive efforts (Drevenhorn, 2018). If this method is used, the nurse will educate the patient using eight great communication strategies. Priority number one for the physician is to assess Mrs. Eve’s readiness to undertake lifestyle adjustments. Ensuring that Mrs. Eve is prepared to tolerate adjustments to her daily routine increases the probability that she will adhere to her medication regimen.
Conclusion
Without efficient care coordination, the patients are at a greater risk for unfulfilled needs and inadequate disease management, which is detrimental to their health. Despite attempts at hypertension control and the goal to minimize mortality and comorbidities, death and comorbidities persist. The nurse is responsible for promoting patient rights, diplomacy, and campaigns. Due to the growth in healthcare requirements, changes in healthcare systems, and technological developments, nurses must adapt appropriately. Using evidence-based methods, nurses play a vital role in managing and controlling blood pressure levels.
References
Belozo, F. L., Katashima, C. K., Cordeiro, A. V., Lenhare, L., Alves, J. F., & Silva, V. R. R. (2018). Effects of ninety minutes per week of continuous aerobic exercise on blood pressure in hypertensive obese humans. Journal of Exercise Rehabilitation, 14(1), 126–132. Web.
Centers for Disease Control and Prevention. (2023). Facts about hypertension. Web.
Drevenhorn, E. (2018). A proposed middle-range theory of nursing in hypertension care. International Journal of Hypertension, 2018, 1–11. Web.
Milman, T., Joundi, R. A., Alotaibi, N. M., & Saposnik, G. (2018). Clinical inertia in the pharmacological management of hypertension. Medicine, 97(25), e11121. Web.
NursingExplorer. (2018). Nursing license requirements in New York. Nursing Explorer. Web.
Ozaras, G., & Abaan, S. (2018). Investigation of the trust status of the nurse–patient relationship. Nursing Ethics, 25(5), 628-639. Web.
Ozemek, C., Tiwari, S., Sabbahi, A., Carbone, S., & Lavie, C. J. (2020). Impact of therapeutic lifestyle changes in resistant hypertension. Progress in Cardiovascular Diseases, 63(1), 4–9. Web.
Tailleart, A. (2022). A guide to nursing licenses and renewals in New York. Incredible Health. Web.