1) A description of a patient who presented with a hypertension problem during your Practicum
2) Explain the patient’s history including drug treatments and behavioral factors.

3) Then, suggest two health promotion strategies for the patient.
4) Include suggestions for reinforcing hypertension management.

High Blood Pressure is a cardiovascular disorder that needs good treatment and
management plan. This plan needs a patient-provider collaboration. It is important for the patient
to have appropriate education and great commitment to the treatment and management plan.
Different strategies can be used to give better results in the management of the condition to the
comfort of the patient. Alongside the plan, patient’s behavioral changes can particularly yield
good results in management of the condition. These include increased exercises, eating a healthy
diet, and avoiding smoking. Two approaches are recommended for the treatment and
management of Hypertension. Pharmacologic therapy approach is much dependent on standards
set by government agencies and professional associations like the American Heart Association
while nonpharmacologic therapy deal with patient’s behavioral change (Buttaro &Trybulski,

Mr. Lewis’s case

During my Practicum one patient, Mr. Lewis aged 55 years (not his real name) came for
observation after having breathing difficulties. Going through the patient’s file revealed that
indeed he has had this condition for about two years. A closer observation gave further evidence
to confirm my worries. Mr. Lewis was overweight as he had a BMI of 28/m2, BP at 150 mm Hg
and a waist circumference of 130 cm, way above the recommended (NHLBI, 2002).
He has been experiencing unusual fatigue for the last two years. Overweight people
experience breathlessness when performing a task, yet unknown to them it might be a symptom
of hypertension. Other symptoms of hypertension include chest pain, blood in urine, severe
headache, vision problem, irregular heartbeat and pounding in the chest (Medscape 2014).
Mr. Lewis was a smoker, had poor eating habits and exercised less. Perhaps he could not
remember the last time he was in a gym. Mr. Lewis has not been on any serious medication.
This condition meant that I had to put him on immediate treatment and management of his
condition. At an early stage, BP can be managed by lifestyle modifications and low combination
of thiazide diuretic and an ACE inhibitor as recommended by American Heart Association and
the Center for Disease Control and Prevention algorithm (Medscape, 2014). He responded well
and within a week I reviewed his condition with remarkable results. His condition was stage 1
hypertension that needed more of lifestyle modification than drugs treatment. Fatigue levels
reduced drastically and the congestion in his chest was notably down.

Two health promotion strategies for the patient (Mr. Lewis)
Mr. Lewis can do better by exercising regularly and eating healthier. Losing weight helps
prevent hypertension. He needs to eat a diet rich in fruits and vegetables, free or law fat milk
products and adequate intake of minerals like potassium, calcium, and magnesium. He needs to
reduce sodium chloride intake in his diet too (Medscape, 2014).Smoking affects the quality of

oxygen that one gets in the bloodstream. Mr. Lewis should stop smoking and go for aerobics to
help burn the fats in his body.

High Blood Pressure Management

Hypertension needs to be managed as it is a serious health challenge. It increases the risk
for diabetes and is very fatal in pregnancy. It can lead to a higher risk of stroke, renal disease and
poor vision.. Treatment is best recommended for younger patients as a management plan with
maxima doses depending on disease’s status and progression. At an early stage, change in
lifestyle is the best way to manage high blood pressure (Medscape, 2014).


Buttaro, T M., Trybulski, J., Polgar BP., & Sandberg, CJ. (2013). Primary care: A collaborative
practice (4th Ed.). St. Louis, MO: Mosby. Part II, “Evaluation and Management of
Cardiovascular Disorders” pp 486- 611)
National Heart Lung and Blood Institute. (2002). Primary prevention of hypertension: Clinical
and public health advisory from the National High Blood Pressure Education Program.

Meena, SM., Kamran R., & David GH. (2014). Treatment and Management of Hypertension.
Medscape medical journal. Edited by David JM.

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