Model essay on hypertension medicine "Study on internal medicine nursing methods of hypertension patients"
Abstract: Hypertension has high incidence, many complications and high disability rate. It is one of the important risk factors for the onset, morbidity and mortality of cardiovascular diseases, and has attracted more and more attention. How to carry out medical care for patients with hypertension, relieve their pain and reduce the incidence rate has become a major problem for nursing staff. Firstly, the author introduces some misunderstandings in the nursing of patients with hypertension, and then puts forward the correct internal medicine nursing methods to treat patients with hypertension, so as to relieve the mental stress of patients, relieve their pain and reduce the recurrence rate.
Keywords: hypertension internal medicine nursing countermeasures
China Library Classification Number R47 Document Identification Number B1671-8801(2013)1-0388-01.
Hypertension is a worldwide chronic disease with high incidence and many complications, which often leads to renal failure, heart failure, myocardial infarction, cerebral congestion and stroke. Its high disability rate is one of the important risk factors for the onset, morbidity and death of cardiovascular diseases. At present, in China, the vast majority of patients have little or incomplete knowledge of hypertension, which leads to great mental stress, which in turn leads to aggravation of the disease and difficulty in controlling blood pressure. How to carry out medical care for hypertensive patients, relieve their mental stress, relieve their pain and reduce the recurrence rate has become a major problem faced by nursing staff.
1 nursing misunderstanding of patients with hypertension
With the development of science and technology and the continuous innovation of modern human medicine, people gradually realize that bad lifestyle, the stimulation of social environment and the influence of mental illness are all causes of hypertension. Does hypertension exist in China? Three highs? 、? Three lows? That is, high prevalence rate, high disability rate and high mortality rate; Low awareness rate, low medication rate and low control rate. This situation is often related to some misunderstandings in the treatment of hypertension.
1. 1 has a strong drug dependence and does not attach importance to non-drug treatment. Many hypertensive patients are highly dependent on drugs, but they don't pay enough attention to non-drug treatment. However, the key to the prevention and treatment of hypertension is not drugs, but non-drug treatment and active prevention and treatment. The so-called non-drug therapy is to develop a good lifestyle, healthy work and rest and diet, overcome bad habits, quit smoking and limit alcohol, and properly strengthen physical exercise. However, too many hypertensive patients mistakenly believe that taking antihypertensive drugs can achieve the effect of treating diseases, so that they disdain non-drug treatment. Many patients take antihypertensive drugs without controlling drinking and smoking. This practice not only affects the efficacy, but also increases the physical load of patients and endangers their health.
1.2 patients use drugs intermittently and tend to use powerful antihypertensive drugs. Many hypertensive patients can't take medicine on time because of discontinuous medication, which leads to frequent fluctuations in blood pressure. Blood pressure is stable when taking medicine, but disordered when not taking medicine. The fluctuation of blood pressure will aggravate the patient's physical load, damage the body function, affect the treatment effect, and lead to the deterioration of the condition. In fact, perennial hypertension does not need immediate blood pressure reduction, but needs to be steadily reduced, and the elderly are not suitable for using rapid antihypertensive drugs because of the decline of physical function, which increases the physical and mental burden. When taking antihypertensive drugs, patients should start with small doses and closely observe the curative effect. If the patient's blood pressure drops too fast, the drug dosage should be adjusted. After the blood pressure is stable, it can be gradually reduced according to the doctor's advice, and the drug should not be stopped at will. It should be emphasized that some antihypertensive drugs may cause postural hypotension. Patients should stay in bed for 2 to 3 hours after taking the medicine, and can get out of bed after getting up normally.
2 Correct nursing methods for patients with hypertension
2. 1 scientifically guide the use of drugs in patients with hypertension. In order to solve the problem of drug abuse and incorrect drug use in patients with hypertension, medical staff should guide patients to take drugs scientifically and correctly, educate patients, and conduct health education in the form of explanation, demonstration, distribution of publicity materials and individual counseling. The contents of education include: the normal range of blood pressure, matters needing attention in measuring blood pressure, inducing factors of hypertension, self-care knowledge, misunderstanding of current hypertension prevention and treatment, the significance of insisting on medication and matters needing attention in medication, etc.
Because patients have different constitutions, they will have different degrees of reaction to the drugs used. Therefore, in the process of antihypertensive treatment, we should closely observe the adverse reactions of drugs according to the types of antihypertensive drugs taken, pay attention to keeping blood pressure stable, and avoid stopping taking drugs immediately when blood pressure drops, and then taking drugs when blood pressure rises. It is necessary to arrange the medication time reasonably, pay attention to the change of blood pressure and adjust the medication as needed.
2.2 urge patients with hypertension to form a good lifestyle. In order to avoid the recurrence of hypertension, medical staff should strengthen the supervision of hypertension patients, adjust their work and rest styles, ensure reasonable rest and adequate sleep, and urge them to change their traditional eating habits. They should pay attention to the principles of low salt, low fat, low calorie and low cholesterol in their diet, and patients should eat light and digestible food. For patients who smoke and drink alcohol, they should be urged to quit smoking and limit alcohol, so as to reduce the risk of increased circulating arterial pressure and increased vascular wall fragility and reduce the occurrence of other complications. Patients should be instructed to eat more fruits and vegetables, quit smoking and drinking, and try not to drink stimulating drinks such as coffee and strong tea. Obese people should make a reasonable weight loss plan and strictly limit calorie intake. And strengthen physical exercise, adopt non-drug nursing methods, combine work and rest, so that patients can maintain a stable and relaxed mood and a good mental state as much as possible to avoid excessive tension and fatigue.
2.3 Pay attention to the psychological care of patients with hypertension. When a patient is emotionally stimulated, his blood pressure will rise. In the process of nursing, we should pay attention to adjust the patient's mood in time. Patients with hypertension are usually very sensitive to their blood pressure. Once they find that their blood pressure rises and they need to take medicine, they are prone to nervousness and depression. The mood of patients directly affects the absorption, distribution, metabolism and excretion of drugs. Psychological nursing is an important auxiliary treatment measure for patients with hypertension, which can effectively control blood pressure and reduce the mortality rate of patients with hypertension. Careful nursing and effective treatment are the key to reduce or delay the complications of hypertension. Patients should have a correct understanding of the disease, explain the symptoms that have appeared, encourage patients to enhance their confidence and courage to overcome the disease, and actively cooperate with the treatment. In nursing work, we should carefully observe the different psychology of patients, patiently and actively listen to the voices of these patients, give them psychological counseling, teach them the methods of decompression, teach patients to adjust themselves psychologically, guide patients to establish a sound personality and normal emotional response, and keep psychological balance at all times. Hold regular lectures on hypertension to raise patients' awareness of the importance of the disease, strengthen patients' compliance with various treatment measures, and make patients who did not pay attention to treatment begin to receive treatment. And can consciously quit smoking and drinking, control weight, life rules, happy mood, psychological balance, so as to achieve the purpose of controlling hypertension. Supervise patients' families, try to keep patients away from hypertension inducing factors, reduce bad stimulation, ensure patients have a quiet and comfortable rest environment, and try to maintain the stability of blood pressure.
3 Conclusion
Although hypertension is an incurable disease with high incidence, many complications and high disability rate, it does not mean that there is no cure. While actively cooperating with doctors to take treatment measures and routine care, medical staff should clearly understand the nursing misunderstandings of hypertensive patients, give good medication guidance, help improve the medication rate of hypertensive patients, standardize their medication, and reduce the occurrence of hypertension complications.
refer to
Liu. Psychological nursing care of 22 elderly patients with hypertension. China medical frontier-No.8, 2009.
[2] Hu. Nursing care of elderly patients with hypertension. Forum on Basic Medicine-2065438+27,00.
[3] Liu, Xie Cuiping, Lu Xingyou. Effect of nursing intervention on medication compliance of hypertensive patients. Modern Hospital-August, 2008
The second model essay of hypertension medical paper "Community medical prevention and treatment of hypertension"
The rising prevalence of hypertension in China has become a risk factor that affects the quality of life and leads to the death of people. In addition to strengthening drug treatment, we should also strengthen the active prevention of hypertension in order to save economic costs more effectively and achieve better social benefits. Actively carry out community management, change the treatment mode, train qualified and responsible community doctors, publicize and educate the public, advocate a healthy lifestyle, and improve the working and living environment in order to effectively control the incidence of hypertension and prevent the occurrence of cardiovascular and cerebrovascular diseases.
Hypertension; Community management; Etiological prevention; Prevention of diseases; medicine
Hypertension is a common chronic disease in middle-aged and elderly people, and it is the main cause of cardiovascular and cerebrovascular diseases in middle-aged and elderly people, such as coronary heart disease and stroke. It is a disease that seriously endangers health and affects the quality of life. In recent years, with the change of people's living habits and diet structure, the prevalence of hypertension in China is on the rise, and the trend of youthfulness is becoming more and more obvious. Hypertension has become the first risk factor of death in people over 40 years old [1]. Therefore, it is of great significance to effectively control the incidence of hypertension and prevent the occurrence of cardiovascular and cerebrovascular complications.
1 Epidemiological characteristics of hypertension
In China, hypertension has high prevalence, high mortality and high disability rate. Three highs? And what about those with low awareness rate, low treatment rate and low control rate? Three lows? Features. The number of patients with hypertension in China is as high as 200 million [2], with more than 3 million new cases every year, but the control rate of hypertension in China is very low, less than 10%. There are more than 5 million stroke patients in China, and the number of people who die from the disease is as high as 200 thousand every year, of which 76% patients have a history of hypertension. Many studies show that only by improving the active prevention and treatment of hypertension can the occurrence of cardiovascular and cerebrovascular diseases be effectively reduced.
2 Community management of hypertension
For the treatment of hypertension, drugs are mainly used in clinic, but many studies show that preventing and controlling hypertension can save more economic costs, and the social benefits are incomparable with any antihypertensive drugs. /kloc-in the past 0/0 years, various institutions and groups related to the China government have done a lot of work in the prevention and treatment of hypertension, formulated relevant prevention and control policies and plans, and achieved certain results. Community intervention can improve patients' compliance behavior and is an important management means of hypertension control. Only by combining non-drug methods with drug treatment can hypertension be effectively controlled.
3 Etiological prevention of hypertension
That is, to eliminate the etiology or inducing factors of hypertension. It refers to a series of planned and organized activities to create a healthy environment for residents, change people's behavior and reduce risk factors, thus promoting health and improving the quality of life of patients with hypertension. It is of great significance for the prevention of hypertension and related cardiovascular diseases.
3. 1 self-care education
Provide health education services and hold health talks. Inform every resident of the dangers of hypertension, carry out free clinics to help residents understand their blood pressure, teach residents the methods of measuring blood pressure, and regularly monitor blood pressure, posture, posture and sphygmomanometer and make records.
Actively carry out physical exercise, control weight, and insist on walking as the most convenient aerobic exercise. Walking for 30 ~ 50 minutes in the morning can reduce blood pressure 10mmHg[3].
3.2 Reasonable adjustment of diet
Reduce the intake of sodium salt, a high-salt diet will lead to an increase in blood pressure, and actively promote the benefits of a low-salt diet. If the daily salt intake of healthy adults does not exceed 6g, the daily salt intake of each person will increase by 2g, and the average systolic blood pressure will increase by 2mmHg[4].
Increase the intake of potassium, calcium and magnesium appropriately. Potassium supplementation is beneficial to sodium excretion and can reduce the pressor response of sympathetic nerve.
Traditional cooking methods in China often lead to the loss of potassium, so we should advocate eating more fresh vegetables and fruits, such as spinach, bananas, oranges and other foods with more potassium. Most research reports believe that insufficient calcium in the diet will increase blood pressure. The main way to supplement calcium is to eat animal food, especially dairy products, followed by increasing the amount of bean products and fresh vegetables.
Increase the intake of high-quality protein, and high-quality protein generally refers to protein (such as fish) and protein. Current research shows that the quality of protein is related to the incidence of hypertensive stroke.
Reduce dietary fat, especially unsaturated fat.
3.3 Quit smoking and limit drinking
Vigorously publicize the health hazards of alcohol and tobacco. Smoking, in particular, can increase blood pressure by damaging arterial endothelial cells and producing vasospasm. People who smoke should be educated to discourage them from quitting smoking as soon as possible. Alcohol can increase the sensitivity of blood vessels to various pressor substances, thus raising blood pressure. Therefore, we advocate giving up alcohol completely, at least not drinking alcoholic beverages. People with high blood pressure risk factors should give up drinking.
3.4 Adjust psychology and reduce mental stress.
Middle-aged people are under the double pressure of work and family for a long time, and their bodies are often in a sub-health state. It is easy to ignore the alarm signal of the body, which leads to the formation of hypertension, cardiovascular and cerebrovascular diseases and diabetes. Studies have shown that people with long-term anxiety, nervousness, sleep disorders or long-term exposure to noise are prone to hypertension. Therefore, educating and helping residents, finding out targeted psychological problems, giving them counseling, advocating slow life, maintaining a happy mood and improving the working and living environment are all conducive to the prevention and treatment of hypertension. Studies have shown that patients with essential hypertension are accompanied by different degrees of emotional disorders, and simple antihypertensive treatment without adjusting emotions often has poor antihypertensive effect [5].
4 Prevention of hypertension
Community management should not only vigorously publicize and educate, but also strengthen the prevention of diseases. In other words, early detection, early diagnosis and early treatment of hypertension should be achieved. Carry out hypertension survey, train community doctors regularly, improve the treatment level and strengthen the sense of responsibility of community doctors. Establish the first blood pressure system and regular monitoring for people over 35 years old and at high risk, so as to find patients early. In addition, we will promote the establishment of hypertension clinics, regular doctors and follow-up services. Monitor blood pressure regularly, find patients early and improve the awareness rate of hypertension.
5 Drug treatment of hypertension patients
For patients with hypertension, in addition to the necessary non-drug treatment, individualized drug treatment is given to patients who meet the medication standards to achieve the highest curative effect. Strictly follow the principle of hypertension medication and try to choose simple, effective, safe and cheap antihypertensive drugs to reduce blood pressure to normal.
There are many commonly used drugs to treat hypertension, such as diuretics, calcium antagonists, ARB, ACEI, vasodilators and so on. Can be used alone or in combination according to the patient's condition. Community doctors should strengthen the study of hypertension drugs, make them master the use method and compatibility principle of each drug skillfully, make good use of all kinds of antihypertensive drugs, and make more patients' blood pressure control reach the standard [6]. While lowering blood pressure, pay attention to protecting important target organs.
For critically ill patients with hypertension, regular examination and active treatment should be carried out to prevent complications and death of patients. In case of sudden severe illness, the vital signs should be stable and referred as soon as possible.
6 outlook
The incidence of hypertension in China is high and its harm is serious, so the whole society should be vigilant. From 1960s to 1970s, Europe, America and Japan carried out active prevention and treatment of chronic diseases such as hypertension in the whole society, and achieved good results, which is worth learning from. Among them, it is more important to change the treatment mode of hypertension. We should vigorously advocate prevention, nip the disease in the bud as soon as possible, and transfer the treatment of hypertension from clinic to society. This requires us to actively carry out effective community management, but our country started slowly in this respect, which requires us to increase investment in community medical care and actively train qualified community doctors. As a doctor, we should constantly improve our medical professional skills, including studying marginal disciplines such as psychology and sociology. Patients should actively cooperate with doctors and adhere to long-term comprehensive treatment. Improve various management systems and create a perfect community health service environment for community residents.
refer to
He ·GUD Wu et al. Analysis of the main causes of death of men and women in China [J]. British Medical Journal, 2005,353 (11):124-1134.
[2] Editorial Committee of China Hypertension Prevention and Control Guidelines (Basic Edition). In 2009, the basic edition of hypertension prevention and control guidelines in China [M]. Beijing: People's Health Publishing House, 2009.
Zeng Zhengpei, Feng Gu, Li Ming. Summary of the 6th National Endocrinology Conference of Chinese Medical Association [J]. China Journal of Endocrinology and Metabolism, 2002,18 (1): 80-81.
Wang. Clinical analysis of 77 cases of hypertension in young people [J]. Journal of Qiqihar Medical College, 2006,27 (6): 669-670.
Hong Wei, Bing Bing, Liu Jun. A control study on the influence of psychosocial factors on the treatment of hypertension [J]. chinese mental health journal, 2000, 14 (5): 3 18-320.
Kong Lingna, Liu, Zhou Yingqing. Meta-analysis of the influence of community nursing intervention on hypertension in the elderly [J]. China General Medicine, 20 10, 13 (5): 1462.
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