What are the contents of hypertension care services?

Hypertension nursing services are not as simple as “reminders to take antihypertensive drugs” as everyone thinks. The core is centered around the two goals of stable blood pressure control and prevention of complications, covering the entire process of services from initial onset assessment, in-hospital care to long-term home management. The purpose is to help patients minimize the damage to the heart, brain and kidneys caused by hypertension and improve the quality of life.

I have been doing community hypertension care for almost 6 years and have encountered all kinds of patients. The 62-year-old Uncle Zhang who I just received last week is a typical example. His physical examination showed high blood pressure of 170 and low blood pressure of 100. He was so panicked at home that he couldn't even eat. When he came, we first gave him a full set of baseline assessments - it was not as simple as just repeatedly measuring blood pressure, we had to ask him clearly whether he had any symptoms or not. There is no family history of high blood pressure. Do you usually drink braised liquor every day? Do you have occasional dizziness or black eyes? It is also necessary to combine his blood lipids, blood sugar, and carotid artery ultrasound results to determine his hypertension risk stratification. First, rule out the possibility of secondary hypertension. This is the prerequisite for all nursing interventions, otherwise it will be a waste of time to adjust medicine randomly.

When many patients first come into contact with nursing care, what they are most concerned about is "what medicine should I take?" But in fact, half of our energy is spent on lifestyle intervention. For example, Uncle Zhang, who has a heavy mouth, used to eat almost 12 grams of salt a day. We calculated it for him to not exceed 5 grams a day. We also specially made a list of invisible salt for him, telling him noodles, salt, There is salt hidden in things that are not salty, such as lajiang and plums, so you have to eat less. They also made an exercise plan with him. He walked briskly for 40 minutes with the old guys in the community every day after dinner, without running or jumping vigorously. He did this for 20 days without increasing the dosage of medicine. His high blood pressure has stabilized within 135. Everyone tells everyone that he can control his blood pressure without taking a lot of medicine.

Of course, medication guidance is also indispensable. Aunt Li, who I managed before, learned this lesson. Last year, her blood pressure stabilized for 3 months, so she secretly reduced the amount of antihypertensive medication by half. She felt that it was "three parts poisonous" and she took less if she could. As a result, she suddenly woke up one morning and fell into a spin in the bathroom. Fortunately, we made the follow-up call early that day. When we found something was wrong, we immediately called her family members to send her to the hospital, so it didn't cause a stroke. Now we will give exclusive medication reminders to the patients we deal with. If someone takes antihypertensive drugs and develops side effects such as dry cough and swollen ankles, we will immediately provide feedback to the doctor to adjust the plan. We will not force the patient to bear the burden, let alone change antihypertensive drugs on their own.

Now, there are actually different opinions in the industry about whether health products can be used for high blood pressure care. Some experts believe that regular potassium supplements and Omega3 and other health products can indeed help control blood pressure. As long as they do not replace drugs, there will be no problem.； Another group of people are worried that patients may easily be deceived by false propaganda, treating health products as "miraculous medicines" and causing problems if they stop prescribing them. Our current approach is not to proactively recommend any health products to patients, but if the patient is already taking them, we will help him check the ingredients to confirm that there is no conflict with the antihypertensive drugs he is taking. We will also repeatedly emphasize to him that health products are at most auxiliary, and regular antihypertensive drugs must not be stopped.

Now our nursing service is connected to the background of home monitoring. The patient's home smart blood pressure measurement value will be automatically synchronized to our system. If the blood pressure exceeds 140/90 for three consecutive days, we will take the initiative to call and ask if he has stayed up late or eaten salty recently. If the patient complains of chest tightness or numbness in one side of his hands and feet, we will directly help him connect to the green channel of the higher-level hospital to avoid queuing and delay. To put it simply, hypertension care is essentially a "pressure-control housekeeper" for patients. It does not provide rigid regulations, but adjusts the plan according to the patient's living habits, so that everyone can easily stabilize their blood pressure without having to worry about it every day.