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Diet and Hypertension

10:04 PM | Labels: , ,

Lowering and maintaining a healthy blood pressure requires a commitment to a healthy lifestyle. A hypertension sufferer should not rely solely on medication. A healthy diet and exercise regimen should also be put into place. Doing so will lower the risk of heart disease, heart attack and stroke significantly.
What is considered high blood pressure?
Hypertension (High Blood Pressure)  140/90
Prehypertension  139/89
Healthy Blood Pressure  120/80
Hypotension (Low Blood pressure)  89/59 and lower
Diet and Hypertension
A diet that will help lower and maintain a healthy blood pressure is low in refined sugars, has small portions, contains foods rich in omega 3 and fiber and keeps a safe range of cholesterol (LDL, HDL, and triglyceride) levels. Desirable LDL (a.k.a. bad cholesterol) levels are below 130 and desirable HDL (a.k.a. good cholesterol) levels are above 50. In order to increase her HDL levels one should increase aerobic exercise, quite smoking (if it’s a factor),  avoiding trans fats all together, have a drink or two of alcohol a day (but no more because that would increase triglyceride levels), and increase monounsaturated fats and soluble fiber in his/her diet. A patient with hypertension should aim for triglyceride levels to be below 200. Elevated triglycerides are the result of eating too many calories.
Other Considerations
If your doctor puts you on a diuretic for hypertension you should avoid taking Advil (ibuprofen) and all nonsteroidal anti-inflammatory drugs (NSAID’s) because they inhibit the actions of diuretics and ACE inhibitors.


Food
Eat                             Suggestions

·         Grains- 6 to 8 servings/day
Couscous, long grain rice, quinoa, bulgur wheat
·         Fruit- 4 to 5 servings/day
Purple grapes are excellent for BP
·         Vegetables- 4 to 5 servings/day
Green leafy raw, steamed asparagus
·         Dairy- 2 to 3 servings/day
Cottage cheese, milk, yogurt
·         Meat including fish & poultry-
2 or less servings/day
Egg whites
·         Fats and Oils- 2 to 3 servings/day
Olive oil
·         Nuts and Beans- 4 to 5/WEEK
Lentils, almonds


Don’t Eat                      Instead

·         Sodium
Garlic, chives, oregano, basil, rosemary


 Author: Andrea Antczak, Nursing Student

Works Cited

all-about-lowering-cholesterol.com. (2010). Cholesterol level scale and cholesterol charts. Retrieved Oct. 28, 2010, from all-about-lowering-cholesterol.com: http://www.all-about-lowering-cholesterol.com/cholesterol-level-scale.html
Gloria Tsang, R. (2006, May). How to Lower Triglycerides? Retrieved Oct. 28, 2010, from HealthCastle.com: http://www.healthcastle.com/triglycerides.shtml
Richard N. Fogoros, M. (2010, April 28). Raising Your HDL Levels. Retrieved Oct. 28, 2010, from About.com: http://heartdisease.about.com/cs/cholesterol/a/raiseHDL.htm
RxList.com. (2009, June 24). Diuril. Retrieved Nov. 10, 2010, from RsList.com: http://www.rxlist.com/diuril-drug.htm
WebMD.com. (2010). High Blood Pressure Diet. Retrieved Nov. 9, 2010, from WebMD.com: http://www.webmd.com/hypertension-high-blood-pressure/guide/high-blood-pressure-diet?page=2

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Pain Management

9:02 PM | Labels:


Chronic pain is a very real ailment that should never be ignored or underestimated. It is persistent pain that lasts over a period of weeks, months or even years. It can be devastating and negatively affect the overall quality of one’s life.
It may have an obvious underlying cause or be the direct result of a past injury, but in many cases the cause isn’t known. Types of chronic pain include central pain which is caused by damage to or dysfunction of the central nervous system (CNS), which includes the brain, brainstem, and spinal cord; and neuropathic pain which is caused by tissue damage. Common causes of central pain include, but are not limited to, brain and spinal cord trauma, stroke and epilepsy. Neuropathic pain is caused by physical injury to nerve fibers resulting in incorrect signals being sent to the brain. (American Chronic Pain Association, 2010).
There are many ways pain medication is delivered to the body. The method chosen for a patient will reflect the sight, the severity and the cause of the pain. The intrathecal delivery system delivers the medication directly to the spine via a pump that is surgically placed between the skin and muscle of the abdominal area. The intrathecal delivery system is adequate for a sufferer who’s tried most other conservative methods without sufficient results. This method will minimize the side effects of the pain medication and maximize the results.  (George Mandybur, Bobbie Ryan, & Scott Basham, 2009). The least invasive way medication is delivered is orally. There are a great number of oral medications prescribed for pain. Many of these are narcotics and are highly addictive. Some pills are meant to be absorbed in the mouth or under the tongue (sublingually). Pain medications are also administered via injection. These routes include intravenous (directly to bloodstream), subcutaneous (into the fatty tissue), and intramuscular (into muscle). Another method is the transdermal delivery system. This is the use of a patch containing pain medication that sticks directly to the skin where it will be absorbed over a period of 48 to 72 hours. And, finally, pain medication can be administered rectally via a suppository or a needless injection, for patients who cannot swallow pain pills. (ACOR Inc., 2007).
Pain medication can offer much anticipated relief to a patient with chronic pain. This will improve the quality of life for the individual. Pain medication will give the sufferer a chance to live a normal life and participate in activities they participated in before the pain started. The absence of pain is likely to improve the psychological state of the patient. Pain relief may improve symptoms of depression, anger, anxiety, sadness or even suicidal thoughts. (Stanford School of Medicine, 2010).
Although pain medication offers a number of beneficial responses, it also has many undesirable effects as well. Over the counter pain relievers such as Tylenol and NSAID’s may cause liver damage. And prescription pain killers often carry the risk of addiction and other serious side effects. One may not realize they are even addicted until they stop taking the medication and immediately feel overwhelming sickness and pain that is worse than it was before they started the medication. (National Library of Medicine, 2010). Long term use of pain medication will wear down one’s organs. It can lead to liver failure, kidney failure, and heart attack. Pain killers also carry many undesirable side effects that a patient may choose to endure in the pursuit of pain relief.
The side effects of pain medication can be mild to severe; however, most pain medication users will experience them to some degree. These side effects include dizziness, drowsiness, weakness, loss of appetite, indigestion problems, skin problems, vision problems, acne, respiratory problems, psychological problems and more. Indigestion problems include nausea, vomiting, constipation, stomach ache, diarrhea, and difficulty urinating. Skin problems include itchiness and sensitivity. Vision problems include blurred vision and spidery lines at the edges of vision. Respiratory problems include difficulty breathing, increased heart rate and hyperventilation. Psychological problems include confusion, hallucinations, agitation and depression. (Pradnya, 2010).
Chronic pain can be costly. Possible costs of chronic pain include doctor appointment, chiropractor appointments, medications, loss of work, hired help and assistance devices. Pain killers cannot be called into the pharmacy, nor can a patient receive more than a month supply at a time. Thus, in order to receive pain medications, a patient must see the doctor at least once a month. Many pain management doctors ask that you receive other forms of treatment for the pain along with the medication such as massages, chiropractics, acupuncture etc. Then there’s the cost of the prescription. If the patient has insurance they will have to pay their prescription deductable, if not, they will have to pay for each pill. In many cases, chronic pain will cost the person their job, hence their insurance. (Griffin, 2005).
Chronic Pain is a serious problem that has the potential to ruin someone’s life. If not treated, in many cases, it’s progressive and debilitating. Pain medication can offer relief and a chance for a chronic pain sufferer to live a normal life, but there are many side effects and other dangers associated with pain medication. These options need to be weighed out with a doctor who’s knowledgeable in pain management. 

Author: Andrea Antczak, Nursing Student


References


ACOR Inc. (2007, Jan. 17). Pain medication delivery. Retrieved Oct. 25, 2010, from Cancer-Pain.org:  http://www.cancer-pain.org/treatments/medication.html
American Chronic Pain Association. (2010, Oct. 26). Conditions A to Z. Retrieved Oct. 25, 2010, from ACPA.org: http://www.theacpa.org/7/Conditions.aspx
George Mandybur, M., Bobbie Ryan, R., & Scott Basham, N. (2009, April). intrathecal drug pump. Retrieved Oct. 25, 2010, from MayfieldClinic.com: http://www.mayfieldclinic.com/PE-        PUMP.htm
Griffin, R. M. (2005, Jan. 31). The Cost of Pain. Retrieved Oct. 26, 2010, from MedicineNet.com: http://www.medicinenet.com/script/main/art.asp?articlekey=50430
National Institue of Neurological Disorders and Stroke. (2010, July 24). Chronic Pain Information Page.   Retrieved Oct. 25, 2010, from NINDS.gov: http://www.ninds.nih.gov/disorders/chronic_pain/  chronic_pain.htm
National Library of Medicine. (2010, August 9). Pain Medications. Retrieved Oct. 26, 2010, from MedLinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm
Pradnya, S. (2010). Pain Killer Side Effects. Retrieved Oct. 26, 2010, from Buzzle.com:                 http://www.buzzle.com/articles/pain-killer-side-effects.html
Stanford School of Medicine. (2010). Psychological Therapy. Retrieved Oct. 26, 2010, from Stanford     Pain Management Center: http://paincenter.stanford.edu/patient_care/therapy.html

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Obesity

6:42 PM | Labels: , , , , , , , , ,

My weight has fluctuated a lot over the past few years. As a result I understand the difficulties associated with weight loss and maintaining a healthy weight. I'm happy to report now that I'm very close to MY ideal weight (not to be confused with my "IBW" which is what "they" say I'm supposed to weigh. But anyway, here's a paper I'm working on for my nutrition class. It's a fairly organized compilation of the results of my research. Sources are cited. I hope you like it and learn something from it :) If you, yourself, are not struggling with obesity, chances are you know someone who is. Circulate the knowledge.
(I'm working on my transitions and conclusion still :)


Overview

Obesity is a condition of excess fat deposits accumulated around the body. Obesity reduces one’s overall quality of life and poses many health risks. Everyone is at risk for obesity, but some are more so than others. Obesity is a common concern in the United States and cases of childhood obesity are rising rapidly. Treatment of obesity requires more than taking a pill or eating some vegetables. It requires construction and maintenance of a healthy lifestyle. Nursing for the obese patient requires special considerations and a thorough understanding of what it is and how it’s affecting the patient’s life. The first step in understanding a patient’s weight problem is figuring out how many pounds overweight they are.
  
                               
Calculating Ideal Body Weight            
Obesity is diagnosed in people who weight 30 or more pounds over their ideal body weight (IBW). People who weigh 40 or more pounds over their IBW are considered morbidly obese. Ideal body weight is calculated in men by starting with a base weight of 110 pounds and adding 5.06 pounds for every inch the man is over five feet in height. In women, IBW is calculated by using 100.1 pounds as a base weight and adding 5.06 pounds for every inch in height the woman is over 5 ft. For example, a woman who is five feet and three inches tall has an IBW of 115.28 pounds. If this woman weighs 168 pounds she is 52.72 pounds overweight and is considered morbidly obese. (ManuelsWeb.com, 2006). What causes this to happen?
Complications
Calories are converted into energy by the human body. If the intake of calories is higher than the body needs for the person’s activity level, the calories will be converted into and stored as fat. The more fat that is stored the greater the risk for complications. Complications that may be caused by obesity include, but are not limited to, low energy level, high blood pressure, heart disease, stroke, high levels of cholesterol and triglycerides, type 2 diabetes, liver disease, pancreatitis, gastroesophageal reflux disease, gallstones, cataracts, certain cancers, worsening arthritis, gout, joint problems, back pain, infertility, sleep apnea, urinary incontinence, depression caused by a poor self image, and death. (Carson-DeWitt, 2010).  Many people are facing these risks and ailments due to obesity.
Statistics

There are over 1 billion overweight adults in the world. At least 300 million of them are obese. In 2006 the National Health and Nutrition Examination Survey (NHANES) estimated that 32.7 percent of U.S. adults 20 years and older where overweight; 34.3 percent are obese and 5.9 percent where morbidly obese. By 2008 that number rose to 33.8 percent; 32.2 percent of men and 35.5 percent of women. In 2008 18 percent of adolescences; 20 percent of children ages 6 to 11; and 10 percent of children ages 2 to 5 were obese in the United States. (Obesity in America, 2010). Obesity rates in America have slowed in recent years compared to the dramatic increase in obesity in previous decades. This may be because so many American’s are already overweight. Obesity rates among children are still increasing at an alarming rate.

Childhood Obesity

Obesity in children has more than tripled in the past 30 years. A child who is obese has a greater chance of being obese as an adult and has a shorter life expectancy. Obesity in children and adolescence increases the risk for stigmatization, low self-esteem and depression. These kids also have greater risk for bone and joint problems, cardiovascular disease, and sleep apnea. Parents greatly influence the dietary intake of their children which is directly linked to their body weight. It is important for parents to provide their children with a variety of different meals and healthy snacks to help ensure the development of good lifestyle choices. A child daily diet should include fruit, vegetables, grains, meat and dairy. A child should not be expected to completely avoid junk foods that cause obesity, but he/she needs to learn moderation and how to compensate with healthy food. For example, a child should not be instructed to not eat a piece of cake at a birthday party, this may cause the child to feel singled out or humiliated. Instead, the parent should provide fruit for dessert that night. (National Center for Chronic Disease Prevention and Health Promotion, 2010). There are many more things that can be done to fight obesity.

The Fight

To begin the fight against obesity one must make changes in their lifestyle. These changes should not be viewed as temporary and need to be maintained after the weight is lost. A slow, steady decrease in calorie consumption while maintaining or even increasing nutrient intake will help to decrease body weight. Physical activity needs to be implemented into the weight loss and lifestyle plan as well. The chances of acquiring an obesity related complication will decrease by doing these things. An obese patient should eat approximately two cups of fruit and two and a half cups of vegetables a day. The fruits and vegetables chosen each day should vary. At least 3 ounces of whole grains should be eaten daily and about 3 cups of fat-free milk. Only lean meats should be eaten during the weight loss process such as turkey and chicken breast. After the desired weight is achieved other meats, such as beef, should be consumed in moderation. The obese patient should eat about 2000 calories a day and less than 10 percent of those calories should be from saturated fats. Daily cholesterol intake should be less than 300 mg. Trans fats should always be avoided. Alcohol consumption should be avoided all together during the weight loss process. (U.S. Department of Health and Human Services; U.S. Department of Agriculture, 2005).

How much physical activity do you need?
Calorie Calculations: The body burns approximately 4.5 calories per pound for every hour of running; about 3.6 calories per pound every hour of playing basketball; and about 2.7 calories per pound for every hour of weight lifting.
To Lose Weight: About 300 minutes of moderate physical activity a week (along with decreased calorie intake)
To Maintain Weight: About 150 minutes of moderate activity and 75 minutes of vigorous physical activity per week (along with a healthy diet that eats fats and sugars in moderation). Keep in mind that it varies from person to person.

Dietary Recommendations Children 
Dietary recommendations are different for children and adolescents. Obese children should gradually reduce their calorie intake as well with a goal of approximately 1500 to 2000 calories a day. But for kids, 30 to 35 percent of these calories should be from fat. The focus of fat intake for an obese child is making sure the fats are mostly monounsaturated and polyunsaturated. These types of fats can be obtained from fish, nuts and vegetable oils. Children who are trying to lose weight should avoid sodas, potato chips, cookies, pizza, sugary cereals and any other source of refined carbohydrates. After the desired weight is achieved, these foods should be eaten in moderation in addition to adequate physical activity. (U.S. Department of Health and Human Services; U.S. Department of Agriculture, 2005).

Nursing Care for the Obese Patient
 Learning how to eat healthy can be difficult process at first for the obese patient. It is the nurse’s job to understand the difficulties that an obese patient is dealing with on a daily basis. Besides physical health problems, they may be suffering from psychological health problems as well. They may be angry, embarrassed and/or depressed. A nurse should look for signs of depression and try to make the patient comfortable talking about it. The patient needs to be monitored closely during the first few weeks of treatment and encouragement should be given as much as possible. It is the nurse’s job to educate the patient on proper diet and activity to achieve the desired outcome. Also, the nurse must make sure that the patient understands the actions of the medications he/she is taking, how to take them properly and the possible side effects. (Harris RN, 2008).
           
Obesity is a danger to one’s health and a common problem in America. It is a struggle that many people deal with on a daily basis. Losing weight is not an easy process, especially in someone who is 30 pounds or more over weight. Adequate lifestyle changes need to be made in order to have a fighting chance against obesity. Education on how to eat and exercise properly should be obtained from a qualified health care professional. Obesity is a condition that is never considered safe and no one should strive to be overweight for any reason.




References

1. Carson-DeWitt, M. R. (2010, Oct. 15). Overweight (Obesity; Morbid Obesity). Retrieved Nov. 10, 2010, from AuroraHealthCare.org: http://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate="11647.html"
2. Harris RN, M. H. (2008, June). Nursing care of the morbidly obese patient. Retrieved Nov. 10, 2010, from NursingCenter.com: http://www.nursingcenter.com/prodev/ce_article.asp?tid=788177
3. ManuelsWeb.com. (2006). IBW & ABW calculator. Retrieved Nov. 19, 2010, from            ManuelsWeb.com: http://www.manuelsweb.com/IBW.htm
4. National Center for Chronic Disease Prevention and Health Promotion. (2010, June 3). Childhood Obesity. Retrieved Nov. 20, 2010, from CDC.gov: http://www.cdc.gov/HealthyYouth/obesity/index.htm
5. Obesity in America. (2010). Statistics . Retrieved Oct. 28, 2010, from Obesity In America.:             http://www.obesityinamerica.org/statistics/index.cfm
6. U.S. Department of Health and Human Services; U.S. Department of Agriculture. (2005). Dietary Guidelines for American's . Retrieved Nov. 21, 2010, from cnpp.usda.gov:             http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2005/2005DGPolicyDocumen t.pdf


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