HEART HEALTH PROGRAM MASTER TRAINING WORKSHOP ON HYPERTENSION Role of CHNs LHVs in Hypertension Cont

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HEART HEALTH PROGRAMMASTER TRAINING WORKSHOP ON
HYPERTENSIONRole of CHNs / LHVs in Hypertension
ControlDECEMBER 19 20, 2002

• Dr. Sunita Dodani, Assistant Professor
• Family Medicine, CHS

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Role of CHNs / LHVs in Hypertension Control

• Nurses and LHVs are
• main pillars
• THEY ARE OUR
• EYES AND EARS
• IN THE COMMUNITY

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1.     Screening of Patients
Role of CHNs / LHVs in Hypertension Control

• Identification of new cases (detailed
  history taking).

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2.     Initial assessment
Role of CHNs / LHVs in Hypertension Control

• Weight
• Height
• Pulse
• Blood Pressure Monitoring
• Waist Hip Ratio

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3.     Medication review (Initial and
Follow-up Patients)
Role of CHNs / LHVs in Hypertension Control

• a.       Review medication records.
• b.      Check patients compliance.

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4.     Patient Counseling
Role of CHNs / LHVs in Hypertension Control

• Self measurement of blood pressure.
• Significance of blood pressure monitoring.
• Explanation of what is Blood Pressure
• And why it needs to be controlled.
• Diet review including salt intake.
• Exercise.
• Stress management.

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5.     Follow up visits
Role of CHNs / LHVs in Hypertension Control

• a.       Record Maintenance
• b.      Check controlled hypertensive
•  (i)   Measure pulse, blood pressure, weight and
  height and waist to hip ratio.
• (ii)  Inquire about general health and side
  effects of the drugs (if any)
• (iii)  Ensure that the optimal blood pressure is
  being
• maintained, as recommended by the physician.
  The blood pressure after taking medication should
  
• ideally be controlled (target of lt 130
  /85 mmHg).
• (iv)  Ensure patient compliance.

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5.     Follow up visits Contd.
Role of CHNs / LHVs in Hypertension Control

• (V) Reinforce life-style advice
• Ensure that the routine laboratory investigations
  are complete (If ordered by Physicians)
• 12 lead electrocardiograph (ECG) (at diagnosis
  and every 5 years, unless specified otherwise)
• Blood electrolytes and creatinine (once a year)
• Blood glucose - fasting for at least 8 hours
  (once a year)
• Serum total cholesterol level (once a year)
• Urine test for protein. (once a year)

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6.     Referral to a Physician
Role of CHNs / LHVs in Hypertension Control

• a. All new suspected hypertensives on initial
  visit.
• b. High normal blood pressures with risk factors
  and associated disease.
• c. Un-Controlled hypertensives with risk factors
  and associated disease.
• d. When the patient develops any symptoms
  related to complications of hypertension such
  as chest pain, paralysis or eye complication.
• e.  If the patients condition is unstable or
  he/she reports any severe side effects of drug
  therapy or has developed any risk factors or any
  other diseases.