50

Cardiovascular system

Management moments

Dash into dietary changes

Studies indicate that using the National Institutes of Health Dash into Dietary Changes (DASH) combination diet lowers blood
pressure and may also help prevent it. The diet is low in cholesterol; high in dietary fiber, potassium, calcium, and magnesium; and
moderately high in protein. If you educate your client about this diet, he may be able to control his blood pressure without the use
of medication.
Heres an example of a DASH plan based on a 2,000-calorie diet. Depending on caloric needs, the number of servings in a food
group may vary.
Food group

Daily servings

Serving sizes

Grains

7 to 8

1 slice bread
1
/2 cup celery
1
/2 cup cooked rice, pasta, or cereal

Vegetables

4 to 5

1 cup raw leafy vegetable

/2 cup cooked vegetable
6 oz vegetable juice

Fruit

4 to 5

6 oz fruit juice
1 medium fruit
1
/4 cup dried fruit
1
/4 cup fresh, frozen, or canned fruit

Low-fat or nonfat dairy products

2 to 3

8 oz milk
1 cup yogurt
11/2 oz cheese

Meat, poultry, and fish

2 or less

3 oz cooked meat, poultry, or fish

Nuts, seeds, and legumes

4 to 5 per week

11/2 oz or 1/3 cup nuts

/2 oz or 2 tablespoons seeds
1
/2 cup cooked legumes
1

Take an average of two or more blood

pressure readings rather than relying on one
single abnormal reading to establish hypertension.
Administer medications as prescribed to
lower blood pressure.
Assess blood pressure reading in the lying,
sitting, and standing positions to monitor for
orthostatic hypotension (observe for pallor,
diaphoresis, or vertigo).
Assess neurologic status and observe for
changes that may indicate an alteration in
cerebral perfusion (stroke or hemorrhage).
Monitor and record intake and output and
daily weight to detect fluid volume overload.

313419NCLEX-RN_Chap03.indd 50

Maintain the clients prescribed diet

because a high-sodium, high-cholesterol diet
may contribute to hypertension.
Encourage the client to express feelings
about daily stress to reduce anxiety.
Maintain a quiet environment to reduce
stress.

Teaching topics
Explanation of the disorder and treatment
plan
Medications and possible adverse effects
Taking blood pressure daily and recognizing when to notify the physician

4/8/2010 7:01:47 PM