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Submitted to: STEPHEN ZARATE, RN


Description of the Learner: 46 years old male, married, Roman Catholic, unemployed, born on August 7, 1970 in La
Trinidad, Benguet. He came to ER with a chief complaint of dizziness. He verbalized, Bigla na lang akong nahilo
nung naglalakad ako. Kaya dumiretso na kami dito sa ospital. Patient didnt take any medications. Upon arrival in
SLU-ER, patient claimed condition persisted and experienced body weakness. He was assessed and vital signs were
taken. With elevated blood pressure of 180/120. Patients grip was weak and with muscle strength of 5/5 in both
upper and lower extremities. Stares blankly and has delayed response when being asked questions. Hes CBG result
was 163 mg/dl.
Learning needs: What causes hypertension, signs and symptoms of hypertension, what to do to manage
hypertension, preventive measures to prevent elevation of blood pressure
Learning Diagnosis: Knowledge deficit: proper management of Hypertension related to lack of information about ongoing disease
Goal: to increase patients knowledge about hypertension and preventive measures to avoid acquiring it again

Behavioural Learning

Upon completion of the topic

on hypertension, patient will
be able to:
identify what causes the
elevation of blood pressure
Identify ways to manage

Discuss different measures to


- causes of

Method and
- One-on-one
discussion with
visual aids

Allotment and
- 5 minutes and
visual aids;
hand-out on

- One-on-one
discussion with
visual aids

10 minutes
visual aid; handout on
10 minutes


Method of Evaluation

instant oral
feedback: patient will correctly
identify at least 3 causes of

instant oral
feedback: patient will correctly
identify about 2-3 ways to
manage hypertension
instant oral

prevent hypertension


discussion with
visual aids

visual aid; handout on


feedback: patient will correctly

identify about 3-5 measures to
prevent hypertension

What is hypertension (high blood pressure)?

Blood pressure is the force exerted by the blood against the walls of blood vessels, and the magnitude of this force
depends on the cardiac output and the resistance of the blood vessels.
Hypertension is defined as having a blood pressure higher than 140 over 90 mmHg, with a consensus across medical
Ranges of blood pressure (in mmHg):
Normal blood pressure is below 120 systolic and below 80 diastolic
Prehypertension is 120-139 systolic or 80-89 diastolic
Stage 1 high blood pressure (hypertension) is 140-159 systolic or 90-99 diastolic
Stage 2 high blood pressure (hypertension) is 160 or higher systolic or 100 or higher diastolic
Hypertensive crisis (a medical emergency) is when blood pressure is above 180 systolic or above 110
Causes of hypertension
Physical inactivity
A salt-rich diet associated with processed and fatty foods
Alcohol and tobacco use.
Diabetes (both due to kidney problems and nerve damage)
Kidney disease

Management and prevention of Hypertension


Below is what a typical 2,000 calorie-per-day DASH diet may consist of:

6 to 8 daily servings of grains - including pasta, rice, cereal and bread. One serving could be a slice of

whole-wheat bread, cup of cooked pasta, rice or cereal, or 1 oz of dry cereal.

4 to 5 servings of vegetables - these may include fiber- and vitamin-rich vegetables, including broccoli,
sweet potatoes, greens, carrots or tomatoes. One serving could be a cup of raw or cooked vegetables, or 1

cup of leafy green vegetables (raw).

4 to 5 servings of fruits - these are rich in fiber, magnesium, potassium, vitamins and other minerals.

One serving may include cup of fresh, canned or frozen fruit, or 1 medium fresh fruit.
2 to 3 servings of low-fat dairy - major sources of calcium, protein and vitamin D include cheese, yogurt

and milk. For the DASH diet to work, these dairy products must be either low-fat or fat-free. One serving
could include 1 cup of skim or 1% milk, 1.5 oz of cheese, or 1 cup of yogurt.
Up to 6 servings of fish, poultry or lean meat - even though meats are rich in proteins, B vitamins, zinc
and other nutrients, DASH dieters should keep these nutrients down and make sure the mainstay of their diet

is high in fruit and vegetables. One serving may include 1 oz of poultry (cooked, skinless), lean meat or
seafood, 1 egg, 1 oz of tuna (packed in water, no salt added).
4 to 5 servings of nuts, seeds and legumes - these are good sources of protein, potassium, magnesium,
fiber, phytochemicals, and other essential nutrients. Examples include sunflower seeds, beans, peas, lentils,

almonds, peanuts and pistachios.

2 to 3 servings of fats and oils - the human body needs fat to properly absorb essential vitamins as well
as some other nutrients. For a healthy immune system, we have to consume adequate amounts of fats. One
serving may include 1 teaspoon of margarine, 1 tablespoon of low-fat mayonnaise, or 2 tablespoons of light

salad dressing.
Up to 5 servings per week of sweets - being on a DASH diet does not mean giving up sweets altogether.

Dieters need to keep their intake limited. One serving could include 1 cup of lemonade, a cup of sorbet, 1
tablespoon of sugar, jam or jelly.
Alcohol - DASH dieters should consume no more than two drinks for men and one drink for women per day.

Salt restriction - typical salt intake is between 9 and 12 g a day and modest blood pressure reductions
can be achieved even in people with normal levels by lowering salt to around 5 g a day - the greatest
effects are seen in people with hypertension
Moderation of alcohol consumption - expert guidelines say moving from moderate to excessive
drinking is "associated both with raised blood pressure and with an increased risk of stroke"
High consumption of vegetables and fruits and low-fat - people with, or at risk of, high blood
pressure are advised to minimize intake of saturated fat and total fat and to eat whole-grain, high-fibre
foods, at least 300 g of fruit and vegetables a day, beans, pulses, and nuts, and omega-3-rich fish twice a
Reducing weight and maintaining it - hypertension is closely correlated with excess body weight,
and weight reduction is followed by a fall in blood pressure
Regular physical exercise - guidelines say "hypertensive patients should participate in at least 30 min
of moderate-intensity dynamic aerobic exercise (walking, jogging, cycling or swimming) on 5 to 7 days a
Stress reduction - avoiding sources of stress, where possible, and developing healthy coping strategies
for managing unavoidable stress can help with blood pressure control, especially as many people turn to
alcohol, drugs, smoking and unhealthy foods or overeating to cope with stress.
Smoking can also raise blood pressure, and because of its wider effects on heart health and the rest of
the body, giving up smoking is highly recommended for people with high blood pressure.

Reference: Gill, M.(2016). Hypertension: Causes, Symptoms and Treatments. MNT. Retrieved at: