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Dr. Sunita Dodani, Assistant Professor Family Medicine, CHS

HEART HEALTH PROGRAM MASTER TRAINING WORKSHOP ON HYPERTENSION Role of CHNs / LHVs in Hypertension Control DECEMBER 19 & 20, 2002. Dr. Sunita Dodani, Assistant Professor Family Medicine, CHS. Role of CHNs / LHVs in Hypertension Control. Nurses and LHVs are “ main pillars” THEY ARE OUR

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Dr. Sunita Dodani, Assistant Professor Family Medicine, CHS

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  1. HEART HEALTH PROGRAMMASTER TRAINING WORKSHOP ON HYPERTENSIONRole of CHNs / LHVs in Hypertension ControlDECEMBER 19 & 20, 2002 Dr. Sunita Dodani, Assistant Professor Family Medicine, CHS

  2. Role of CHNs / LHVs in Hypertension Control Nurses and LHVs are “ main pillars” THEY ARE OUR ‘EYES AND EARS’ IN THE COMMUNITY

  3. Role of CHNs / LHVs in Hypertension Control 1.     Screening of Patients Identification of new cases (detailed history taking).

  4. Role of CHNs / LHVs in Hypertension Control 2.     Initial assessment • Weight • Height • Pulse • Blood Pressure Monitoring • Waist – Hip Ratio

  5. Role of CHNs / LHVs in Hypertension Control 3.     Medication review: (Initial and Follow-up Patients) a.Review medication records. b.      Check patient’s compliance.

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

  7. Role of CHNs / LHVs in Hypertension Control 5.     Follow – up visits: 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 < 130 /85 mmHg). (iv)  Ensure patient compliance.

  8. Role of CHNs / LHVs in Hypertension Control 5.     Follow – up visits:Contd. (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)

  9. Role of CHNs / LHVs in Hypertension Control 6.     Referral to a Physician: 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 patient’s condition is unstable or he/she reports any severe side effects of drug therapy or has developed any risk factors or any other diseases.

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