Broader implications to patient care

LadyinScrubs, ASN, RN · Mar 21, 2012

Hello, i was wondering if anyone can give me some advice on what they think this means
doing an assignment based on hypertention .. and it asks us to talk about the broader implications , e.g public health issues.
would going in to stroke, CHD, Kidney disease and also looking at cost burden to the NHS, epidemiology together with user involvement in terms of compliance with treatment/lifestyle changes....
Any advice would be great

As you progress through your studies, you will learn to look at a problem and also the issues that problem may cause. Hypertension is an excellent example. If you search the US Department of Health and Human Services' website for the National Institute of Health (NIH) and then do a search in the NIH for hypertension + statistics, or HTN +kidney failure, HTN + stroke, +heart diesease, etc. you should get enough information to help you understand the far reaching impact that HTN has upon your pt and society.

Now, if the pt has a co-morbidity (another problem) such as diabetes, then there are additional problems beyond HTN. Go to the NIH and search for diabetes+hypertension. What you will find, if you do those searches, is HTN is a very serious problem and will start to understand why HTN is branded a "silent killer." Beyond co-morbidities, there are social implications. If the person has a HTN related MI, stroke, or some other problem that causes them to be hospitalized, there is an impact upon the pt, their family, possibly their employer, and most certainly their finances (even if it is only the cost of the hospitalization and medical care). The NIH should have statistics about the financial impact of HTN.

When I was a CNA, I did home care and had a patient who had a HTN- related stroke. Etiology: the pt had HTN and was taking meds to control it. However, the pt was very social and enjoyed drinking with friends. He was also a VFW member and took a volunteer job with the VFW that required him to go to many events which enabled him to increase his ETOH intake. Eventually the impact of HTN combined with HTN meds and ETOH caused a stroke in the pons area of his brain. He survived the stroke but had severe limitations. Within 2 years he went from a 6'3" virle, strong, very successful business owner, to a man who was bedbound and needed all his ADLs done for him to death.

The impact upon his wife was severe. The family's finances werre impacted and this 70 year old woman had no skills other than being a great mother. Within a few months of his stroke, the wife could not afford hired care and had to do his total care herself. As his dementia progressed, he mixed up his days with his nights, would try to run away from home, and the wife became completely home bound. This man's hypertension, stroke, dementia, and eventual death was all related to his hypertension. Last I heard his formerly financially- secure widow had to sell the family home to pay the medical bills. I have no idea what she is doing now, how she is supporting herself, or where she is living.

The bottomline is this: as a nurse, you will be trained to look at the person as a complete bio-social-psycho entity. This is why you are being asked to look beyond the diagnosis of HTN into the broader implications--meaning what the bio-psycho-social impact of htn is on the pt, their family, the employer, their job, the person's finances, and the cost of providing health care uponthe family, upon the hospital/city/state/country........

Esme12, ASN, BSN, RN · Mar 21, 2012

Wow....Well said. I have nothing to add! :yeah:

nurseprnRN, BSN, RN · Mar 22, 2012

good case example, ladyinscrubs. :yeah:

op, if you want to look at real money, look up some info on end-stage renal disease (esrd). no matter what your age, medicare pays for your hemodialysis. do you have any idea how many people are on hemodialysis in this country? you can look at the us renal data set online for all sorts of stats on numbers and costs. and what would a huge cause of renal failure be? and who pays for medicare? what's the average life expectancy for esrd? what's the consequence of all that loss of productivity to this country? all that should be good for a couple of pages.

you can find costs of stroke, too, by looking up the national stroke association.