13. Health education in the geriatric patient

The geriatric prevention goals are to reduce mortality caused by diseases (acute and chronic), maintain the functional independence of the person, increase active life expectancy and improve quality of life.

One of the major issues in which nurses must emphasize, is the prevention of hypertension.

Hypertension is the sustained increase in blood pressure in relation to age-appropriate considerations, for patients older than 60 years, the normal BP is <160/90mmHg and hypertension is> 170/100mmHg.

Can be considered three degrees of severity of hypertension, depending on their organic impact:

• Grade 1: no visceral impact
• Grade 2, appearance of:
• Left ventricular hypertrophy
• Mild hypertensive retinopathy
• Proteinuria
• Increased plasma creatinine
• Grade 3: signs/symptoms as a result of damage to various organs:
• Heart failure
• Hypertensive encephalopathy
• Cranial hemorrhage
• Hypertensive retinopathy
• Renal insufficiency

Hypertension is an asymptomatic process, but there is sometimes mild headache, fatigue, confusion, and vision and hearing problems.

In connection with the treatment, there are two measures:

• Pharmacological:
• Diuretics
• Beta-blockers
• ACE inhibitors
• Calcium channel blockers
• Angiotensin II antagonists
• Alpha blockers
• No drug:
• Changing habits and risk behaviors
• Balanced and organized life
• Removing the tobacco consumption
• Practice physical activity
• Feeding
• Decrease alcohol, salt and coffee
• Avoiding overweight and obesity

Nursing plays an important role in the prevention of this disease, from the nursing consultation we can influence the process stages (uptake of hypertension, diagnosis and control and monitoring).

Measurement of blood pressure must be annual in:

• Patients older than 50 years.
• Patients with first-degree hypertension.
• In diabetic and hypercholesterolemic.
• Smokers and alcohol consumers.
• Patients exposed to psychosocial stress.
• Patients on antihypertensive drug treatments, hormonal contraceptives or corticosteroids.

I believe that nurses have an important role in preventing tipically diseases in the elderly. The health education is imperative.

Bibliography

• Dieter Faulhaber, H. Como prevenir y sanar la hipertensión. Medidas efectivas para su control y tratamiento. Barcelona: Ediciones Robinbook; 2007.
• Fisterra. [Monografía de internet]. [Fecha de consulta 29 de abril de 2013]. Disponible en: http://www.fisterra.com/salud/1infoConse/hipertension_arterial.asp
• Hergueta, G. Guía de hipertensión arterial (2ª edición). Madrid: ediciones Norma-Capitel; 2002.