Question

case Scenario # 2

A couple in their 50s is shopping in a mall where a health fair is set up. You are a nurse participating at a booth offering blood pressure readings. After much coaxing, the woman persuades her husband to have his blood pressure taken. You obtain a reading of 168/94 mm Hg. The wife reacts strongly, saying, “I told you that your lack of exercise and overeating would catch up with you one day. How am I going to manage being a widow at such an early age?” The husband responds by saying, “Don’t worry about me. I’m just as healthy as ever, and I plan to live until I’m 99 years old. I’m sure there’s something wrong with that machine.” Both of them turn to you. The wife says, “Tell him it’s not the machine and that he isn’t taking care of himself!”

   1.   Identify possible interpretations of an isolated blood pressure reading of 168/94 mm Hg. List factors that may have affected the reading’s accuracy.

   2.   Analyze the man’s reaction to this situation. Indicate the teaching points about blood pressure that may be appropriate at this time.

   3.   Outline potential ways to deal therapeutically with the wife’s anxiety, describing possible verbal and nonverbal interactions.  

Answer 1

1.A blood pressure reading of 168/94mmHg is very high.

The factors which could have affected the patient's blood pressure accuracy are

• Psychological factor :wife coaxed husband to get reading done
• Physiological factors :shopping in the mall could have altered the reading because of some physical exercise
• Others :Tension ,stress ,overactivity

2.The man has a positive approach in general by saying he feels healthy now and there could be some technical error in the machine

The appropriate teaching to be provided are

• A repeat check will be done after 15-30 minutes to identify any difference or same reading
• Inform this is just a screening which can make you alert to take care of his health at right tine
• Educate to do daily exercise
• Follow health diet avoid overeating
• Maintain normal weight
• Keep blood pressure reading in normal range
• Encourage to visit a provider for further evaluation

3.The ways to deal with anxiety are

• Educate the women about the risk factors and possible cause
• Educate about the disease condition and its management this can help to gain knowledge and reduce anxiety due to ignorance