Applying Neuman systems theory to a hypertensive patient case study

Nueman Systems Theory Nursing

Perceptions

Case Study Data upon Admission

J. is a middle aged man with four children and a hard working wife. He is a full-time truck driver and stands at 5'11" at 190 lbs. Recently, he has had some serious issues regarding the health of his cardio system. He was diagnosed with hypertension and hyperlipidemia, and prescribed with Zestril, HCTZ, and Pravastatin. Yet the patient has not been filling his prescriptions based on a lack of funds available for his own health care. Mr. J. then went into a state of hypertensive crisis and was hospitalized. At the time of his admission, his stats were as follows: B/P was at 200/136 upon his admission, drowsy and slightly disoriented, seeing "small spots," symmetrical strength, no hindering of motor skills, properly working cranial nerves, pulses +2 upper and lower, with a dilation of -4mm in his pupils. After his first day in the hospital he is noticeably more lethargic with a blood pressure of 180/1000 even with nitroprusside therapy. He said he began feeling better, but still showed come clear signs of issues ongoing.

2. Nursing Diagnosis and Assessment

a. Stressors

There are a number of stressors that are obvious with the patient's history and lifestyle choices. Although Mr. J. quit smoking 2 1/2 years ago, before that he had a long history of tobacco use. This tobacco use may have a lasting influence on his cardio system. Moreover, Mr. J. admits to moderate alcohol use with no narcotic abuse. He claims to drink between 8-1o beers weekly. At 190 lbs, he is slightly overweight, as his target weight should be around154-180 lbs. He has a family history of heart conditions, as his mother was hypertensive and his father unfortunately died at 52 with CVA complications. Thus, there is a heredity element to his condition that demands an increased devotion to meeting nursing goals in order to counteract his genetic predisposition to cardiac issues.

b. Variances from Wellness

There are a number of issues which increase Mr. J.'s variance from wellness. He is currently employed full-time for the last ten months, after being unemployed for the previous two. This shows an added stress to perform in his job, as he was previously leaving his wife to provide for the whole family. This creates stress, but also makes his sedentary for most of the day. As a truck driver, he spends most of his work day in a seated position, with limited exercise or strenuous movements. Additionally, Mr. J. has no health insurance. As such, he has limited access to care, which often places him in danger of not getting his needed medicines, but also of not taking them in a proper regiment.

3. Nursing Interventions

b. Goal: Secure Access to Health Care

Primary Prevention: Nursing staff must provide information on low-cost health policies that Mr. J. may qualify for in order to get the coverage he needs to pay for his required medications and preventative treatments.

Secondary Prevention: Contact healthcare advocates, like the Patient Advocate Foundation to pay for his current hospital visit and secure funding for the access to medications and treatments right away.

Tertiary Prevention: Nursing staff should set savings goals with Mr. J. And his wife to increase monthly savings so that the family can afford to pay the premiums of the healthcare insurance, whether it is from his wife's employer or another public agency that offers lower cost insurance plans for those in need.