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Hypertension 高血压 (reading & sharing) #2

The hypertension guidelines recommend that high risk patients should begin medications if their average BP is ≥130/80 mmHg. For lower risk patients (no history of cardiovascular disease or an ASCVD risk <10%) medications are recommended for primary prevention when their average BP is ≥140/90 mmHg.

高血压指南建议,如果高危患者的平均血压为 ≥130/80 mmHg,则应开始药物治疗。对于低风险患者(无心血管疾病病史风险 <10%),当平均血压为 ≥140/90 mmHg 时,建议使用药物进行一级预防。

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Hypertension 高血压 (reading & sharing) #1

The most recent American College of Cardiology/ American Heart Association clinical practice guidelines define hypertension as systolic BP greater or equal to 130 mmHg or diastolic BP greater or equal to 80 mmHg. Patients are then classified as having either stage 1 or stage 2 hypertension. Stage 2 usually requires medication in addition to lifestyle modifications to control blood pressure. If the diastolic and systolic blood pressure readings fall into different classifications, the higher classification is used. To make a clinical diagnosis of hypertension, two or more blood pressure readings obtained over two or more visit must fall into a particular classification (but not during acute illness or pain).

最新的美国心脏病学会/美国心脏协会临床实践指南将高血压定义为收缩压大于或等于 130 mmHg 或舒张压大于或等于 80 mmHg。然后将患者归类为患有 1 期或 2 期高血压。2 期高血压除了改变生活方式外,通常需要药物治疗来控制血压。如果舒张压和收缩压读数属于不同的分类,则使用较高的分类。为了对高血压进行临床诊断,在两次或多次就诊中获得的两个或多个血压读数必须属于特定类别(但不是在急性疾病或疼痛期间)。

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Venous Ulcer (Reading and Sharing)

Risk Factors: include age 55 and older, family history of chronic venous insufficiency, high body mass index, venous reflux in deep veins, medical history of (pulmonary embolism, superficial or deep vein thrombosis, lower extremity skeletal or joint disease), multiple pregnancies, physical inactivity, and a history of venous ulcers.

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Chronic Obstructive Pulmonary Disease (COPD) – Reading & Sharing

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. It is highly prevalent, and as it progresses, causes patients to become too disabled to work, thus creating substantial economic and social burdens. In 2010, U.S. healthcare data estimated the total economic burden from COPD at $50 billion, of which $30 billion was related to direct medical expenditures and the remaining $20 billion related to morbidity, loss of work, and premature death. There are also unacknowledged and unquantified costs including the economic value of care provided by family members and their potential lost wages as they stay home to care for the patient.

As the disease progresses, some patients will choose mechanical ventilation as a palliative treatment option. although the patient with advanced disease is eligible for hospice care, many hospices cannot afford to accept the patient with mechanical ventilation into their programs because this high-tech intervention drives the cost of care beyond the standard insurance reimbursement. Thus, patients and families may be deprived of the benefits of hospice care.

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Cystic Fibrosis (Reading & Sharing Part 2)

Bronchiectasis develops early in the course of cystic fibrosis, being detectable in infants as young as 10 weeks of age, and is persistent and progressive. Recent data reveal that neutrophil elastase activity in BAL fluid in early life is associated with early bronchiectasis in children with cystic fibrosis.

Nursing Assessment

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