Teaching Plan for Hypertension

Description of the Learner: A client has hypertension and has been proven to have history of it on both parents.The client verbalized willingness and interest on knowing the
information regarding the benefits, management and causes of hypertension. The learner has no visual or hearing impairments. Learner is able to understand and speak in
tagalog and prefers the use of this dialect in a one-on-one discussion.
Learning Need: Definition of Hypertension
Learning Diagnosis: Knowledge Deficit: Hypertension related to lack of information
Goal: The client will be able to understand what hypertension is and apply the management and interventions .
BLOs
Upon completion of the topic on

Learning Content

Teaching Method

Resources Needed

Method of Evaluation

Hypertension is a systolic blood

One-to-one discussion

3 minutes

Instant oral feedback: The client

pressure greater than 140 mmHg

Provide pamphlet.

Handout: Definition of

will be able to define what

and a diastolic pressure greater

Show model.

Hypertension.

hypertension is.

hypertension for 20 minutes, the

client will be able to:
1. Define what hypertension is.

than 90 mmHg over a sustained

period, based on the average of
two or more blood pressure
measurements taken in two or
more contacts with the health
care provider after an initial

screening.
2. Enumerate the 8 major risk
factors for cardiovascular

Major Risk Factors (In addition to

problems in Hypertensive

Hypertension)

Patients.

One-to-one discussion

3 minutes

Instant oral feedback: The client

Smoking

Provide pamphlet.

Handout: Major risk factors for

will be able to enumerate the 8

Hyperlipidemia (Excess

Show Model

cardiovascular problems in

major risk factors for

hypertensive patients.

cardiovascular problems in

Cholesterol)

Diabetes Mellitus

Age older than 60 years

hypertensive patients.

old.

Gender (men and

menopausal women)

Family History of
cardiovascular disease
(in female relative
younger than 55 years
old).

Diet: high salt, fats, and

alcohol intake

3. Enumerate the clinical

Stress

manifestations of hypertension.

Instant oral feedback: The client

Physical examination may

One-to-one discussion

6 minutes

will be able to enumerate at least

reveal no abnormalities

Provide pamphlet.

Handouts: Clinical Manifestations

4 clinical manifestations of

of hypertension.

hypertension.

Severe headaches

Fatigue or confusion

Dizziness

4. State the Lifestyle

Nausea

Problems with vision

Chest pains

modifications for hypertension

Prevention and Management.

Instant oral feedback: The client

Lose weight

Limit alcohol intake

Regular Exercise

Reduce sodium intake

Maintain intake of Dietary

5 minutes

will be able to state the lifestyle

One-to-one discussion

Handouts: Lifestyle modification

modifications for hypertension

Provide pamphlet.

for hypertension prevention and

prevention and management.

management.

Potassium.

Maintain intake of Dietary

Calcium and Magnesium.

Stop Smoking

Reduce intake of fats and

cholesterol

5. State the DASH (Dietary

Approaches to Stop
Hypertension) Diet.

Instant oral feedback: The client

DASH stands for Dietary
Approaches to Stop
Hypertension. The diet is
simple:
Eat more fruits,
vegetables, and low-fat
dairy foods

One-to-one discussion

3 minutes

will be able to state the DASH

Provide pamphlet.

Handouts: DASH Diet

Diet with its servings.

Cut back on foods that

are high in saturated fat,
cholesterol, and trans
fats
Eat more whole-grain
foods, fish, poultry, and
nuts
Limit sodium, sweets,
sugary drinks, and red
meats
In research studies,
people who were on the
DASH diet lowered their

Total Time: 20 minutes

blood pressure within 2

weeks.
Bibliography:
DOH, ( 2007) ,Public Health Nursing in the Philippines
Academy of Medical-Surgical Nurses. (2012). Scope and Standards of Medical-Surgical Nursing Practice (5th ed.)
Ignatavicius, D.D. & Workman, M.L. (2013). Medical-Surgical Nursing: Patient-Centered Collaborative Care (7th ed.). Philadelphia: Elsevier/Saunders.
Public Health Nursing in the Philippines, 10th Ed., by the NLPGNI., p. 324-329

What Are the Benefits of the DASH Eating Plan?

Following the DASH eating plan and eating less sodium (salt) can lower high blood pressure or your risk for the condition. Following DASH also can improve blood lipid levels, which
also helps reduce your cardiovascular risk.
Results from the DASH research showed that following a DASH plan containing 2,300 milligrams (mg) of sodium per day lowered blood pressure. Following a DASH plan containing
1,500 mg of sodium lowered blood pressure even more (systolic blood pressure was lowered by about 7 to 12 mmHg).
One important note: If you take medicine to control high blood pressure, you should keep taking it. However, you should tell your doctor that you're now following the DASH eating
plan.

Following the DASH Eating Plan

The DASH eating plan is easy to follow using common foods available in your grocery store. The plan includes daily servings from different food groups. The number of servings you
should have depends on your daily calorie (energy) needs.
To figure out your calorie needs, you need to consider your age and physical activity level. If you want to maintain your current weight, you should eat only as many calories as you
burn by being physically active. This is called energy balance.
If you need to lose weight, you should eat fewer calories than you burn or increase your activity level to burn more calories than you eat.
Consider your physical activity level. Are you sedentary, moderately active, or active?

Sedentary means that you do only light physical activity as part of your typical daily routine.
Moderately active means that you do physical activity equal to walking about 1.5 to 3 miles a day at 3 to 4 miles per hour, plus light physical activity.
Active means that you do physical activity equal to walking more than 3 miles per day at 3 to 4 miles per hour, plus light physical activity.

Use the chart below to estimate your daily calorie needs.

Daily Calorie Needs for Women

Calories Needed for Sedentary Activity
Level

Age (years)

Calories Needed for Moderately Active

Activity Level

Calories Needed for Active Activity

Level

1930

2,000

2,0002,200

2,400

3150

1,800

2,000

2,200

51+

1,600

1,800

2,0002,200

Daily Calorie Needs for Men

Calories Needed for Sedentary Activity

Level

Age (years)

Calories Needed for Moderately Active

Activity Level

Calories Needed for Active Activity

Level

1930

2,400

2,6002,800

3,000

3150

2,200

2,4002,600

2,8003,000

51+

2,000

2,2002,400

2,4002,800

After figuring out your daily calorie needs, go to the table below and find the closest calorie level to yours. This table estimates the number of servings from each food group that you
should have. Serving quantities are per day, unless otherwise noted.
DASH Eating PlanNumber of Food Servings by Calorie Level
1,200
Cal.

1,400
Cal.

1,600
Cal.

1,800
Cal.

2,000
Cal.

2,600
Cal.

Grainsa

45

56

68

1011

Vegetables

34

34

34

45

45

56

Fruits

34

45

45

56

Fat-free or low-fat dairy

productsb

23

23

23

23

23

3 or less

34 or less

34 or less

6 or less

6 or less

6 or less

Food Group

Lean meats, poultry, and fish

Nuts, seeds, and legumes

3 per week

3 per week

34 per week

4 per week

45 per week

23

23

Sweets and added sugars

3 or less per week

3 or less per week

3 or less per week

5 or less per week

5 or less per
week

2,300 mg/day

2,300 mg/day

2,300 mg/day

2,300 mg/day

2,300 mg/day

2,300 mg/day

Fats and oils

Maximum sodium limitd

a

Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free
dressing = zero servings.
c

2,

The DASH eating plan has a sodium limit of either 2,300 mg or 1,500 mg per day.
DASH Eating PlanServing Sizes, Examples, and Significance

Food Group

Serving Sizes

Examples and Notes

Significance of Each Food Group to the

DASH Eating Plan

Grainsa

1 slice bread
1 oz dry cerealb
cup cooked rice, pasta, or cerealb

Whole-wheat bread and rolls, whole-wheat

Major sources of energy and fiber
pasta, English muffin, pita bread, bagel,
cereals, grits, oatmeal, brown rice, unsalted
pretzels and popcorn

Vegetables

1 cup raw leafy vegetable

cup cut-up raw or cooked vegetable
cup vegetable juice

Broccoli, carrots, collards, green beans,

green peas, kale, lima beans, potatoes,
spinach, squash, sweet potatoes, tomatoes

Rich sources of potassium, magnesium, and

fiber

Fruits

1 medium fruit
cup dried fruit
cup fresh, frozen, or canned fruit
cup fruit juice

Apples, apricots, bananas, dates, grapes,

oranges, grapefruit, grapefruit juice,
mangoes, melons, peaches, pineapples,
raisins, strawberries, tangerines

Important sources of potassium,

magnesium, and fiber

Fat-free or low-fat dairy productsc

1 cup milk or yogurt

1 oz cheese

Fat-free milk or buttermilk; fat-free, low-fat, Major sources of calcium and protein
or reduced-fat cheese; fat-free/low-fat
regular or frozen yogurt

Lean meats, poultry, and fish

1 oz cooked meats, poultry, or fish

1 egg

Select only lean; trim away visible fats;

broil, roast, or poach; remove skin from
poultry

Rich sources of protein and magnesium

Nuts, seeds, and legumes

cup or 1 oz nuts
2 Tbsp peanut butter
2 Tbsp or oz seeds
cup cooked legumes (dried beans, peas)

Almonds, filberts, mixed nuts, peanuts,

walnuts, sunflower seeds, peanut butter,
kidney beans, lentils, split peas

Rich sources of energy, magnesium, protein,

and fiber

Fats and oilsd

1
1
1
2

Soft margarine, vegetable oil (canola, corn,

olive, safflower), low-fat mayonnaise, light
salad dressing

The DASH study had 27% of calories as fat,

including fat in or added to foods

Sweets and added sugars

1 Tbsp sugar
1 Tbsp jelly or jam
cup sorbet, gelatin dessert
1 cup lemonade

Fruit-flavored gelatin, fruit punch, hard

candy, jelly, maple syrup, sorbet and ices,
sugar

Sweets should be low in fat

tsp soft margarine

tsp vegetable oil
Tbsp mayonnaise
Tbsp salad dressing

Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

Serving sizes vary between cup and 1 cups, depending on cereal type. Check the product's Nutrition Facts label.

For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free
dressing = zero servings.
d

The DASH Eating Plan as Part of a Heart Healthy Lifestyle

Making other heart healthy lifestyle changes while following the DASH eating plan is the best way to prevent or control high blood pressure. For example, try to maintain a healthy
weight, be physically active, make healthy eating choices, and don't smoke.

Maintain a Healthy Weight

Maintaining a healthy weight is an important part of a heart healthy lifestyle. If you're overweight or obese, you can lose weight while following the DASH eating plan. By reducing
your daily calorie intake by 500 to 1,000 calories, you can slowly lose weight.
A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. To create a weight-loss or weight-maintenance plan that's right for you, talk with your
doctor or a registered dietitian.
For more information about maintaining a healthy weight or losing weight, go to the Health Topics Overweight and Obesity article.

Be Physically Active
Physical activity also is an important part of a heart healthy lifestyle. You can benefit from as little as 60 minutes of moderate-intensity aerobic activity per week. Walking is an
excellent heart healthy activity. The more active you are, the more you'll benefit.
You can do aerobic activity with light, moderate, or vigorous intensity. If you choose activities at a moderate intensity level, aim to do at least 2 hours and 30 minutes (150 minutes)
per week. If you choose vigorous-intensity activities, do at least 1 hour and 15 minutes (75 minutes) per week. You can do these activities for 10 minutes or more at a time. In
addition, try to include muscle-strengthening activities at least 2 days per week.

Children and youth should do 1 hour (60 minutes) or more of physical activity every day; at least 3 days per week the activity should be of vigorous intensity. A great way to
encourage physical activity is to do it as a family.
To get started and stay active, make physical activity part of your daily routine, keep track of your progress, and be active and safe.
If you have a heart problem or chronic diseasesuch as high blood pressure, heart disease, or diabetesask your doctor what types of physical activity are safe for you.
You also should ask your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.
For more information about physical activity, go to the Health Topics Physical Activity and Your Heart article.

Make Healthy Eating Choices

Reduce Sodium
While following the DASH eating plan, choose and prepare foods with less sodium (salt). Be creativetry herbs, spices, lemon, lime, vinegar, and salt-free seasoning blends while
cooking and at the table to add flavor to your foods. For examples of how to season foods without using salt, visit the National Heart, Lung, and Blood Institutes (NHLBIs) Flavor
That Food Web page.
Most of the sodium that people eat comes from processed foods. So, make sure you read the Nutrition Facts label on prepared foods to check the amount of sodium in each item.
For more information about how to read a Nutrition Facts label, see boxes 10 and 11 in the NHLBIs "Your Guide to Lowering Your Blood Pressure With DASH."
Buy low-sodium, reduced-sodium, or no salt added versions of foods when they're available. Rinse all canned vegetables and beans before cooking and eating them.
Increase Potassium-Rich Foods
The DASH eating plan includes foods rich in potassium, such as fruits and vegetables, to help keep blood pressure levels healthy. In general, potassium should come from food
sources only, not supplements. To find information on the potassium content of selected foods, search the USDA National Nutrient Database for Standard Reference
at http://ndb.nal.usda.gov/ .

Reduced-sodium products and salt substitutes likely contain potassium chloride as a main ingredient. This substance may harm people who have certain medical conditions, such as
diabetes and kidney disease. Check with your doctor before trying reduced-sodium products and salt substitutes that contain potassium chloride.
Limit Alcohol

If you drink alcoholic beverages, do so in moderation: up to 1 drink per day for women and up to 2 drinks per day for men. A drink equals 12 fluid ounces of regular beer, 5 fluid
ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits.

Don't Smoke
If you smoke or use tobacco, quit. Smoking harms nearly every organ in the body, including the heart, blood vessels, lungs, eyes, mouth, reproductive organs, bones, and digestive
organs. Also, try to avoid secondhand smoke.
Talk with your doctor about programs and products that can help you quit. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals,
workplaces, and community groups offer classes to help people quit smoking. Ask your family and friends to support you in your efforts to quit.
For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBIs "Your Guide to a Healthy Heart."