1. What are the top 3 chronic diseases experiencing by an older person?

Number 1: Hypertension (high blood pressure)

Fifty-eight percent of older adults were treated for hypertension – a common condition
that involves both how much blood a heart pumps, as well as how resistant the arteries
are to the blood flow. When a heart pumps a lot of blood, and you have narrow arteries
which resist the flow, that’s when you get high blood pressure, also known as
hypertension. The danger of hypertension is not only that a person can have it for years
and not know it, but it can cause other serious health conditions, like stroke and heart
attacks.
 Number 2: High cholesterol
Forty-sevent percent of older adults were treated for high cholesterol – a condition that
occurs when the body has an excess of bad fats (or lipids), resulting in the arteries
getting clogged, which can lead to heart disease.
Number 3: Arthritis
Thirty-one percent of older adults were treated for arthritis – an inflammation of the
joints, which causes pain and stiffness and is more common in women.

2. What will be the possible complications if these chronic diseases (top3 ) were not treated or
managed properly? Explain.
Hypertension Complication

The excessive pressure on your artery walls caused by high blood pressure can damage
your blood vessels as well as your organs. The higher your blood pressure and the longer
it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
 Heart attack or stroke. High blood pressure can cause hardening and thickening of
the arteries (atherosclerosis), which can lead to a heart attack, stroke or other
complications.
 Aneurysm. Increased blood pressure can cause your blood vessels to weaken and
bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
 Heart failure. To pump blood against the higher pressure in your vessels, the
heart has to work harder. This causes the walls of the heart's pumping chamber to
thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have
a hard time pumping enough blood to meet your body's needs, which can lead to
heart failure.
 Weakened and narrowed blood vessels in your kidneys. This can prevent these
organs from functioning normally.
 Thickened, narrowed or torn blood vessels in the eyes. This can result in vision
loss.
  Metabolic syndrome. This syndrome is a group of disorders of your body's
metabolism, including increased waist size, high triglycerides, decreased high-
density lipoprotein (HDL) cholesterol (the "good" cholesterol), high blood pressure
and high insulin levels. These conditions make you more likely to develop
diabetes, heart disease and stroke.
 Trouble with memory or understanding. Uncontrolled high blood pressure may
also affect your ability to think, remember and learn. Trouble with memory or
understanding concepts is more common in people with high blood pressure.
 Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading
to a certain type of dementia (vascular dementia). A stroke that interrupts blood
flow to the brain also can cause vascular dementia.
High Cholesterol Complication
High cholesterol can cause a dangerous accumulation of cholesterol and other deposits
on the walls of your arteries (atherosclerosis). These deposits (plaques) can reduce
blood flow through your arteries, which can cause complications, such as:
 Chest pain. If the
arteries that supply
your heart with blood
(coronary arteries) are
affected, you might
have chest pain
(angina) and other
symptoms of coronary
artery disease.
 Heart attack. If plaques
tear or rupture, a
blood clot can form at
the plaque-rupture site
— blocking the flow of
blood or breaking free
and plugging an artery
downstream. If blood flow to part of your heart stops, you'll have a heart attack.
 Stroke. Similar to a heart attack, a stroke occurs when a blood clot blocks blood
flow to part of your brain.

Arthritis Complication
Severe arthritis, particularly if it affects
your hands or arms, can make it difficult
for you to do daily tasks. Arthritis of
weight-bearing joints can keep you from
walking comfortably or sitting up
straight. In some cases, joints may
become twisted and deformed.
 3. Formulate 3 NCP in order of priority for older person with chronic disease select only one.

HYPERTENSION

ASSESSMENT NURSING DIAGNOSIS NURSING GOAL NURSING INTERVENTION RATIONALE EVALUATION

SUBJECTIVE Acute Pain related to The patient will report 1. Establish rapport 1. To build foundation of trust The goal is met.
 “NANANAKIT ULO KO increased cerebral pressure relief of pain/discomfort. After the intervention,
AT ANG BATOK KO” AS as evidenced by headaches 2. Assess vital signs 2. To have a baseline of data patient reported decrease
VERBALIZED BY THE and stiffness of neck. in pain with Pain Scale of
PATIENT. 3. Encourage and maintain bed rest 3. Minimizes stimulation and promotes 1/10
 VERBAL REPORTS OF during acute phase. relaxation. V/S:
THROBBING PAIN  BP: 120/80
LOCATED IN 4. Provide or recommend non 4. Measures that reduce cerebral  PR: 85
SUBOCCIPITAL REGION, pharmacological measures for vascular pressure and that slow or  RR: 18
PRESENT ON relief of headache such as cool block sympathetic response are  TEMP: 36.5 C
AWAKENING AND cloth to forehead; back and neck effective in relieving headache and
DISAPPEARING rubs; quiet, dimly lit room; associated complications.
SPONTANEOUSLY AFTER relaxation techniques (guided
BEING UP AND ABOUT imagery, distraction); and
 REPORTS OF STIFFNESS diversional activities.
OF NECK, DIZZINESS,
BLURRED VISION, AND 5. Eliminate or minimize 5. Activities that increase
NAUSEA. vasoconstricting activities that vasoconstriction accentuate the
may aggravate headache (straining headache in the presence of
OBJECTIVE: at stool, prolonged coughing, increased cerebral vascular
bending over). pressure.
 PAIN SCALE: 7/10
 BP: 140/100 6. Assist patient with ambulation as 6. Dizziness and blurred vision
 PR: 100 needed. frequently are associated with
 RR: 18 vascular headache. Patient may also
 TEMP: 36.5 C experience episodes of postural
hypotension, causing weakness
when ambulating.

7. Provide liquids, soft foods, 7. Promotes general comfort. Nasal

frequent mouth care if nosebleeds packing may interfere with
 occur or nasal packing has been swallowing or require mouth
done to stop bleeding. breathing, leading to stagnation of
oral secretions and drying of mucous
membranes.

8. Administer medications as 8. Reduce or control pain and decrease

indicated. stimulation of the sympathetic
nervous system.May aid in the
reduction of tension and discomfort
that is intensified by stress.

ASSESSMENT NURSING DIAGNOSIS NURSING GOAL NURSING INTERVENTION RATIONALE EVALUATION

SUBJECTIVE Impaired physical mobility The client will indicate the 1. Establish rapport 1. To build foundation of trust The goal is met.
 “NAHIHIRAPAN SIYA related to a decrease in action to improve After series of
KUMILOS” AS motor function secondary to mobility. 2. Assess vital signs 2. To have a baseline of data intervention, patient has
VERBALIZED BY THE S.O. upper motor neuron seen performing light
damage. 3. Teach the client to perform active 3. Active range of motion increase exercises.
OBJECTIVE: range of motion exercises on a mass, tone and muscle strength and
limb that is not sick at least four improve cardiac and respiratory
 LIMITED ABILITY TO times a day. function.
PERFORM GROSS
MOTOR SKILLS; 4. Perform passive range of motion 4. Voluntary muscles to lose tone and
 LIMITED ABILITY TO exercises on the affected strength when not in use.
PERFORM FINE MOTOR extremity three to four times a Contracture of the flexor and
SKILLS; day. Perform exercises slowly to adductor muscles can occur because
 UNCOORDINATED OR allow time for the muscles to relax the muscles are stronger than the
JERKY MOVEMENTS; and prop limb above and below extensor and abductor.
 LIMITED RANGE OF the joint to prevent strain on the
MOTION; joints and tissues.
 DIFFICULTY TURNING;
 DECREASED REACTION 5. If the client in bed doing the 5. Mobility and prolonged damage
TIME; action to straighten posture. neurosensory function can cause
 HAD MILD STROKE A permanent contractures.
MONTH AGO
 BP: 140/100 6. Prepare the progressive 6. Bed rest long or decreased blood
 PR: 100 mobilization. volume can cause a drop in blood
 RR: 18 pressure suddenly (orthostatic
 TEMP: 36.5 C hypotension) because the blood
back into the peripheral circulation.
Increased activity will gradually
decrease fatigue and increase in
7. Slowly help clients advance of prisoners
active ROM to functional activity
as indicated. 7. Giving a boost to the client to
perform on a regular basis.

ASSESSMENT NURSING DIAGNOSIS NURSING GOAL NURSING INTERVENTION RATIONALE EVALUATION

SUBJECTIVE Deficient Knowledge related Patient will verbalize 1. Establish rapport 1. To build foundation of trust The goal is met.
 “NAGAMOT KO NA DATI to Information understanding of disease After intervention, patient
YAN E KAYA HINDI NA misinterpretation process and treatment 2. Assess vital signs 2. To have a baseline of data has verbalized
AKO UMIINOM NG And Denial of diagnosis regimen. understanding of the
MAINTENANCE” AS 3. Define and state the limits of 3. Provides basis for understanding trearment regimen.
VERBALIZED BY THE desired BP. Explain hypertension elevations of BP, and clarifies
PATIENT. and its effects on the heart, blood frequently used medical
vessels, kidneys, and brain. terminology. Understanding that
OBJECTIVE: high BP can exist without symptoms
is central to enabling patient to
 BP: 140/100 continue treatment, even when
 PR: 100 feeling well.
 RR: 18
 TEMP: 36.5 C 4. Assist patient in identifying 4. These risk factors have been shown
modifiable risk factors (obesity; to contribute to hypertension and
diet high in sodium, saturated fats, cardiovascular and renal disease.
and cholesterol; sedentary
lifestyle; smoking; alcohol intake
of more than 2 oz per day on a
regular basis; stressful lifestyle).

5. Discuss importance of eliminating 5. Nicotine increases catecholamine

smoking, and assist patient in discharge, resulting in increased
formulating a plan to quit heart rate, BP, vasoconstriction, and
smoking. myocardial workload, and reduces
tissue oxygenation.
6. Lack of cooperation is a common
6. Reinforce the importance of reason for failure of
adhering to treatment regimen antihypertensive therapy.
and keeping follow-up Therefore, ongoing evaluation for
appointments. patient cooperation is critical to
successful treatment. Compliance
usually improves when patient
understands causative factors and
consequences of inadequate
intervention and health
maintenance.

7. Monitoring BP at home is reassuring

7. Instruct and demonstrate to patient because it provides visual
technique of BP self-monitoring. and positive reinforcement for
Evaluate patient’s hearing, visual efforts in following the medical
acuity, manual dexterity, and regimen and promotes early
coordination. detection of deleterious changes.

8. Adequate information and

8. Explain prescribed medications understanding that side effects
along with their rationale, dosage, (mood changes, initial weight gain,
expected and adverse side effects, dry mouth) are common and often
and idiosyncrasies subside with time can enhance
cooperation with treatment plan.

9. The combined vasodilating effect of

9. Avoid or limit alcohol intake; alcohol and the volume-depleting
effect of a diuretic greatly increase
the risk of orthostatic hypotension.

10. Because patients often cannot feel

10. Antihypertensives: Take the difference the medication is
prescribed dose on a regular making in blood pressure, it is
schedule; avoid skipping, altering, critical that there is understanding
or making up doses; and do not about the medications’ working and
discontinue without notifying the side effects. For example, abruptly
healthcare provider. Review discontinuing a drug may cause
potential side effects and/or drug rebound hypertension leading to
interactions; severe complications, or medication
may need to be altered to reduce
 adverse effects.

11. Diuretics can deplete potassium

11. Instruct patient about increasing levels. Dietary replacement is more
intake of foods/ fluids high in palatable than drug supplements
potassium (oranges, bananas, figs, and may be all that is needed to
dates, tomatoes, potatoes, raisins, correct deficit. Some studies show
apricots, Gatorade, and fruit juices that 400 mg of calcium per day can
and foods/ fluids high in calcium lower systolic and diastolic BP.
such as low-fat milk, yogurt, or Correcting mineral deficiencies can
calcium supplements, as also affect BP.
indicated).
12. Excess saturated fats, cholesterol,
12. Explain rationale for prescribed sodium, alcohol, and calories have
dietary regimen (usually a diet low been defined as nutritional risks in
in sodium, saturated fat, and hypertension. A diet low in fat and
cholesterol). high in polyunsaturated fat reduces
BP, possibly through prostaglandin
balance in both normotensive and
hypertensive people.

13. Besides helping to lower BP, aerobic

13. Encourage patient to establish an activity aids in toning the
individual exercise program cardiovascular system. Isometric
incorporating aerobic exercise exercise can increase serum
(walking, swimming) within catecholamine levels, further
patient’s capabilities. Stress the elevating BP.
importance of avoiding isometric
activity.
14. Community resources such as the
14. Provide information regarding American Heart Association,
community resources, and support “coronary clubs,” stop smoking
patient in making lifestyle clinics, alcohol (drug) rehabilitation,
changes. Initiate referrals as weight loss programs, stress
indicated. management classes, and
counseling services may be helpful
in patient’s efforts to initiate and
maintain lifestyle changes.