While smoking is a proven risk factor for heart related illnesses and stroke, its connection to hypertension is still debatable. Conversely, active and passive smoking increase the accumulation of fatty substances inside blood vessels, developing a health issue termed as atherosclerosis which accelerates blood pressure (Talukder, 2011) . In addition to smoking, weight gain is also connected to developing hypertension. Weight loss reduces the straining of the heart, while being overweight results to extra strain on the human’s heart (Narkiewicz, 2010) . When the heart is strain ing in doing its activities, then the patient has a high chance of developing hypertension. Therefore in this case, some of the data that the nurse will assess to understand the contributing factors to the patient’s hypertensions are his lifestyles more so his smoking and feeding behavior.
Hydrochlorothiazide is an oral drug that is used in treating or rather lowering hypertension. For a patient diagnosed with hypertension, failure to take hydrochlorothiazide results to the worsening of the situation and this might even be made worse when his/her lifestyle involves activities such as smoking, lack of physical exercise and high consumption of fatty foods (Narkiewicz, 2010) . Therefore, if the patient has not been taking his medication, some of the nursing diagnoses that the nurse can identify are the pulse, precordium to test whether there is an apical elevation and also can listen to the sound of the heart to understand the extent of the patient’s hypertension.
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In case the patient has been using hydrochlorothiazide and his condition has not improved, then the next pharmacologic option for the patient is the use of beta blockers and ACE inhibitors which are more effective than hydrochlorothiazide. In addition, the patient should be advised to adjust his lifestyle by avoiding stress, smoking, consumption of fatty foods and also adopting to a lifestyle that involves regular physical exercises.
References
Narkiewicz, K. (2010). Obesity and hypertension—the issue is more complex than we thought. Nephrology Dialysis Transplantation, Volume 21, Issue 2 , 264–267.
Talukder, H. (2011). Chronic cigarette smoking causes hypertension, increased oxidative stress, impaired NO bioavailability, endothelial dysfunction, and cardiac remodeling in mice. American Journal of Physiology Heart and Circulatory Physiology , 388-396.
