0513F Elevated blood pressure plan of care documented (CKD)

Name of the Procedure:

Elevated Blood Pressure Plan of Care documented (CKD)

• Commonly known as: Hypertension Care Plan for Chronic Kidney Disease
• Medical term: Hypertension Management Plan for Chronic Kidney Disease (CKD)

Summary

A structured approach to managing elevated blood pressure in patients with chronic kidney disease (CKD). This plan outlines lifestyle changes, medications, and monitoring strategies to control blood pressure and reduce the risk of kidney damage.

Purpose

• Addresses: High blood pressure (hypertension) in patients with CKD.
• Goals: To lower and maintain blood pressure within target ranges, slow CKD progression, prevent cardiovascular events, and improve overall health outcomes.

Indications

• Persistent high blood pressure readings.
• Diagnosis of chronic kidney disease.
• Risk factors like diabetes, family history of kidney disease, or cardiovascular issues.

Preparation

• Follow-up with primary care and specialists.
• Home blood pressure monitoring.
• Pre-appointment lab tests (e.g., blood and urine tests) to assess kidney function.
• Medication review and adjustments.

Procedure Description

1. Initial Assessment: Medical history, physical exam, and blood pressure measurement.
2. Diagnosis Confirmation: Lab tests to confirm CKD stage and assess kidney function.
3. Plan Development:
   • Medication: Prescribe antihypertensive drugs.
   • Lifestyle: Recommend diet, exercise, and smoking cessation.
   • Monitoring: Schedule regular follow-ups and home blood pressure tracking.
4. Education: Inform the patient about CKD, hypertension, and the importance of adherence to the care plan.

• Tools: Blood pressure monitor, lab tests (e.g., GFR, creatinine).
• No anesthesia or sedation involved.

Duration

• Initial assessment: 30-60 minutes.
• Ongoing management: Varied, with regular check-ups every 1-3 months.

Setting

• Typically outpatient clinics, primary care offices, or nephrology clinics.

Personnel

• Involves primary care physicians, nephrologists, nurses, dietitians, and possibly pharmacists.

Risks and Complications

• Side effects of medications (e.g., dizziness, fatigue).
• Risks associated with poor control of blood pressure (e.g., cardiovascular disease, worsening kidney function).
• Close monitoring required to manage and mitigate these risks.

Benefits

• Lower blood pressure within target ranges.
• Slow progression of CKD.
• Reduction in the risk of cardiovascular events.
• Improved quality of life.
• Benefits typically realized over several weeks to months.

Recovery

• Ongoing management, no specific recovery period.
• Adherence to medication and lifestyle modifications.
• Regular follow-ups to adjust the care plan as needed.

Alternatives

• Dietary approach through DASH diet (Dietary Approaches to Stop Hypertension).
• Weight loss programs.
• Alternative antihypertensive medication regimens.
• Pros: Non-medication options may appeal to patients preferring lifestyle interventions.
• Cons: May not be sufficient alone; often best used in conjunction with pharmacological treatment.

Patient Experience

• Patients might experience increased awareness and control over their health.
• Possible initial challenges in adapting to lifestyle changes and medication side effects.
• Emphasis on patient education and support to improve adherence and comfort.
• Pain management not typically required, focus on long-term health and well-being.