NURS FPX 6614 Assessment 1 Defining a Gap in Practice NURS-FPX 6614 Structure and Process in Care Coordination ​​​​​​​Defining a Gap in Practice: Executive Summary

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Currently, hypertension affects approximately 116 million individuals in the United States (CDC, 2020). Elevated blood pressure, caused by the forceful circulation of blood throughout the body, results in the thickening of the left ventricular walls of the heart. This thickening is associated with severe cardiac events such as heart attacks, heart failure, and sudden cardiac death (Oparil et al., 2018). Moreover, evidence indicates that individuals who are obese are more susceptible to hypertension symptoms, necessitating healthcare interventions including medications or lifestyle modifications (Semlitsch et al., 2021). The integration of team-based care and the care coordination process holds promise in improving patient health outcomes. This executive summary aims to compare the effectiveness of lifestyle modifications versus medication regimens in managing hypertensive symptoms among overweight patients and assess the influence of care coordination on patient decision-making.

Clinical Priorities for Overweight Hypertensive Patients

The World Health Organization defines obesity as having a weight exceeding 20% of the ideal weight (WHO, 2021). Being overweight or obese is associated with various adverse health consequences, including hypertension, Type II Diabetes mellitus, coronary artery disease, heart failure, kidney disease, and hyperlipidemia (WHO, 2021). Obesity not only predisposes individuals to hypertension but also exacerbates its symptoms. Overweight hypertensive patients exhibit altered hormonal signals, abnormalities in the sympathetic nervous system, and impaired kidney function. Excessive visceral fat, characteristic of obesity, places additional strain on the cardiovascular system (CVS) (Chrysant, 2019). This heightened CVS strain ultimately leads to uncontrolled or persistent hypertension, resulting in symptoms such as dizziness, nosebleeds, headaches, vision changes, chest pain, and muscle tremors (Chrysant, 2019). Thus, it is imperative to develop effective healthcare strategies, encompassing medication regimens or lifestyle modifications, to help overweight patients manage their hypertensive symptoms.

Care Coordination and its Role

Care coordination plays a pivotal role in aiding healthcare providers in assisting overweight hypertensive individuals in managing their hypertension symptoms. Streamlined care coordination processes facilitate improved communication between patients and healthcare professionals, including physicians, nutritionists, pharmacists, and nurses (Karam et al., 2021). Care coordination involves a team-based approach aimed at involving patients in their own care alongside other healthcare team members (Karam et al., 2021).

In-depth Analysis or Knowledge Gap

While hypertension symptoms in overweight patients can be managed through medication, evidence indicates that medications may lead to adverse effects exacerbating the condition in obese hypertensive patients (Gebreyohannes et al., 2019). Furthermore, the side effects associated with antihypertensive medications can impede patient adherence (Gebreyohannes et al., 2019). Research by Cosimo Marcello et al. (2019) suggests that adopting low-salt diets and regular exercise may assist obese individuals in controlling their hypertension symptoms. The evidence demonstrates that patients can safely reduce weight and maintain stable blood pressure through a combination of healthy eating and regular exercise (Cosimo Marcello et al., 2019).

PICOT Question

In overweight adults with hypertension, do lifestyle modifications compared to antihypertensive medications result in lower blood pressure within a six-month period?

Population: Overweight adults

Intervention: Lifestyle modifications

Comparison: Lifestyle modifications versus medications

Outcome: Low blood pressure

Time: Six months

Explanation of the Selected Gap

Proper care planning is essential to mitigate the potentially fatal consequences of hypertension, as noted by Alsaigh et al. (2019). Lifestyle changes play a significant role in reducing blood pressure and delaying the onset of hypertension in otherwise healthy individuals. Before initiating pharmacologic therapy, hypertensive patients should consider implementing lifestyle modifications (Alsaigh et al., 2019). Care coordinators play a crucial role in educating overweight hypertensive patients and assessing their knowledge level through open-ended questions. This is a pivotal aspect of the care coordinator’s role, as it involves instructing patients on making necessary behavioral changes to achieve desired outcomes (Karam et al., 2021).