Each discussion board requires a minimum of 250 words and at least 1 peer reviewed source within the last 5 years.

Each discussion board requires a minimum of 250 words and at least 1 peer reviewed source within the last 5 years.

Each discussion board requires a minimum of 250 words and at least 1 peer reviewed source within the last 5 years.

Discussion Question 1
The patient in the case study is pre-hypertensive. Pre-hypertension is a classification of hypertension that is characterized by systolic blood pressure of between 120 mmHg and 139 mmHg. The diastolic blood pressure ranges between 80 mmHg and 89 mmHg. The patient is at risk of developing hypertension. He is not suitable for the initiation of any drug therapy now. However, the patient should engage in activities that promote healthy behaviors and lifestyles. This includes eating healthy diets, engaging in active physical activity, losing excessive body weight, and avoiding alcohol and smoking (Kaneko et al., 2023). The patient should also undergo regular blood pressure screening for the timely diagnosis and treatment of potential health risks such as hypertension, overweight, and obesity.

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There exist other categories of blood pressure. The first one is normal blood pressure. The systolic blood pressure of less than 120 mmHg and diastolic blood pressure of less than 80 mmHg characterizes normal blood pressure. Normal blood pressure does not require any interventions for health management and promotion. However, patients should be educated about healthy lifestyles and behaviors that minimize disease risk. The other category of blood pressure is stage 1. The systolic blood pressure of 140-159 mmHg and diastolic blood pressure of 90-99 mmHg characterize blood pressure stage I. Patients diagnosed with stage I hypertension should be initiated on treatment and engage in lifestyle and behavioral modifications. The other category of blood pressure is stage 2 hypertension. Systolic blood pressure of 160 mmHg and above and diastolic blood pressure of 100 mmHg characterize this class of blood pressure (Kaneko et al., 2023). The mainstream approach to treating blood pressure stage 2 is the use of pharmacological interventions and lifestyle and behavioral modifications.
 
References
Kaneko, H., Yano, Y., Lee, H., Lee, H.-H., Okada, A., Suzuki, Y., Itoh, H., Matsuoka, S., Fujiu, K., Michihata, N., Jo, T., Takeda, N., Morita, H., Nishiyama, A., Node, K., Kim, H. C., Yasunaga, H., & Komuro, I. (2023). Blood Pressure Classification Using the 2017 ACC/AHA Guideline and Heart Failure in Patients With Cancer. Journal of Clinical Oncology, 41(5), 980–990. https://doi.org/10.1200/JCO.22.00083

Discussion Question 2
Auscultation is one of the physical assessment techniques in nursing. The auscultation of the cardiovascular system is among the physical assessment techniques in the checkoff activity. Nurses and other healthcare providers use the stethoscope to auscultate the heart sounds. The stethoscope has the bell that identifies low-pitched sounds while the diaphragm identifies high-pitched sounds such as systolic clicks. The auscultation is done on different points. Patient auscultation should be performed in four standard positions that include upright, supine, left lateral decubitus, and leaning forward. The auscultation should be done in all the cardiac areas that include pulmonic, aortic, tricuspid, and mitral regions. The focus is on identifying S1 and S2 heart sounds and any systolic murmurs (Malik & Goyal, 2023). The auscultation of the left lower sternal border is important to determine the presence of S3 or S4 heart sounds.
The auscultation also entails turning the patient to the lateral decubitus position to listen for the presence of low pitched diastolic murmur of the mitral stenosis. The patient should then be turned to the upright position where the mitral, pulmonic, tricuspid, and aortic regions are auscultated for diastolic and systolic murmurs, S1 and S2 heart sounds. One should also listen to aortic regurgitation and friction rubs by having the patient lean forward. The nurse should also determine the effect of breathing on the intensity of any abnormal heart sounds heard on auscultation. For example, breathing accentuates murmurs of the right side of the heart (Malik & Goyal, 2023). The nurse should also document findings such as location, timing, radiation, pitch, intensity, duration, and relation to respiration, quality, and maneuvers when reporting abnormal heart sounds such as murmurs.
References
Malik, M. B., & Goyal, A. (2023). Cardiac Exam. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK553078/

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Each discussion board requires a minimum of 250 words and at least 1 peer reviewed source within the last 5 years.

Discussion 1: You are performing blood pressure checks on individuals at Walmart. The first person who presents for screening has a blood pressure of 139/89. How would you categorize this? What are the other categories of blood pressure?

Discussion 2: During the checkoff, you will be required to identify each auscultation point for the cardiac assessment. Discuss the landmark for each auscultation point, along with the difference that the bell and diaphragm can identify.

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