How FNPs Can Help Patients Prevent CHD
As online Family Nurse Practitioner (FNP) programs often emphasize, education and disease prevention are critical components of patient care. Preventing coronary heart disease (CHD) starts at an early age, and taking proactive measures throughout one’s life can culminate in the prevention of CHD. Many of the health issues that are linked to CHD are preventable, so it’s imperative for FNPs to be prepared to share strategies and lifestyle changes with patients who are at risk for developing health issues such as high blood pressure, diabetes, and obesity. This preparation starts in FNP programs, and FNPs can use this knowledge to educate men, women, and adolescents on how they can lower their risk of CHD starting in their teens and 20s and continuing through their 60s and beyond.
Teenagers and 20-Somethings
Stop smoking. According to the American Cancer society, 18 percent of all adults in the U.S. are smokers. In addition, 14 percent of high school students and 4 percent of middle school students smoke. Cigarette smokers are two to four times more likely to develop CHD than nonsmokers. The chemicals in tobacco cause damage to blood vessels in the heart. Smoking can lead to atherosclerosis, a disease in which plaque builds up inside the arteries. The carbon monoxide in cigarette smoke reduces oxygen in the blood, which increases blood pressure and heart rate, causing the heart to work harder to supply oxygen to the body. Smoking, whether social or habitual, is one of the biggest risk factors for CHD.
The Centers for Disease Control and Prevention (CDC) recommends quitting smoking all at once rather than gradually to prevent further harm. FNPs can share cessation methods with patients and recommend nicotine replacement products such as gum and patches to combat withdrawal symptoms. FNPs can provide follow-up visits and assessment of a patient’s physical and emotional health while they are making this transition. There are prescription medications available to help patients stop smoking. Having a relationship with a trusted FNP will allow careful evaluation if this is a method that may be implemented in the patient’s health care plan. Patients also can be directed to help lines (1-800-QUIT-NOW) and online support resources.
Eat heart-healthy. With its impact on blood pressure, cholesterol levels, and diabetes risk, diet plays a big role in heart health. A heart-healthy diet keeps saturated fats to a minimum and includes plenty of fruits, vegetables, fish, and whole grains.
FNPs work closely with patients to teach them heart-healthy eating habits that best fit their lifestyle. For example, the Mediterranean diet has been associated with reduced risk of CHD. This eating style replaces butter with olive oil; salt with herbs and spices; and red meat with plenty of plant-based foods, fish, and poultry. Red wine can be consumed in moderation, but the CDC warns that too much alcohol can raise blood pressure. FNPs often collaborate with interdisciplinary providers, such as nutritionists, who can meet with patients and develop weekly nutritional meal plans.
Embrace exercise. Regular physical activity can also keep blood pressure, cholesterol, and diabetes risk under control. Experts recommend at least 30 minutes of moderate-intensity movement five to six days a week. This can include sports, gym workouts, exercise classes, walking, cycling, and even gardening or housekeeping. Finding an enjoyable activity is key to establishing a regular exercise habit. FNPs utilize their relationship with patients to understand what type of lifestyle changes will work best and be the easiest to maintain while still getting results. Setting goals and milestones will help patients feel successful. Exercise therapists and trainers collaborate with FNPs and work with patients who are at high risk to develop CHD.
Learn stress management. Knowing how to cope with stress brought on by family, work, finances, and other responsibilities promotes resiliency and a healthier heart. Yoga, tai chi, massage, deep breathing, exercise, and spending time in nature are all healthy ways to reduce stress. FNPs take the time to get to know the whole patient and help patients understand how stress management is connected to disease prevention. They can also work with their patients to identify realistic stress management activities.
Get adequate sleep. Lack of sleep has been linked to heart attacks, high blood pressure, increased risk of diabetes, and obesity. Young adults, unfortunately, do not place enough importance on getting proper amounts of sleep. Most adults need seven to nine hours of sleep daily. They can achieve this by making sleep a priority, sticking to a regular sleep schedule, and seeking treatment for sleep-related disorders when necessary. FNPs can work with patients to develop a sleep schedule that fits his or her lifestyle — balancing work, home life, children, time for exercise, and other responsibilities. Setting good sleep habits at a young age is imperative to long-term health.
Maintain a healthy weight. Metabolism slows in midlife, making it easy to put on extra weight. Having a body mass index (BMI) of 25 or higher — or a waist measurement more than 40 inches for men or 35 inches for woman — can signal excess pounds. Being overweight increases the risk of CHD; therefore, maintaining a healthy weight is an important aid in prevention. The role of an FNP does not change as a patient ages. At this stage, FNPs still work with patients to develop a heart-healthy diet and establish an exercise routine.
Get screened. While blood pressure is generally checked during most doctor visits, adults in their 40s also should have their cholesterol levels regularly checked as well as routine diabetes screenings. Identifying problems early allows for treatment initiation and better outcomes in preventing CHD. Screening may vary if a patient’s family is identified as high risk.
Follow treatment plans. Adhering to recommended lifestyle changes and taking medications that have been prescribed to treat other conditions such as diabetes, high cholesterol, and high blood pressure is crucial for adults in order to lower additional health risks. Regular check-ins with patients allow FNPs to keep track of the progress they are making and offer suggestions if patients are struggling in certain areas.
Lower blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended for adults with high blood pressure. The plan limits sodium intake while promoting consumption of whole grains, fruits, vegetables, and low-fat dairy products. FNPs work with patients to help them understand the importance of maintaining a healthy diet and the consequences of a poor diet.
Stay heart aware. Since the risk of CHD increases with age, aging adults should learn the signs of a heart attack. FNPs take the time to walk patients through the signs and symptoms of a heart attack so patients are educated and ready to respond appropriately. Knowing when to seek emergency treatment can be the difference between life and death.
60-Somethings and Beyond
Get regular ankle-brachial index tests. This noninvasive test compares blood pressure measured at the ankle with blood pressure measured at the arm to identify narrowing or blockages of the arteries in the legs. Such peripheral artery disease signals a high risk of heart attack. There are preventive measures to stabilize PVD and promote comfort. FNPs have the opportunity to spend time with their patients and teach them about long-term heart health.
Keep up the good work. Maintaining the lifestyle behaviors and knowledge adopted over previous decades maximizes heart health. Such preventive efforts can go a long way toward keeping a body functional and fit through older adulthood. Regular check-ins and having a good relationship with patients is key to ensuring they are doing their best to avoid preventable diseases.
FNPs play a key role in helping their patients lead healthy lives. Whether it’s advising a 21-year-old to quit smoking or educating a 61-year-old on how to set daily reminders to take medications, FNPs are providing the primary and preventive care that will make a difference long after their patient’s examination is complete.
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