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HYPERTENSION PSM GROUP 2.pptx 3.pptxhhhjj
- 1. HYPERTENSION Rishabh Kumar Singh ReshnaS.B. Keerthana P Ratnam Pandey
- 2. SOCIO-DEMOGRAPHIC PROFILE • Name :Mrs. Lakshmi • Age: 63 y/o • Gender : Female • Address: Koodapakkam • Education : up to 12ᵗʰ standard • Occupation : housewife • Income: Rs. Nil • Religion : Hindu • Marital status: Married • Ration card: BPL card • Migration: no
- 3. CHIEF COMPLAINTS • Shecame to the OPD with the chief complains of dizziness, giddiness, sweating for the past 1 month
- 4. HISTORY OF PRESENTING ILLNESS •The patient was apparently asymptomatic a month ago after which he developed giddiness, dizziness and palpitation • Giddiness and was insidious in onset which gets aggrevated while walking, climbing stairs and relieved on taking rest. • Palpitation was sudden in onset aggrevated after severe work and relieved on taking rest. • No history of abdominal discomfort • No history of vomitting, loose stools
- 5. PAST HISTORY • Sheis a known case of hypertension for past 10 years. • History of diabetes is present • No history of similar complaints in the past • No history of tuberculosis, epilepsy, asthma • No history of any surgery
- 6. TREATMENT HISTORY • Shewas prescribed with anti- hypertensives- Enalapril and oral hypoglycemic drugs.
- 7. PERSONAL HISTORY • Normalappetite, Mixed Diet • Normal sleep patterns • Normal bowel and bladder habit • No history of alcohol consumption • No history of smoking
- 8. DIET HISTORY • Typeof diet: mixed • Cooking practices: cooking • Type of salt used: iodized • Type of oil used: sunflower oil • Removal of starch from boiled rice: yes • Washing vegetables with flowing water: yes • Cooking in CLOSED vessels
- 9. • Diet history(24 hour recall method) TIMINGS FOOD ITEMS CALORIE CONTENT(KCAL) PROTEIN CONTENT BREAKFAST 1 CUP OF TEA 3 IDLI 1 CUP SAMBAR 84 140 60 3.6 6.6 4.0 BRUNCH 2 BISCUITS 26 2.0 LUNCH 1 CUP RICE 1 CUP SAMBAR 1CUP BEETROOT PORIYAL 410 82 72 7.9 4.0 1.6 EVENING 1 BOWL OF GROUNDNUT 567 14.3 DINNER 2 DOSA 1 CUP COCONUT 210 42.4 2.0 1.0
- 10. SUMMARY OF DIETARYINTAKE RECOMMENDED INTAKE ACTUAL INTAKE COMMENT CALORIES 1725.4 Kcal 1400kcal 325.4 Kcal deficit PROTEINS 60g 43.3g 16.7g deficit Per capita salt consumption: 10-15 g/day Per capita oil consumption: 100ml
- 11. FAMILY HISTORY • Nameof the head of the family: Mr. Perimal • Number of family members: 5 • History of cough among family members: nil • Number of children in the family who are in close contact with the index case: 1
- 12. NAME RELATI ON TO THE HOF AGE/ SEX MARITA L STATUS EDUCA TION OCCUPA TION INCOME (P.M) REMAR KS Mr.Perima l Head of the family 65/M MARRIE D Bachel or’s Degree Industrial worker Rs.25,000 /- - Mrs. Lakshmi wife63/F MARRIE D Up to 12ᵗʰ standar d housewif e - - Mr.Saurab h son 27/M MARRIE D Bachel or’s Degree Industrial worker Rs.12,000 /- - Mrs.leela Daught er in law 22/F MARRIE D Up to standar d 12ᵗʰ housewif e - - Master Ramanan grandso n 3/M UNMAR RIED - -
- 13. • Type ofthe family: joint • Family tree: 65y/o 63y/o 27y/o 22y/o 3y/o
- 14. • Total monthlyincome of the family: Rs.37,000/- • Per capita income: Rs.7,400/- • Socio economic status: upper class according to Modified BG Prasad scale • Debts: no • Healthcare facilities: PHC Kodapakkam, 2km from the residence • Vital events in the family in the past one year: nil • Social participation: yes • Any other significant details: nil
- 15. MICRO-ENVIORNMENT: 1.HOUSING: • House plan: •Set back: • Type of the house: Rented • Duration of the residence: 5years • Detached • floor: tiled • Roof: concrete • Walls:brick • Construction of the house: pucca • Number of windows : 3 • Number of doors: 2 a.lighting: adequate b. cross ventilation: present • Number of living rooms : 2 • Number of persons per room: 2 • Overcrowding: absent • Domestic hazards : nil Environmental History
- 16. 2. KITCHEN • Separate •Platform present • Fuel used for cooking: LPG • Smoke outlet: present • Washing area for utensils: present • Procurement: a.Storage of perishable items: covered b.Storage of non perishable items: covered c.Cooked food storage: • Kitchen garden : absent • Sullage disposal : nil
- 17. 3. WATER • Source:ground water • Distance between dwelling and source of water: nil • Regularity: regular • Collection and storage of water: overhead tank • Frequency of collection: frequent • Storage of water: closed • Household purification of water: filtration • Drawing of water from container: by tap
- 18. 4. SANITATION • Sanitarylatrine: present • Type of latrine: bore hole latrine • Open field defecation: no • Method of disposal of stools of infants/children: nil • Solid waste: collection and disposal • Waste storage : dustbin • Waste segregation; present • Frequency of disposal: everyday • Location and distance of disposal site from the dwelling: 100m from the residance • Method of disposal: dustbin • Domestic animals in the house : absent • Cattle shed; no • Vectors and rodents: absent • Measures for control of rodents/vectors: DDT 5. CULTURAL HISTORY Hindu by religion 6.AVAILABLE HEALTHCARE FACILITIES IN THE AREA AND UTILIZATION Kodapakkam PHC is one km away from the area of residence.
- 19. GENERAL EXAMINATION • Height:180.34cm •Weight: 80kg • BMI:24.7KG/m2 • No pallor • No icterus • No Cyanosis • No clubbing • No Lymphadenopathy • No edema Vital examinations: Temperature: afebrile Pulse: 65beats/min Blood pressure: 130/120 Respiratory rate: 16
- 20. HEAD TO TOEEXAMINATION:- • Skin: normal • Nails:smooth without pits or grooves • Foot: appears normal • Peripheral pulses: SYSTEMIC EXAMINATION:- • CVS: S1 and S2 heard, no murmur • RS: normal vesicular breath sound heard • ABDOMEN: soft,non-tender,no organomegaly • CNS: No focal neurological deficit CLINICAL DIAGNOSIS: From the above history and clinical examination, the patient is found to have Hypertension. MEDICO-SOCIAL DIAGNOSIS: Mrs. Lakshmi, 63y/o male from Koodapakkam living in a pucca house educated up to 12ᵗʰ standard belonging to upper class according to modified BG Prasad scale is suffering from
- 21. LEVELS OF PREVENTION LEVELSOF PREVENTIO N MODES OF INTERVENTIO N WHICH LEVEL HAS FAILED? HOW COULD HAVE BEEN PREVENTED PRIMARY HEALTH PROMOTION SPECIFIC PROTECTION ✓ ✓ HEALTH EDUCATION AWARENESS,REDUC ED SALT INTAKE SECONDARY EARLY DIAGNOSIS AND PROMPT TREATMENT - ADEQUATE EXERCISE, PROPER DIET TERTIARY DISABILITY LIMITATION REHABILITATI ON - - MECICATION,FOLLO WUP EXERCISE,MEDICATI ON,FOLLOWUP
- 22. SUMMARY: Mrs. Lakshmi a63 y/o Female came to the opd with complaints of dizziness,giddiness,and palpitation on walking and climbing stairs for the past 1 month and she is a known case of hypertension for past 10 years. MANAGEMENT: • Surveillance: measure and monitor • Exercise • Dash diet • Education and communication • Lifestyle modification ADVICE: • AT individual level: reduce salt intake,adequate exercise,followup every 3 months • At family level: proper diet, screening and regular exercise. • At community level: health education,identification of
- 23. National health programs, schemes and acts related to the case • National program for preventive and control of Cancer, Diabetes, Cardiovascular diseases and Stroke(NPCDCS).