Advanced FNP Children & Families. Reply to peer discussion week 6

• You should respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.

Natacha Pascal-Milfort

Hypertension

Hypertension in a Three-Year-Old

Hypertension occurs when the blood pressure in an individual rise beyond the normal range. For a toddler, when the range goes

beyond the 95th percentile, it is considered a case of hypertension. The workup for hypertension in a three-year-old will seek to

determine the causes of the ailment. Additionally, it will look to identify the risk factors facing the three-year-old. It will also seek

to carry out blood and urine tests to identify any abnormalities. That will guide the intervention to be applied in this scenario.

In this instance, the differential diagnosis will be a function of age. For a three-year-old, the common cause of hypertension is an

identifiable medical condition (Mayo Clinic, 2021). To illustrate, it might be caused by renal vascular abnormalities, urologic and

congenital renal abnormalities, or aortic coarctation. Therefore, interventions should focus on addressing the specific medical

condition.

As for the assessment process, it will tackle different areas. For instance, it is critical to assess if there is a history of hypertension

in the child’s family. It is also critical to assess whether the child has different congenital abnormalities or kidney-related

problems (Mayo Clinic, 2021). The pediatrician should also monitor the vital signs of the three-year-old patient. Additionally, it is

crucial to assess if the child has any hypertension-related problems.

The management of hypertension in the three-year-old should primarily focus on identifying the cause and seeking ways of

addressing it. For instance, it is critical to consider surgery if it is a case of renal vascular hypertension, coarctation of the aorta,

or renal segmental hypoplasia (Rodriguez-Cruz, 2017). In some cases, it is advisable to consider pharmacologic treatments such

as diuretics. The doctor should offer advice on how long the child should stay on medication. Non-pharmacological measures

such as weight management, decreasing salt intake, and encouraging physical activity are critical in hypertension management

for the three-year-old.

Changes in Case of a Ten-Year-Old.

The care plan would be different if the child were a ten-year-old. That is because older children tend to develop hypertension for

the same reasons as adults (Mayo Clinic, 2021). For example, they might have excess weight, lack adequate physical activity, and

poor nutrition. Therefore, the cause of hypertension might not be a particular identifiable cause. The assessment of the ten-year-

old should primarily focus on weight problems, nutrition issues, lack of physical exercise, and whether there is a history of

hypertension in the family. As well, it is critical to look for hypertension-related problems. In terms of management, surgery

might not be needed. Interventions to address hypertension will primarily be pharmacological and making lifestyle changes.

Risk Factor Counselling and Advice

Different risk factors are related to the occurrence or worsening of hypertension in a child. For instance, obesity, an increasing

body mass index, poor nutrition, and disordered sleep (Riley et al., 2018). It is critical to address the risk factors. That will entail

making lifestyle changes such as lowering salt intake, reducing screen time, and encouraging physical activity. Children should

have their blood pressure measured annually beginning at 3 years of age. Teach parents how to take blood pressure and

consistently use the right arm and appropriately sized cuff (Ball et al., 2017). Additionally, it is essential to seek the advice of a

pediatrician in case of any concern or inquiry.

References

Ball, J., Bindler, R. M. G., Cowen, K. J., & Shaw, M. R. (2017). Principles of Pediatric

Nursing: Caring for children (7th ed.). Pearson Education.

Mayo Clinic. (2021, July 30). High blood pressure in children – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-children/symptoms-causes/syc-20373440 (Links to an external site.)

Riley, M., Hernandez, A. K., & Kuznia, A. L. (2018). High Blood Pressure in Children and Adolescents. American Family Physician, 98(8), 486-494. https://www.aafp.org/afp/2018/1015/afp20181015p486.pdf (Links to an external site.)

Rodriguez-Cruz, E. (2017, March 9). Pediatric hypertension treatment & management: Approach considerations, Nonpharmacologic therapy, pharmacologic therapy. Medscape. https://emedicine.medscape.com/article/889877-treatment (Links to an external site.)