A1. NURSING MANAGEMENT OF SEVERE HYPERTENSION COMPLICATED BY CVA
Ngu Ralph Taboh ( HND BSN), SandaUmaru Adamu (BSN), Charles Mvondo(MD), Jean claude Ambassa (MD), Fanka Marcel (RN), Cabral Tantchou (MD), Ayong Hilary Gah (BSN)
Authors’ affiliations: Cardiac Centre - Saint Elizabeth Catholic General Hospital Shisong
Corresponding author: Ngu Ralph Taboh, Tel: (+237) 674-415-935, Email. This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Background: Cerebrovascular accident (CVA) is the 4th leading cause of death. Hypertension (HTN) is considered to be one of the most important risk factors for stroke. Post-stroke, a patient’s blood pressure (BP) may become difficult to manage. Some patients experience persistent HTN, some experience orthostatic hypotension, while others require a decrease in their anti-HTN medications.
Method: A nursing case study of a 48 year old male patient hospitalized at the cardiac center of Shisong hospital, and followed up for two weeks. The nursing care included routine vital signs and routine procedures, bed bath, bed sore prevention, and cross specialization.
Results: Persistent BP was decreasing as medications adjusted and patient adherence improved. Patient was able to move with the assistance of crutches, first degree bed sores were managed, enteral feeding was discontinued and patient able to feed self with assistance from care givers. Our total hospitalization for 2016/2017 was 1983 with 160 (8.06%) representing CVA and HTN. Total mortality rate stood at 223, with 29 (13%) representing CVA and HTN.
Conclusion: The nursing management of hypertension complicated by CVA in the cardiac center has witness over the last few years. Challenges have been in the area of increasing number of patients arriving at late stage of disease and limited human resources in terms of critical care nurses and physiotherapists.
Key words: Nursing management, severe hypertension, Cerebrovascular Accident
A2. CASE STUDY PRESENTATION OF A PATIENT WITH DIABETES MELLITUS UNDERGOING CORONARY ARTERY BYPASS GRAFT, (CABG) - SHARING THE PERIOPERATIVE MANAGEMENT AND NURSING CHALLENGES.
Ayong Hilary Gah, Charles Mvondo, Jean claude Ambassa, Fanka Marcel, Flora Fondjio, Cabral Tantchou.
Authors’ affiliations: Cardiac Centre - Saint Elizabeth Catholic General Hospital Shisong
Corresponding author: Ayong Hilary Gah, Tel: (+237) 67-64-10-307, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Background: Diabetes and hypertension are among the leading causes of death worldwide, the course of management is long term and challenging especially with chronic cases. The main objective of the study is to show the perioperative challenge of managing a case of CABG associated with Diabetes and hypertension. Sharing the challenges, experiences and managing strategies can never be undermined but stands as a way for progressive future positive outcomes.
Method: A progressive follow up of a 48 years old female patient with the diagnosis of coronary artery disease, sequential follow up from the pre-operative ward, theatre, intensive care and discharge done with special focus on the intra operative management of Diabetic crisis.
Results: 603 operations were performed by Cardiac center Shisong from 2011-2017. From the total, 19(3.2%) were coronary CABG. Out of the CABG cases 1 (5.3%) was having diabetes and hypertension as part of the diagnosis. Despite the diabetic challenge and daily dressings of the case, wound healed by second intention and pharmacological management proceeded as per protocol on discharge.
Conclusion: Managing hypertension and diabetes is long term but becomes challenging when it has to do with cases undergoing open heart surgery. Team work, strict drug management and dressing techniques are indicators for success.
Key words: Nursing case study, Perioperative, Diabetes Mellitus 2, CABG
A4. FACTORS PREDISPOSING DIABETES MELLITUS PATIENTS TO DEVELOPING HYPERTENSION & VICE VERSA IN THOSE ATTENDING SHISONG HOSPITAL – NWR OF CAMEROON
Presenter: Fanka Tanlaka Marcel.
(HND -Nursing, clinical Perfusionist)
Cardiac Centre – Shisong Hospital
Tel: (+237) 675-355-599
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Introduction: Hypertension (defined as a blood pressure ≥140/90 mmHg) is an extremely common comorbid condition in diabetes, affecting ∼20–60% of patients with diabetes, depending on obesity, ethnicity, and age. In type 2 diabetes, hypertension is often present as part of the metabolic syndrome of insulin resistance also including central obesity and dyslipidemia.
Method: A retrospective randomized clinical study was done on 20 patients who were hospitalized at the Cardiac Centre of Shisong Hospital from October to December 2017and who were initially Diabetic patients who later developed Hypertension and vice versa. Data was collected using an observational guide and analysed using MS Excel 2010. ss
Results: Amongst the predisposing factors, poor compliance to treatment, Diet, physical inactivity and overweight were demonstrated at 40%, 21.5% and 10.4% and 8% respectively as the key risks factors.
Conclusion: Strict management and follow-up are very mandatory in patients where Diabetes and hypertension co-exist especially as complications of stroke and mortality indicate higher chances
Key words: Predisposing factors, Hypertension, Diabetes Mellitus
A3. ASSESSING ANTHROPOMETRY PARAMETERS AS INDICATORS OF DEVELOPING HYPERTENSION AND DIABETES MELLITUS IN A TARGETED POPULATION IN KUMBO – NWR OF CAMEROON
Presenter: Fanka Tanlaka Marcel.
(HND -Nursing, clinical Perfusionist)
Cardiac Centre – Shisong Hospital
Tel: (+237) 675-355-599
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Introduction: Diabetes mellitus and hypertension are common diseases that coexist at a greater frequency than chance alone would predict. Hypertension in the diabetic individual markedly increases the risk and accelerates the course of cardiac diseases.
Method: A clinical randomized progressive study was conducted on 138 patients amongst those who were freely screened at the cardiac centre of Shisong Hospital from all parts of Cameroon during the celebration of the World Hypertension, Diabetic and Heart day’s celebrations. This was on May 17th, September 29th and November 14th 2017 respectively. Data was collected on body measurements and Body mass Index (BMI), arm circumference and waist circumference were calculated to predict the risk of developing HTN and DM II as risk factors of cardiovascular pathologies.
Results: BMI demonstrated that 39.8% of the population are overweight, 14.4% were Obesity stage 1, 8.9 % at Obesity stage 2 and 1.3% at Obesity stage3. According to arm circumference, 39.9% and 34.1% showed abnormal values and elevated risks respectively.. Waste circumference on the other hand should that 21.7%, 21.6% and 4.3% were respectively at risk, obesed and very high risk.
Conclusion: Although the three indicators gave varied results, the common evidence proved that our population is fast growing towards a stage of developing HTN, DMII and other cardiovascular diseases. Cardiac health awareness is a great necessity by the health care system of Cameroon.
Key words: anthropometry, Hypertension, Diabetes Mellitus