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Dynamic observation

Achieving and maintaining target blood pressure levels requires long-term medical follow-up with regular monitoring of patient compliance with recommendations on lifestyle changes and adherence to prescribed antihypertensive drugs, as well as treatment corrections depending on the effectiveness, safety and tolerability of treatment. In dynamic monitoring, the establishment of personal contact between the doctor and the patient, patient education in schools for patients with hypertension, increasing the patient's commitment to treatment.

• When prescribing antihypertensive therapy, planned visits to the doctor to assess the tolerability, effectiveness and safety of treatment, as well as monitoring the implementation of the recommendations received, are carried out with an interval of 3-4 weeks until the target blood pressure level is reached.

• If the effectiveness of antihypertensive therapy is insufficient, a previously prescribed drug can be replaced or another antihypertensive agent added to it.

• In the absence of an effective reduction in blood pressure against the background of 2-component therapy, it is possible to add a third drug (one of the three drugs, as a rule, should be a diuretic) with mandatory follow-up monitoring of the effectiveness, safety and tolerability of combination therapy.

• After reaching the target level of blood pressure during therapy, follow-up visits for patients with medium and low risk who regularly measure blood pressure at home are planned with an interval of 6 months.
For patients with high and very high risk, for patients receiving only non-drug treatment, and for people with low adherence to treatment, the intervals between visits should not exceed 3 months.

• At all planned visits, it is necessary to monitor patients' compliance with treatment recommendations. Since the state of the target organs changes slowly, a control examination of the patient to clarify their condition is impractical to conduct more than 1 time per year.

• With "resistant" hypertension (blood pressure> 140/90 mm Hg during treatment with three drugs, one of which is a diuretic, in submaximal or maximum doses), one should make sure that there are no objective reasons for resistance to therapy (clause 7.11). In case of true refractoriness, the patient should be referred for an additional examination.

• Treatment of a patient with hypertension is carried out constantly or in fact in most

sick for life, because its abolition is accompanied by an increase in blood pressure. With persistent normalization of blood pressure within 1 year and compliance with measures to change the lifestyle of patients with low and medium risk, a gradual decrease in the number and / or reduction of doses of antihypertensive drugs is possible. Reducing the dose and / or reducing the number of medications used requires an increase in the frequency of visits to the doctor and self-monitoring of blood pressure at home, in order to ensure that there are no repeated increases in blood pressure.
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Dynamic observation

  1. Dynamic observation
    - Clinical study. - Study of blood circulation parameters: blood pressure, pulse, central venous pressure. - Hemoconcentration indicators: hematocrit, hemoglobin, total protein concentration. - Ionogram.a serum. - Parameters of acid-pulmonary balance. - Renal function: diuresis, residual nitrogen. (see also
  2. Dynamic observation
    - Circulatory system: first, blood pressure measurement after 15 minutes, then hourly monitoring of heart rate, central venous pressure. Determination of peripheral circulation. (With a central venous pressure of 12-15 cm of water. Art. Infusions stop!) - Diuresis: control hourly (permanent catheter). At least 50-100 ml of urine and sometimes more should be allocated per hour
  3. Appendix No. 6 Journal of dynamic monitoring of individuals with signs of neuropsychic instability
    to Art. 20 of the manual, approved by order of the Minister of Defense of the Russian Federation in 1997 N___ Journal of Dynamic Monitoring of Persons with Signs of Neuropsychic Instability {foto6} * see Appendix No. 3; ** indicates the current state of the serviceman at the time of the next consultation, as well as the event (if any
    When organizing a dynamic follow-up clinic, the physician should be strictly guided by the relevant orders and instructions on the aircraft. The most common diseases of the ear, throat, nose among the military are chronic tonsillitis, acute and chronic rhinitis, sinusitis and otitis media. Primary prevention of these diseases includes: - implementation of measures to
  5. Dynamic observation and rehabilitation in the clinic of children with respiratory and circulatory diseases
    Questions to repeat: 1. Functional tests used to evaluate the respiratory system. 2. Functional tests used to determine the state of the cardiovascular system. Test questions: 1. The problem of children often suffering from respiratory diseases in a polyclinic. Prevention of acute pneumonia in young children. 2. Features of the treatment of bronchitis and acute
  6. Journal of dynamic observation of individuals with signs of neuropsychic instability
    {foto6} * see Appendix No. 3; ** indicates the current state of the serviceman at the time of the next consultation, as well as measures (if necessary) of an organizational or psychological plan aimed at helping this person. Upon dismissal from the Armed Forces due to health reasons or transfer to another unit, the corresponding section is made
    LESSON PURPOSE: To master the technique of compiling and processing time series. LESSON METHODOLOGY: Students independently prepare for a practical lesson in the recommended literature and complete their individual homework. The teacher within 10 minutes checks the correctness of homework and indicates the mistakes made, checks the degree of preparation with
  8. Methylation as a dynamic process
    DNA methylation status in any cell is established as a result of a combination of dynamic methylation and demethylation processes. In a CpG cell population, dinucleotides can have one of three methylation profiles (Turker 1999): fully methylated (methylation level almost 100%), unmethylated (about 0%) and partially methylated (between 0 and 100%), representing an average
  9. Dynamic impedanometry Tympanometry
    Tympanometry - measurement of acoustic immittance as a function of air pressure in the external auditory canal - NSP (ANSI, S3.39 - 1987). In other words, the registration of AI, which is carried out during a smooth change in barometric pressure in the NSP. The fact is that the sound pressure level (SPL) is a function of the volume of a closed cavity. Those. sound emitted into a hermetically sealed cavity,
  10. Dynamic meditation (practice)
    You need to know that with deep meditation you become hypersensitive to environmental conditions that greatly affect the process of your meditation. Colors, sounds, ambient temperature - all this is fixed in your consciousness and subconscious and affects your energy. During meditation, all sharp sounds should be minimized: turn off the phone, do not set the alarm. Remember:
  11. Clinical observation of patients
    {foto6} Clinical examination is the organization of medical activity, which is based on constant, active monitoring of people's health, the detection of diseases in the early stages, the study and elimination of the causes of their occurrence, the targeted conduct of social, medical, sanitary, hygienic and economic activities aimed at improving
  12. Dynamic meditation (theory)
    Meditation is one of the terms used to indicate a way of shifting attention from the outside world to the inner world. The essence of any meditation is constant practice, nothing, absolutely nothing can replace practice. Any teacher can give you only technical techniques, but knowledge should be your own. And only when knowledge becomes your personal experience does it begin
  13. The results of the study of the dynamic and visual-spatial organization of the motor act
    No errors were made in the control group of the subjects when performing the reciprocal coordination test. 17% of patients with an initial degree of ABC made blunders in the form of a tempo violation, smooth task execution (table 5, figure 1), in points this amounted to 1.06 (table 6, figure 2). Patients with a moderate degree (group II) and with a pronounced degree (group III) performed a test in another
  14. The formation of a dynamic gradient of systolic pressure in the cavity of the left ventricle
    In the early 60s. when examining patients with HCM, it was found that in cases of hearing loud systolic noise during cardiac catheterization, an increase in systolic pressure in the cavity of the left ventricle was determined, which sometimes significantly exceeded its level in the ventricular outflow tract and aorta (J. Goodwin, 1960; E. Wigle c et al., 1962; E. Braunwald et al., 1964, etc.). Such
  15. A comprehensive model of dynamic decision making and exit from critical situations
    Based on these concepts, we developed a model (Fig. 1.4) of the anesthetist’s thinking process when performing anesthesia and responding to intraoperative problems. This model resonates with similar ones created for other complex and dynamic spheres of human activity. It includes parallel processing of information and multi-channel on multiple levels of mental activity with
  16. Observation
    The observation method is one of the most objective and reliable methods of psychology. It is a purposeful and systematic study of actions, deeds, behavior in general, attitudes towards service and various phenomena of the surrounding reality in order to detect, register and analyze those facts that can characterize the orientation, character, abilities and other personal
  17. VPF as a complex dynamic system
    (Internet + textbook) Higher mental functions - the constituent system parts of the brain. The term was introduced into the psychol L.S. Vygotsky, the cat distinguished between “elementary” (or “natural”) and “higher psychic functions” (logical thinking, logical memory, arbitrary attention, memorization, speech, etc.). VPF - complex forms are recognized by psi activists based on relevant motives and regulated by respective goals and programs, subject to
  18. Observation method
    The observation method is one of the main methods of psychological study of the activities of military specialists. It consists in the direct perception of the studied object on the basis of registration of selected units (indicators, signs) that characterize the characteristics of the studied activity, the behavior of the individual, the team, individual acts, mental reactions, speech actions, operations activities. Total
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