CQI Project to Monitor Elevated Blood Pressure and Volume



CQI Project to Monitor Elevated Blood Pressure and Volume

Diagnose/Reason/Resolve

GOAL: HTN –85% Goal Sys 100)

PLEASE CHECK DATA BELOW THAT APPLIES TO THIS PATIENT’S VISIT

DRY WEIGHT BLOOD PRESSURE

ٱ Edema 0 1+ 2+ 3+ 4+ BP taken after patient is seated in a

quiet room for 5 mins.

Today Home BP summary: range: Avg

_________ Last Visit _____ Other Previous Visit

DIET PERITONITIS

ٱ High Na Intake ٱ Patient had peritonitis within the last 1 month

ٱ Inappropriate fluid Intake

ٱ Poor Glycemic Control

DIALYSIS MEDICATION

ٱ High Transporter ٱ Non-Compliant with Medication

ٱ Noncompliance with Prescription ٱ Too long F/U time between Med. Change/Review

ٱ Percentage of Glucose in bags too low ٱ Too much Na HC03

ٱ Dwell time too long / too short? ٱ Taking Med that elevate BP

ٱ Poor Drainage/Mechanical/Constipation ٱ Inadequate Education

ٱ Declining Renal Function ٱ Financial Issues

ٱ Orthostatic Symptoms ٱ Side Effects of Medications

COMORBID ILLNESS

ٱ Heart Failure

ٱ Liver Failure

ٱ Local Issues (eg. Lymphedema)

ٱ Neuropathy

Plans To Initiate To Achieve Goal:

1._______________________________________________________

2._______________________________________________________

3. ______________________________________________________

tracking #AL03498

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