Published on

Description of Hypertension. Intermittent or sustained elevation in the diastolic or systolic blood pressure:

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • Exercise reduces weight and improves cardiac efficiency. Also decreases cholesterol
  • Hypertension

    1. 1. Hypertension NPN 200 Medical Surgical I
    2. 2. Description of HypertensionIntermittent or sustained elevation in thediastolic or systolic blood pressure: systolic>140mm Hg and diastolic > 90 mm HgArterioles are primarily affected, resulting in arise of peripheral vascular resistenceRise may be caused by responses of thesympathetic nervous system and stimulationof the renin angiotension mechanismDamage occurs to major organs supplied bythese blood vessels over timeCalled the “silent killer”
    3. 3. Types of HypertensionEssential (primary or idiopathic) hypertension(the most common) Cause unknownSecondary hypertensionPredisposing factors  Smoking, obesity, diet, stress, family history, race, birth control pills, some drugs, pregnancy Associations with disease  Renal disease, atherosclerosis, Cushing’s syndrome, thyroid, parathyroid or pituitary disease, PVD, and diabetes
    4. 4. Hypertension, cont.Malignant hypertension is a severe formof hypertension common to both typesIs a major cause of cardiac disease,renal failure, and CVAPrognosis is good if condition isdetected early and treatment beginsbefore complications occurHypertensive crisis may be fatal
    5. 5. Hypertension, cont.Factors which determine B/P B/P =CO X PVR Cardiac output  Volume of blood pumped from the heart in 1 minute Peripheral vascular resistance  Force in the blood vessels that the LV must overcome to eject blood from the heart  ^ PVR is the result of narrowing of the arteries and arterioles or an ^ blood volume  The vasomotor center in the sympathetic nervous system controls the release of epi and norepi. These are vasoconstrictors.  Vasoconstriciton decreases blood flow to the kidneys which starts the renin angiotension cycle
    6. 6. Hypertension, cont.Data collection Data collection Subjective  Asymptomatic or vague Objective symptoms  B/P ^ 140/90  Chest pain  Fatigue  Epistaxis  Blurred vision  Evidence of  Irritability  Dizziness associated disease  Ringing in ears  Hematuria  Tachycardia  N/V  Proteinuria  SOB and anxiety  Restlessness
    7. 7. Hypertension, cont.Diagnostic tests H&P Liver and kidney exams Series of B/P readings Chest x-ray EKG Urine, BUN, Creatinine Serum K Electrolytes Blood glucose
    8. 8. Hypertension, cont.Medical treatment Lifestyle modifications  Weight reduction, exercise, stop smoking, Drugs  Individualize  Start on any single drug to determine what will control -Low dose thiazide diuretic, beta blocker, calcium channel blocker or Ace inhibitor  Stepped approach – not used as much as in past  Low dose thiazide diuretic, beta blocker, calcium channel blocker or Ace inhibitor  Increases dosages or add another drug  Change drugs and or increases dosages of previous meds
    9. 9. Hypertension, cont.Nursing Care Assess, report and record signs of progress Record B/P in both arms as well as lying, sitting and standing comparison Inspect extremities and neurological function Schedule rest periods Quiet, calm environment Emotional support Give meds as ordered I/O and weight daily Dietary changes if necessary
    10. 10. Hypertension, cont.Patient teaching Must manage effectively to control May need to check B/P at home Teach importance of medication regimen Low fat diet along with Na restriction may be necessary Watch K if on diuretic Include exercise Teach stress management Some antihypertensives cause decreased libido and erection problems Always keep follow up appointments