Image result for hypertension Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.

1. HYPERTENSION
MR.SAMBAD JAGDISH.G
ASSISTANT PROFESSOR
MEDICAL SURGICAL DEPARTMENT
BALAJI COLLEGE OF NURSING

2. INTRODUCTION
• High blood pressure is a common condition in which the
long-term force of the blood against your artery walls is
high enough that it may eventually cause health problems,
such as heart disease.
• You can have high blood pressure (hypertension) for years
without any symptoms. damage to blood vessels and your
heart continues and can be detected. Uncontrolled high
blood pressure increases your risk of serious health
problems, including heart attack and stroke.

3. CONTI…
• No specific cause for hypertension is found in 95% of cases
• Medical guidelines define hypertension as a blood pressure
higher than 130/80 millimeters of mercury (mmHg),
according to guidelines issued by the American Heart
Association (AHA) in November 2017.

5. SYSTOLIC BLOOD PRESSURE
• when the left ventricle contracts and pushes blood into
the aorta, the pressure produced within the arterial
system is called the systolic blood pressure.
• in adult about 120 mmHg

6. DIASTOLIC BLOOD PRESSURE
• When complete cardiac diastole occur and the heart is
resting following the ejection of blood, the pressure
within arteries is much lower and is called diastolic
blood pressure.
• In adult 80mmHg
• Arterial blood pressure is measured with
sphygmomanometer and usually expressed with the
systolic pressure written above the diastolic pressure
BP = 120/80 mmHg

7. FACTOR DETERMINING BLOOD
PRESSURE
BLOOD PRESSURE = CARDIAC × PERIPHERAL
OUT PUT RESISTANCE

8. DEFINITION
• HYPERTENSION : High blood pressure, defined as a
repeatedly elevated blood pressure 140 over 90
mmHg -- a systolic pressure above 140 or a diastolic
pressure above 90.
• chronic hypertension is a "silent" condition. stealthy as
a cat, it can cause blood vessel changes in the back
of the eye (retina), abnormal thickening of the heart
muscle, kidney failure, and brain damage.

9. CAUSES
• According to causes there are two type of hypertension.
• High blood pressure that is not caused by another
condition or disease is called primary or essential
hypertension. If it occurs as a result of another condition,
it is called secondary hypertension.
• PRIMARY HYPERTENSION can result from multiple
factors, including blood plasma volume and activity of the
hormones that regulate of blood volume and pressure. It
is also influenced by environmental factors, such as
stress and lack of exercise.

10. • SECONDARY HYPERTENSION has specific causes and is a
complication of another problem,
• Kidney disease
• A rare cancer of an adrenal gland
• Cushing syndrome, which can be caused by corticosteroid drugs
• Congenital adrenal hyperplasia, a disorder of the cortisol-
secreting adrenal glands
• Hyperthyroidism, or an overactive thyroid gland
• Hyperparathyroidism, which affects calcium and phosphorous
levels
• Pregnancy
• Obesity

12. CLASSIFICATION OF
HYPERTENSION

14. PATHOPHYSIOLOGY

15. SIGNS &SYMPTOMS
• A person with hypertension may not notice any symptoms,
and it is often called the "silent killer." While undetected, it
can cause damage to the cardiovascular system and
internal organs, such as the kidneys.
• Regularly checking your blood pressure is vital, as there will
usually be no symptoms to make you aware of the condition.

17. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• X-ray
• Urine examination
• Blood test
• ECG

19. MEDICAL MANAGEMENT
• DIURETICS. Diuretics, sometimes called water pills, are
medications that act on your kidneys to help your body
eliminate sodium and water, reducing blood volume
• BETA BLOCKERS. These medications reduce the
workload on your heart and open your blood vessels,
causing your heart to beat slower and with less force.
Beta blockers include acebutolol , atenolol and others

20. • ANGIOTENSIN-CONVERTING ENZYME (ACE)
INHIBITORS. These medications — such as benazepril, captopril
and others — help relax blood vessels by blocking the formation
of a natural chemical that narrows blood vessels. People with
chronic kidney disease may benefit from having an ACE inhibitor
as one of their medications.
• ANGIOTENSIN II RECEPTOR BLOCKERS (ARBS). These
medications help relax blood vessels by blocking the action, not
the formation, of a natural chemical that narrows blood vessels.
include candesartan, losartan and others. People with chronic
kidney disease may benefit from having an ARB as one of their
medications.

21. • CALCIUM CHANNEL BLOCKERS. These medications —
including amlodipin, diltiazem and others — help relax the
muscles of your blood vessels. Some slow your heart rate.
• VASODILATORS. these medications, including hydralazine and
minoxidil, work directly on the muscles in the walls of your
arteries, preventing the muscles from tightening and your arteries
from narrowing.
• ALDOSTERONE ANTAGONISTS. Examples are spironolactone
. These drugs block the effect of a natural chemical that can lead
to salt and fluid retention, which can contribute to high blood
pressure

22. NURSING
MANAGEMENT

23. Decreased cardiac output related to inadequate blood
pumped by the heart to meet metabolic demands of the
body.
INTERVENTIONS:
• Check patient’s lab data (cardiac markers, blood cell count,
electrolytes etc.) To determine contributing factors.
• Monitor and record blood pressure in both arms and thighs
• Measure blood pressure in both hands.
• Auscultation of breath sounds and heart rhythm. Observe
patient’s skin color, temperature, and capillary refill time.
• Advise the patient on reducing sodium intake, if needed.
• Administer medication, if needed.

24. Activity intolerance related to insufficient physiological or
psychological energy to endure or desired daily activities
INTERVENTIONS:
• Note each of the factors that contribute to fatigue (age, health,
illness, etc.).
• Evaluate the patient’s degree of activity intolerance and when it
occurs.
• Monitor how the patient responds to activity (pulse, heart rate,
chest pain, dizziness, excessive fatigue, etc.).
• Explain energy conserving techniques (shower chairs, sitting to
brush teeth, etc.).
• Assess any emotional factors that may be contributing to activity
intolerance (such as depression or anxiety).
• Encourage the patient to engage in self-care and progressive
activity when possible.

25. Ineffective coping related to inability to form a valid
appraisal of the stressors, inadequate choices of
practiced responses, and/or inability to use available
resources.
INTERVENTIONS:
• Determine what specific areas the patient has difficulty coping
with.
• Assess the effectiveness of the patient’s current coping skills and
where improvements can be made.
• Help the patient identify specific stressors and how to cope with
them.
• Work with the patient to develop a care plan, and encourage
participation in the plan.
• Help the patient identify and begin planning for necessary

26. Imbalanced nutrition (more than body requirements) related to intake
of nutrients that exceeds metabolic needs
INTERVENTIONS:
• Assess the patient’s understanding of the relationship between
hypertension and obesity.
• Discuss the relationship between hypertension and obesity with the
patient.
• Discuss the need for a decreased caloric intake, as well as a limited
intake of salt, sugar, and fat.
• Determine the patient’s desire to lose weight.
• Help the patient establish a realistic exercise plan.
• Help the patient establish a realistic nutrition plan.
• Refer the patient to a nutritionist, if needed.

28. LIFESTYLE AND HOME REMEDIES
• By chart