It is the ppt on the hypertension, medical surgical nursing. Cause and their types and the medical management .

1. ● HYPERTENSION
DEFINITION:-
Hypertension is a disease of vascular regulation in
which elevation of arterial pressure above the normal
range.
Normal blood pressure: 120/80mm of Hg.
In Hypertension: 140/90 or above

3. CAUSES/TYPES
1.Primary Hypertension:
- It is due to unknown causes or without systemic cause.
Example:
● Family history
● Prolonged mental tension
● Arterial degeneration
● Hormonal or metabolic disturbance.
3.Borderline Hypertension:
-It is defined as intermittent elevation of B.P. with normal readings.
5. Malignant Hypertension:
- It is a Syndrome of markedly elevated blood pressure (above 140 mm of
hg).
6. Benign Hypertension:
- Also known as uncomplicated hypertension, usually of long duration
and mild to moderate severity, may be Primary or Secondary.
2. Secondary Hypertension:
It is due to pathological conditions.
Example:
● Due to kidney disease, e.g., Pyelonephritis.
● Due to endocrine disorders, e.g., cushing Syndrome,
diabetes mellitus.
● Congenital deformities, e.g., Renal artery obstruction.
Others:
● Enlarged ProstateToxaemia in pregnancy
● Excessive body weight
● Excessive sodium intake
● Obesity
● Smoking
6. White Coat Hypertension:
It is due to anxiety only at a time of measuring blood pressure by
doctor or nurse in hospital or clinic.

4. PATHOPHYSIOLOGY:-
There are three control system play a major role in monitoring blood pressure.
● Arterial baroreceptor: They are found in carotid sinus and walls
of ventricles. Baroreceptors help to maintain B.P.
● Regulation of body fluid volume :
↓
↓
↓
Increase blood volume
↓
Increase blood pressure
Change in body fluid that affect systemic arterial pressure
Abnormalities in transport of Na+ ion and water
Increase Na, K, H20 in blood

5. Angiotensin-I
↓
Angiotensin-II/III
↓
Increases sympathetic nervous system activity
↓
Inhibit sodium excretion
↓
Increases blood pressure
● The renin-angiotensin system:-

6. ● SIGNS AND SYMPTOMS:-
● Morning occipital headache
● Fatigue
● Dizziness
● Bluring vision
● proteinuria
● Haematuria (blood in urine)
● Cardiac asthma
● Anginal Pain
● Epistaxis (Nose bleeding)
● Palpitation
● Tinnitus (Ringing in ears)
● Breathlessness.

7. ● DIAGNOSTIC EVALUATION:-
● By measuring B.P.
● Chest X-ray
● Urine test
● Blood test
● History collection
● Physical examination

8. COMPLICATIONS :-
● Heart disease
● Renal failure
● Cerebral haemorrhage
● Angina pectoris.

9. ❏ MEDICAL MANAGEMENT
1. Diuretic: They increase frequency of urine.
Example:
● Thiazide - 40mg
● Furosemide - 20mg.
2. Beta blocker:
Prevents stimulation of beta-adrengeic receptors of sympathetic nervous system. Because
beta adrenergic receptors are responsible for vasoconstriction in blood vessels.
Example:
● Atenolol
● betaxolol
● Timolol
● propranolol

10. 3. Vasodilators:
These drugs acts as blood vessel dilator and open vessels by relaxing their muscular walls and decreased blood pressure.
Example: Nitrates.
● Short acting: Nitroglycerine - 15-12 mg (sublingual)
● Long Acting: Isosorbide dinitrate - 5-10 mg.
4. Calcium channel blockers (calcium Antagonist):
They are used to decrease oxygen demand in Heart and improve coronary blood flow.
Example:
● Verapamil (Antiarrhythmic) (Administer empty stomach before meal).
● Nifedipine.
5. Angiotensin Converting Enzyme inhibitor:
They inhibit Angiotensin I and II Conversion.
Example:
● Captopril
● ramapril
● Benazepril

11. NURSING MANAGEMENT:-
● Assess the Anxiety level of patient.
● Take medical history of patient.
● Ask diet pattern of patient.
● Assess educational level of patient.
ASSESSMENT:-

12. Nursing Diagnosis And
Intervention:
1. Anxiety related to disease
Nursing Intervention-
● Provide proper knowledge about disease condition to
patient.
● Provide comfortable rest to patient.
● Restrict quantity of visitors.
● Give answer to the questions of patient.

13. 3. knowledge deficit about disease condition
Nursing Intervention
● Provide proper knowledge about disease to the patient also try to increase
Knowledge of patient about its disease.
●
4. Alteration in comfort related to disease
Nursing Intervention
● Provide comfortable Position as well as provide rest to patient with raised head
of bed or use pillow.
● Provide general care to patient.
● Give health education to patient.
● Advice patient to Avoid alcohol and smoking

14. Made by priyanshu verma, bsc nursing
student❤⚕