High blood pressure nursing point of view

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Hypertension
By: Khima Rudach
RN ICU
: Imelda Paga
RN ICU

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The blood vessels
 Arteries
 Veins
 Capallaries

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What are arteries?
 Arteries are elastic vessels that
transport blood away from the
heart.
 Largest is aorta & smallest are
capillaries

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Structure of Arteries
 The artery wall consist of three
layers
 Tunica Adventitia
 Tunica Media
 Tunica Intima

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What are veins
 Veins are elastic vessels that
transport blood to the heart. The
smallest vein is called venules.
 Largest vein is vena cava.

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What are capillaries?

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Introduction
Hypertension, referred to as high
blood pressure, HTN or HPN, is a
medical condition in which the
blood pressure is chronically
elevated.

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Classification of HTN
 1) Essential or Primary HTN
 2) Secondary HTN

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Stages of HTN
1) Pre hypertension
2) Stage I
3) Stage ii

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Predisposing cause of
essential HTN
 Obesity
 Sodium sensitivity
 Role of renin
 Insulin resistance
 Sleep apnea
 Genetics
 Age
 Alcohol consumption

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Etiology of Secondary
HTN
 Renal hypertension
 Adrenal hypertension
 Cushing,s syndrome
 Coarctation of aorta
 Drugs
 Rebound hypertension

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Signs & Symptoms
 Usually no s/s
 Headache
 Fatigue
 Dizziness
 Blurred vision
 Facial flushing
 Transient insomnia
 End organ damage.

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Complications
 CVA
 MI
 Cardiomyopathy
 Retinopathy
 Nephropathy
 Encephalopathy

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Diagnosis
 Measuring blood pressure 3
separate reading.
 Factors influence the BP.
 Caffeine, smoking, exercise, size
of cuff
 Position of pt
 2 reading apart from 5 minutes.

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Investigation in newly pt
 Renal profile
 Electrolytes
 Glucose test
 Lipid profile
 ECG
 X ray chest
 Urine for proteinuria

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Treatments
 Lifestyle modification
 Reduce weight and regular aerobic
exercise
 Reduce dietary intake of sugar
 Reduce sodium in diet
 DASH diet
 Stop smoking, tobacco and
alcohol.
 Reduce stress

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Medication
 ACE inhibitors
 Angiotensin ii receptor antagonist
 Alpha blocker
 Beta blocker
 Calcium channel blocker
 Direct rennin inhibitor
 Diuretics

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 Diagnosis Evaluation
 ECG – to determine effects of hypertension
on the heart or presence of underlying heart
disease.
 Chest X-ray-may show cardiomegaly.
 Proteinuria, elevated serum blood urea
nitrogen, and creatinine levels
 S.K+ decrease
 Urine for catecholamines increased in
pheochromocytoma.
 Renal scan
 Ambulatory BP measurements

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 Management
 Lifestyle modification
 Reduce weight and regular aerobic exercise
 Reduce dietary intake of sugar
 Reduce sodium in diet
 DASH diet
 Stop smoking, tobacco and alcohol.
 Reduce stress

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 Medication
 ACE inhibitors
 Angiotensin ii receptor antagonist
 Alpha blocker
 Beta blocker
 Calcium channel blocker
 Direct rennin inhibitor
 Diuretics

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 Nursing Diagnosis
 Deficient knowledge regarding the
relationship between the treatment
regimen and control of the disease
process.
 Ineffective Therapeutic Regimen
Management related to medication
adverse effects and difficult lifestyel
adjustments.

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 Nursing Interventions
 Proving Basic Education.
 Explain the meaning of HPB
 Stress that there can never be total cure, only
control.
 Stress the fact that there may be no correlation
between HPB and symptoms.
 Have the patient recognized that HTN is
chronic and require persistent therapy and
period evaluation.

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 Present a coordination and complementary plan
of guidance-provide information regarding the
total treatment plan.
 Explain the pharmacologic control of HTN.
 Education the patient to be aware of serious
adverse effects report them immediately.
 The dosages are individualized need to be
adjusted
 Warn the patient on vasodilating drugs to use
caution in certain circumstances that produce
vasodilation.

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 Warn patients that BP is often decreased when
circulating blood volume is reduced.
2. Encouraging self Management.
 Enlist the patient’s cooperation in redirecting
lifestyle in keeping with the guidelines of therapy,
acknowledge the difficulty, and provide support and
encouragement.
 Develop a plan of instruction for medication self
management.
 Instruct the patient regarding proper method of
taking BP at home.
 Determined recommended dietary plan and provide
dietary education as appropriate.

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