Hypertension – MedicalScout

Hypertension

A. Introduction:-

  1. For an adult (ages 18 years and older), a normal BP is a systolic BP below 120mm Hg and a dia- stolic pressure below 80 mm Hg.
  2. Elevated blood pressure is defined as a systolic BP between 120 and 129 mm Hg and a diastolic BP below 80 mm Hg.
  3. Hypertension (Stage 1) is defined as an SBP be- tween 130 and 139 mm Hg or a diastolic BP between 80 and 89 mm Hg.
  4. Hypertension (Stage 2) is defined as a SBP at least 140 mm Hg or a diastolic BP at least 90 mm Hg.
  5. If either the SBP or DBP is outside of a range, the higher measurement will determine the classification.
  6. Hypertension is a major risk factor for coronary, cerebral, renal, and peripheral vascular disease.
  7. The disease is initially asymptomatic.
  8. The goals of treatment include reduction of the BP and preventing or lessening the extent of organ damage.
  9. Nonpharmacological approaches, such as lifestyle changes, may be prescribed ini- tially; if the BP cannot be decreased after 1 to 3 months, the client may require pharmaco- logical treatment.

B. Primary or essential hypertension:-

1. Risk factors

  • Aging
  • Family history
  • African American race
  • Obesity
  • Smoking
  • Stress
  • Excessive alcohol
  • Hyperlipidemia
  • Increased intake of salt or caffeine

C. Secondary hypertension

1. Secondary hypertension occurs as a result of other disorders or conditions.

2. Treatment depends on the cause and the organs involved.

3. Precipitating disorders or conditions

D. Assessment

  1. May be asymptomatic
  2. HeadacheC
  3. Visual disturbances
  4. Dizziness
  5. Chest pain
  6. Tinnitus
  7.  Flushed face
  8. Epistaxis

E. Interventions

 

  1. Goals: To reduce the BP and to prevent or lessen the extent of organ damage
  2. Question the client regarding the signs and symptoms of hypertension.
  3. Obtain the Bp 2 or more times on both a with the client supine and standing.
  4. Compare the BP with prior documentation.
  5. Determine family history of hypertension.
  6. Identify current medication therapy.
  7. Obtain weight.
  8. Evaluate dietary patterns and sodium intake.
  9. Assess for visual changes or retinal damage
  10. Assess for cardiovascular changes such as dis tended neck veins, increased heart rate, and dysrhythmias
  11. Evaluate chest x-ray for heart enlargement.
  12. Assess the neurological system.
  13. Evaluate renal function.
  14. Evaluate results of diagnostic and laboratorY studies.

F. Nonpharmacological interventions

  1. Weight reduction, if necessary, or maintenance of ideal weight
  2. Dietary sodium restriction to 2g daily as prescribed
  3. Moderate intake of alcohol and caffeine-containing products.
  4. Initiation of a regular exercise program
  5. Avoidance of smoking
  6. Relaxation techniques and biofeedback therapy
  7. Elimination of unnecessary medications that may contribute to the hypertension

G. Pharmacological interventions

  1. Medication therapy is individualized for each client, and the selection of the medication is based on such factors as the client’s age, pres- ence of coexisting conditions, severity of the hy pertension, and client’s preferences.

H. See Box 52-10 for client education.

 

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