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MEDICAL SURGICAL NURSING HEALTH TALK ON HYPERTENSION

SUBMITTED TO:
MISS. NAZIMA BHATTI LECTURER DEPARTEMENT MEDICAL-SURSICAL NURSING DATE:

SUBMITTED BY:
NAVPREET KAUR M.Sc. NURSING 1ST YEAR MEDICAL-SURSICAL NURSING

NAME OF THE STUDENT:

NAVPREET KAUR M.Sc. NURSING 1ST YEAR MEDICAL-SURSICAL NURSING

NAME OF THE SUPERVISOR:

MISS. NAZIMA BHATTI LECTURER DEPARTEMENT OF MEDICAL SURGICAL NURSING

SUBJECT: TOPIC: STUDENT GROUP: VENUE: DATE: TIME: METHOD OF TEACHING: A.V. AIDS:

MEDICAL-SURSICAL NURSING HYPERTENSION M.Sc. NURSING 1ST YEAR CLASS ROOM 00-APRIL-2012 45 MIN LECTURE CUM DISCUSSION WHITE BOARD, OHP, LEAFLETS, CHART

GENERAL OBJECTIVES: At the end of the presentation the group will improve knowledge, skills and attitude regarding Hypertension.

SPECIFIC OBJECTINVES: At the end of the presentation the group will able to answer: Define hypertension? Explain the risk factors of hypertension? Discuss the causes of hypertension? Explain the signs and symptoms of hypertension? Discuss the diagnostic evaluations for hypertension? Which drugs are used to treat the hypertension? Explain about the nursing management for patient with hypertension? Explain the health education for patient with hypertension?

S.N O

TIME

SPECIFIC OBJECTIVES Introduction about hypertension.

CONTENT

TEACHING AND LEARNING ACTIVITIES Lecture

AUDIO VISUAL AIDS

EVALUATION

1.

2 min

INTRODUCTION:
Hypertension (HTN) or high blood pressure, often referred to as the silent killer disease. Hypertension is a major public health concern internationally. This requires the heart to work harder than normal to circulate blood

2.

2 min

Define hypertension?

DEFINITION:
It is defined as a persistent elevation of the systolic blood pressure at a level of 140 mm Hg or higher and diastolic blood pressure at a level of 90mm Hg or higher.

Lecture

What do you mean by hypertension?

3.

3 min

Explain the risk factors of hypertension?

RISK FACTORS: NON-MODIFIABLE RISK FACTORS: FAMILY HISTORY: There is in any person with family history of hypertension. The genetic predisposition that make certain families more susceptible to hypertension. AGE: Primary hypertension appears between the ages of 30 and 50 years. The incidence of hypertension increases with age 50% to 60% of clients older than 60 years. GENDER: Incidence of hypertension is higher in men than in women until about age 55 years. MODIFIABLE RISK FACTORS: STRESS: Stressors such as noise, infection, pain, decreased oxygen supply, heat, cold , old age, drugs. Over time hypertension can develop. If stress arousal Lecture Chart What are the factors responsible for hypertension?

becomes excessive or prolonged, target organ dysfunction or disease will result. OBESITY: Obesity especially in the upper body (give apple shape), is associated with subsequent development of hypertension. People who are overweight but carry most of the excess weight in the buttocks, hips, and thighs (given them pear shape) are at far less risk for development of hypertension. NUTRIENTS: Sodium consumption can be an important factor in the development of essential hypertension. SUBSTANCE ABUSE: Cigarette smoking, heavy alcohol consumption, and some illicit drug use all are risk factors for hypertension. Lecture Hypertension results from a complex interaction of genes and environmental factors.. Medications: Antihistamine Cocain use Heavy metal poisons (lead, arsenic) NSAIDs Oral contraceptives Some Renal disorders: Acute glomerulonephritis Chronic polynephritis Atherosclerosis Hydronephrosis Severe anaemia Neurologic disorders Increased intracranial pressure Brain tumor Problem with pregnancy: Pregnancy include hypertension What are main the causes for hypertension?

4.

3 min

Discuss the causes of hypertension?

ETIOLOGY:

Eclampsia Flash cards 5. 4 min Explain the signs and symptoms of hypertension?

SIGNS AND SYMPTOMS:


In early stages of hypertension no signs are noted. Headaches (particularly at the back of the head and in the morning). vertigo Tinnitus (buzzing or hissing in the ears) Altered vision or fainting episodes. Occasionally, retinal changes such as hemorrhages , exudates (fluid accumulation), arteriolar narrowing, and cotton wool spots occurs. Increase blood urea nitrogen Alteration in vision and speech Dizziness Weakness Sudden fall Hemiplegia

Lecture and discussion

What are the main signs and symptoms for hypertension?

6.

4 min

Discuss the diagnostic evaluations for hypertension?

DIAGNOSIS:
1. PATIENT ASSESSMENT: HISTORY: Family history of hypertension, diabetes mellitus, cardiovascular disease, renal disease, smoking, obesity etc. History of any disease or trauma to target organ. History of recent weight gain, exercise activities, sodium intake, fat intake, alcohol use, smoking. Psychosocial and environmental factors such as emotional stress, cultural food practices, etc.

Lecture

Which diagnostic test use for the hypertensive patient?

PHYSICAL EXAMINATION: Physical examination should include an accurate determination of blood pressure as well as an elevation of target organs: Vital signs and weight Examination of the neck for distended veins, and enlarged thyroid. Auscultation of the heart for increased heart rate, dysrhythmias, murmur.

The following techniques are strongly recommended: The client should be seated with the arm bared, supported, and positioned at the heart level. The client should not have smoked tobacco or ingested caffeine within the previous 30 minutes. 2. LABORATORY STUDIES: Studies used in the routine evaluation of hypertension include: Complete blood count Urinalysis Determination of serum potassium and sodium level Blood urea nitrogen Serum creatinine level Electrocardiogram Chest radiography These will provide useful information in determining the severity of vascular disease, the extent of target organ

damage, and the possible causes of hypertension. 7. 5 min Which drugs are used to TREATMENT: treat the hypertension? MEDICAL MANAGEMENT: Pamphlets Lecture Which type of drugs used for hypertensive patient?

1. LIFE STYLE MODIFICATIONS:

First line of treatment for hypertension is identical to the recommended preventive lifestyle changes, includes, dietary changes, physical exercise, and weight loss. These have all been shown to significantly reduce blood pressure in people with hypertension. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication. Regarding dietary changes, a low sodium diet is beneficial. A long term (more than 4 weeks) low sodium diet reducing blood pressure. NURSING MANEGMENT:

Lecture

8.

2 min

Explain about the nursing management for patient with hypertension?

Assessment of dietary risk factors, weight, physical activity level, alcohol use, tobacco use Diet modifications including DASH (Dietary Approaches to Stop Hypertension) and limitations on sodium intake Weight reduction strategies Increased exercise Reduce alcohol consumption amounts Brief Tobacco Interventions Nicotine replacement therapies Stress management strategies Obtain medication history and provide patient education regarding medication Assessment and promotion of adherence to treatment plan

Which type of drugs used for hypertensive patient?

Follow-up and documentation of management Lecture Charts Which type of dietary modifications is required for the hypertensive patient?

9.

4 min

Explain the health education for patient with hypertension?

HEALTH EDUCATION: EXERCISE: Studies suggest that regular physical activity may be beneficial for both prevention and treatment of hypertension, to enable weight loss, for functional health status, and to diminish all-cause mortality and risk of cardiovascular disease. In Japanese men, duration of walk-to-work and leisuretime physical activity was significantly associated with a reduction in the risk for incident hypertension. Suggested activities for older adults: Walking, Gardening, Bowling, Light house work, Bicycle or walk to work. Walk to the corner store, bank or post office, Wash the car by hand, Take the stairs instead of the elevator DIET: Diet modifications including DASH (Dietary Approaches to Stop Hypertension) and limitations on sodium intake. Advice to develop a reasonable diet plan, according to the daily energy requirements with reasonable, eat more fresh vegetables, fruit, eat or not eat animal fat, smoked products, control the daily salt intake. Select foods low in salt (fresh fruits and vegetables); Avoiding processed foods Refraining from adding salt at the table Minimizing the use of salt in cooking and Awareness of the salt content in food eaten in restaurants. MEDICATION: Teach the patient about the action and dose of medication. Patient have to take regular blood pressure medication, do not just stop medication. The medical treatment of hypertension is

relatively long. Even normal blood pressure should also adhere to the medication, doctor's medical advice based on changes in amount of drugs. FOLLOW UP: The patients should follow the medical experts recommendation and should alter it unless the doctor told you so. Patient need to go to the hospital on time for routine check up. Patients should be encouraged to tell their doctors about their way of living and diet alteration.