Hypertension Simply called as high blood pressure.

e. as a persistent It is defined elevation of the systolic blood pressure at a level of 140mmHg or higher and diastolic blood pressure of called the or higher Sometimes 90mmHg silent killer because people who have it are often symptoms free

TYPES OF HYPERTENSION

Essential/ idiopathic/ primary hypertension

- the

form of hypertension that by definition, has no identifiable cause. It is the most common type of hypertension, affecting 95% of hypertensive patients, most cases of combined systolic and diastolic elevation fall into this category. Severity of the sequelae increases as the blood pressure, both systolic

Secondary hypertension
Result from an identifiable cause. It

has many different causes including endocrine diseases, kidney diseases, and tumors. It also can be a side effect of many medication or problems are responsible for the elevation in blood pressure and underlying causes may be Severity of the problem depends on the underlying correctable. causes. Personal and environmental factors and duration of occurent diseases

White coat hypertension

more commonly known as

white coat syndrome, is a phenomenon in which patients exhibit elevated blood pressure in a clinical setting but not in other settings. It is believed that this is due to the anxiety some people experience during a

Isolated systolic hypertension

It is a hypertension wherein the

systolic is elevated up to 140mmHG or higher and the diastolic is at normal Elevation is due to increased cardiac out put or atherosclerosis induced changes in blood vessel compliance. of ISH increases with Development advancing age, as does the severity of ISH

Persistent severe hypertension or resistant hypertension

Formerly called Malignant

hypertension Characterized by a diastolic blood pressure above 110 to 120mmHg. Results when hypertension is left
untreated or its unresponsive to treatment and become a truly severe emergency condition as the pressure continues to rise

Rebound Hypertension
A BP that is controlled with

medications and that becomes uncontrolled (abnormally High) with the abrupt discontinuation of medications

Causes/Risk factors

Non-modifiable
Family history

Age specifically to ages 30 50 of age Gender greater risk in male than female Ethnic risk more on black people

Modifiable
Stress

Obesity
Substance abuse Smoking Alcoholism Increase Na, fats, sugar in diet Client with DM, kidney diseases No exercise

Signs and Symptoms

 Elevated SBP and DBP

Dizziness
Blurred visions

Nausea and vomiting

Chest pain

Headache

Pathophysiology

Common Complications

 Myocardial Ischemia CKD

Stroke
Transient ischemic attack

Loss of vision
gangrene

Diagnostic test

Retinal examination use to assess the eyes for possible organ damage

 Urinalysis

Blood chemistry for K , Na, creatinine, fasting

glucose, and total and high density lipoprotein cholesterol levels ECG

Medical Medical management managem ent

Medical management
~Diuretics - Thiazides : decrease blood volume, -Na balance - Lood diuretics: blocks reabsorption of Na,Cl, and water in kidney - Potassium sparing diuretic: ~Beta blockers - olols : decreases heart rate and pressure

~Central

acting Drugs

- Clonidine: Acts on CNS and stimulate the brain to

decrease BP ~Vasodilators

~ ACE inhibitors ~ Angiotensin II receptor blockers ~Ca channel Blockers ~Direct renin inhibitor

Priority Nursing Diagnosis

Priority Nursing Diagnosis

Deficient knowledge regarding

the relation between the treatment regimen and control of the disease process noncompliance with therapeutic regimen related to side effects of prescribed therapy

Planning and Goals

After shift of nursing

intervention, client will understand the disease process and its treatment, participates in a self care program and absence of complications.

NURSING INTERVENTIONS

Nursing Interventions
Support and teach the patient to adhere

to the treatment regimen by implementing necessary lifestyle changes Advice to take meds. As prescribed Schedule to regular follow-up appointments with health care provider to monitor progress or identify and treatment any complications of disease or therapy

Evaluation
Maintains adequate tissue

perfusion
- Maintains BP at normal range

- Demonstrate no symptoms of

angina, palpitations, or vision changes. - Has stable BUN and Creatinine levels - Has palpable peripheral pulses

 Complies with self-care program - Adhere to dietary regimen as prescribed : low CHO, Na and fat intake, increases fruit and vegetables intake - Exercise regularly - Takes medications as prescribed and reports any side effects - Measures blood pressure routinely - Abstains from tobacco and excessive alcohol intake - Keeps follow-up appointments

 Has no complications - Reports no changes in vision - Exhibit no retinal damage on vision testing - Maintains pulse rhythm and respiratory rate within normal range - Reports no dyspnea or edema - Renal function in normal - Demonstrate no motor speech or sensory deficits - Report no headaches, dizziness, weakness, changes in gait or falls