CARE OF THE OLDER PERSON OUTPUT

CLIENT: MRS. VICTORIA PAOR AGE: 65 YEARS OLD GENDER: FEMALE

RESIDENCE: LINDAVILLE PHASE II EVERLASTING ST., SAN ISIDRO, TAGBILARAN CITY

Submitted by: Angelo Gabriel Regalado Submitted to: Mrs. Louila Joy De Claro RN, MAN
 INFORMED CONSENT FORM

I, Victoria Paor, understand that I am being asked to participate on data regarding my health status, lifestyle practices, health care utilization and other data
relevant to my health. If I agree to participate in this health assessment. I will be interviewed for approximately 15- 30minutes about my health. The interview will
take place in my preferred place and time. No identifying information will be included when the interview is transcribed. There are no known risks associated with
this assessment.

I realize that the knowledge gained from this activity may help me, other nursing students and health institutions in the future.

I realize that participation in this activity is entirely voluntary, and I may withdraw from the activity at any time I wish, if I decide to discontinue my participation in
this activity. I will continue to be treated in the usual and customary fashion.

I understand that all data will be kept confidential. However, this information may be used in nursing publications or presentation.

If I need to, I can contact the student Nurse - Mr. Angelo Gabriel Regalado any time during the activity.
The activity has been explained to me. I have read and understand this consent form, all of my questions have been answered, and I agree to participate. I
understand that I will be given a copy of this signed consent form.

________________________ _______10/11/20__________________
Signature of Participant Date

_________________________ 10/11/20___________________
Signature of Witness / Guardian Date

_______________________ ___10/11/20_________________
Signature of Student Nurse Date
 Functional Health Patterns Assessment Tool

Angelo Regalado
Student: _______________________________ Date____08/11/20_____

Patient’s Initials _______________X_______ Male__/___ Female_____ Age___51__

Medical Diagnosis: Hypertension

Reason for seeking health care: Feeling of dizziness and blurry vision

1. HEALTH PERCEPTION-HEALTH MANAGEMENT

Past medical history:

Illnesses: Solid masses on anterior neck

Surgery none

History of chronic disease Hypertension, goiter, and Diabetes

Immunization history (please check all that applies)

Tetanus __/__ Pneumonia ___/_ Influenza ___/__ MMR __/__Polio __/__ Hep B__/__
 Use of Tobacco:

____ None __/__ Quit ( ____ 1 pck/day ____ 1-2 pck/day ____>2 pck/day ____ pck/yr

smokeless tobacco ____ Pipe _____ Cigar______

Alcohol: Amount/Type __________doesnt drink______ Date of lsat drink _____x________

Frequency of use_______________x____________

Other drugs: Amount/type____________x_________ Freq. of use_____x____________

Medication Dose Frequency of Use Last dose

(prescription/non-prescription)

Thyrax 50 mg q.d August 12,2011

2. NUTRITIONAL-METABOLIC
____ Not assessed
Ht ___5’2 ft__ Wt _______63 kg__________ Weight fluctuations for the last 6 months

Type of Diet/Restrictions

Regular _____ Low Salt _____ Diabetic ___/__ Other Supplements____________

Appetite

Normal _/__ increased ___ decreased ___decreased taste ___food intolerance______

nausea ___/__ vomiting_____ Describe: ________________________________

Swallowing difficulties_____/___ gag reflex____normal__ chewing difficulties ____slight difficulty_____

Feeding: ___/___ Self ______ Assist

Condition of Mouth:

Pink__yes___ inflammed__no___ moist__/___ dry_no____

lesions/ulcerations____none____ Describe__________________ teeth/gums____Complete____

Dentures____none_____ upper (partial/full)_______ lower (partial/full)_________

Intravenous fluids type/amount_________PNSS 1 LITER______________________

 NGT________NO_______ Gastrostomy________NO________

Skin Condition:

Color (pallor, ashen, pink, jaundice, cyanotic, ruddy)__________Pallor___________

Temperature (warm, cool, hot)_______warm_______________

Dry, moist, clammy, diaphoretic _______dry________________

Edema: pitting/non-pitting___________non-pitting____________

Turgor: good, poor, tenting _________good___________

Pruritis ______none__________

Intact ______none_________

bruises/lesions describe: (size,location)___________none_________________

Body temperature: ___36.8___Tympanic ______ Oral ______ Rectal

3. ELIMINATION

Not assessed___________

Bowel habits: Describe (consistency, color, amount)_________brown and soft consistency__________________

#BM’s/day_once a day_____ Date of last BM______august 10,2011________

Constipation____no_______ Diarrhea____no______ Incontinence_____no____

Bladder habits:

Describe (color, clarity, amount)_____________dark yellow_________________

Frequency____ Dysuria____ Nocturia____ Urgency____ Hematuria____

Retention_____ Burning____ Hesitancy____ Pressure_____

Inconsistency:

No____ Yes__/__ Daytime_____ NIghtime______

Occasional_______ difficulty delaying voiding_______

Assistive Devices: Folley Catheter

Intermittent catheterization_____ indwelling catheter__/___external catheter_____

Incontinent brief_____

Ostomy: Type______ Appliance_______ Self-care___/____

Inspect abdomen:

Symmetry____/___ flat______ rounded_______ obese_______

 Auscultate abdomen:

Normal bowel sound____/____ Hypoactive______ Hyperactive_______

Palpate abdomen:

Soft_____ firm_/____ tender: describe____________________

Distention : describe________________________

4. ACTIVITY-EXERCISE
Not assessed____________

A. Musculoskeletal: tremors__/____ atrophy_____ swelling______

Self-care Ability

0 - independent

1 - assistive device

2 - assistance from others

3 - assistance from person and equipment

4 - dependent/unable
 SELF-CARE ABILITIES 0 1 2 3 4

Eating /

Bathing /

Dressing /

Toileting /

Bed mobility /

Transferring /

Ambulating /

Stairs /

Shopping /

Cooking /

Home Maintenance /

Assistive Devices:

None___/__ crutches______ bedside commode______ walker______ cane______

splint/brace______ wheelchair______ other______

Gait:

Normal____/___ abnormal______ Describe_____________________________

Range of motion:

Normal___/__ Limited________ Describe___________________________

Posture:

Normal____/__ Kyphosis_____ Lordosis______

Deformities:No ____/__ Yes______ Describe_________________________

Amputation: ______________ Prosthesis______________________

Physical Development Assessment:

Normal____/___ Abnormal________

Describe________________________________
B. Cardiovascular
Not Assessed_________

Pulse:

Regular___/___ Iregular______ Strong_____ Weak______

Radial Rate_____85____ Apical Rate_____________

Blood Pressure:

Standing_________ Lying_____/____ Sitting_________

Extremities:

Temperature:

Cold________ Cool________ Warm___/_____ Hot_________

Capillary Refill:

Brisk______/____ Sluggish___________

Color:_______pinkish__________ (Describe)

Homan’s Sign:

Negative________/_________ Positive_____________

Nails:

Normal____/____ Thickened_________ Others:_________________

 Hair Distribution:

Normal____/____ Abnormal___________ Describe_________________

Pulses:

Femoral________ Popliteal____/______ Post-tibial_________ Dorsalis________

Palpable____/_______ Doppled________

Claudication:

Yes___/______ No_________

C. Respiratory
Not Assessed_________

Inspect chest:

Symmetrical________ asymmetrical_____/____

Respiration:

Rate______18bpm_ Depth (shallow, deep, abdominal, diaphragmatic)___________

Regular___/_____ Irregular______ Periods of apnea__________

Dyspnea at rest____/_____ Orthopnea_________ Dyspnea on exertion_______

Cough: Dry/productive cough (describe)_____none________________

Sputum (describe)_____________none_____________
 Auscultate Chest:

Crackles__none_____ Rhonchi____none___ Friction Rub__none______ Wheezing_______

Describe_____________________

Others:

Chest tube_____noen____ Tracheostomy (describe)____________

Oxygen_______________none_____________________

5. SLEEP-REST

Not Assessed________

Usual sleep habits:

Hours per night___8 hrs______ Consecutive hours slept per night___8 hrs_______

A.M nap____no____ P.M nap__no_____

Feel rested after sleep: Yes_/_____ No______

Awakening during nights: Yes__/_____ No______

Insomnia: Yes___/___ No_______

Methods used to promote sleep:

Medication______ Warm fluids_____ Rituals (bathing, reading, TV, music)_/____

6. COGNITIVE-PERCEPTUAL

Not Assessed_______

Level of Consciousness:

Alert___/___ Lethargic_____ Drowsy____ Stuporous_____ Comatose______

Mood (subjective):

Pleasant_____ Irritable____ Calm___/__ Happy____ Euphoric____ Anxious____

Fearful_____ Other______

Affect (objective):

Surprise_____ Anger_____ Sadness____ Joy_____ Disgust_____ Fear_____

Flat__/__ Blunted____ Full____

Orientation Level:

Person__okay__ Place__okay__ Time__okay__ Significant others_____okay__

Memory:

Recent: Yes____/__ No_____

Remote: Yes______ No___/___

Pupils:

Size___norma___ Reaction (brisk/sluggish)____brisk___

Reflexes:

Normal__/_____ Absent______

Grasps:

Right: strong/weak____strong____

Left: strong/weak__strong________

Push/pulls:

Right: strong/weakstrong______

Left: strong/weak___strong_____

Others:

Numbness___none___ Tingling__none____

Pain:

Denies___none___

Location: describe________________x__________

Radiation: describe_________________x_________

Intensity: (0-10 scale)_______________

Timing (how often events that precipitate)__________x__________

When did pain begin?_____________________x_________________

What alleviates pain?______________________x_________________

What increases pain?______________________x_________________

Thought content:__________________________x________________

Senses:

Visual Acuity___okay___ Glasses_____ Contacts______ Blind R/L______

Prosthesis: (artificial eye) R/L

Hearing:

Impaired (R/L)___x__ Deaf (R/L)___x_ Hearing aid_x____ Tinnitus__x___

Drainage from ears__x___

Touch:

Normal__/____ abnormal______ Describe: Tingling_____ Numbness____

Smell:

Normal____/_ Abnormal_____

Ability to communicate:

Language spoken___visayan and tagalog_ Read___/_ Clear__/__ Articulate_/___

Ability to make decisions

Easy____ moderately easy__/__ moderately difficult_____ difficult______

7. SELF-PERCEPTION-SELF-CONCEPT

Not Assessed_____

Appearance :

Calm__/___ Anxious____ Irritable____ withdrawn____ restless____

Appropriate dress__okay___ Hygiene__okay___

Level of anxiety: (subjective) Rate on 0-10 scale____5___

Face reddened:

Yes_____ No___/_

Voice volume changes:

No____ Yes (loud/soft)_no sound___

Voice quality:

No_/_ Yes (quavering/hesitation)____

Muscle tenseness:

Relaxed fists/teeth clenched__none___

Body language: Describe_______________normal______________

Eye contact:

Answers questions: readily___/___ Hesitantly_____

Usual view of self:

 Positive___/__ Neutral_____ Somewhat negative (subjective)______

Level of control in this situation (0-10) (subjective)_______8___________

Usual level of Assertiveness (0-10) (subjective)___________8_________

Body Image: Is current illness going to result in a change in body structure or function?

No__/__ Unsure_____ Yes (describe)________________

8. ROLE-RELATIONSHIP

Not Assessed______

Does patient live alone? Yes_____ No____/_ With whom?_________

Married___seperated______ Children_____20 _______________________

Next of Kin__________________

Occupation_______yaya___________________

Employment Status:

Employed________ Short-term disability_____ Long-term disability_______

Retired____/___ Unemployed_______

Support system:

Spouse___dead____ neighbors/friends______ none______

Family in same residence_/______ Family in separate residence______

 Family: Interaction (describe)______________

Questions patient regarding:

Concerns about illness:______Worried about financial matter__________________________________

___________________________________________________________

Will admission cause significant changes in usual role?_________no because she is dependent on her childrean________

_____________________________________________________________

Social Activities:

Active______ Limited____/_ None______

Activities participated in:_______going ot church__________________________________

Comfort in social situations (subjective):

Comfortable___/___ Uncomfortable______

****if patient is dependent on others for care note any evidence of physical or psychosocial abuse

9. SEXUALITY-REPRODUCTIVE

Not Assessed_______

Female:

Date of LMP_____2009______ Para__2___ Gravida__2___ Pregnant__not pregnant_____

Menopause:
No______ Yes___/____ Year___2009____

Contraception:

No_____/__ Yes_______ Type_______________________

Hx. of vaginal bleeding:

No______ Yes (describe)______/ lasted for 7 days_________ Last Pap Smear______________

History of sexually transmitted disease:

No___/__ Yes_______

Male

History of Prostate problems:

Yes_____ No______

History of penile discharge, bleeding, lesions:

Yes (describe)________________________ No______

Last prostate exam:______________________________

History of sexually transmitted disease:

No______ Yes (describe)______________________________________

Both: Problems with sexual functioning?________________________________

Sexual concerns at this time?________________________________________

10. COPING-STRESS TOLERANCE

Not Assessed_________

Overt signs of stress (crying, wringing of hands, clenched fists)

Describe: __________Anxious with financial status_____________________________________________

Question patient regarding:

Primary way you deal with stress?________________being around with family____________________

_______________________________________________________________

Concerns regarding hospitalization/illness: (financial/self-care)________worried about financial care and self care_____

______________________________________________________________

Major lost within last year:

No____/___ Yes_______ Describe____________________________________

11. VALUE-BELIEF

Not Assessed_______

Religion:

Protestant_____ Catholic__/___ Jewish_____ Muslim______ Buddist______

None_______ Others________________________________
 Question Patient regarding:

Religious restrictions_________none____________________________________

Religious practices_______________none________________________________

Concerns related to ability to practice usual spiritual or religious customs?

No____/__ Yes (describe)__________________________________________

DEVELOPMENTAL TASK THEORY: LATE ADULTHOOD (65 YEARS OLD)

= Havinghurst lists typical developmental tasks faced by people  aged  over 60 years of age: adapting to a decline in physical strength, adapting to retirement and reduced income, coming to
terms with the death of a spouse, maintaining social relations with people in your  age, accepting and adapting to changing social status

SUMMARY INTERVIEW:

Our Interview started around Oct. 19 2020 and ended at Oct 22 2020. My client was a relative of mine so the interview went smoothly since we were quite close. She is a 65 year old lady who is living with us at the
moment. The interview would start around 10:30 am since she has finished all her morning activities by that time I would always ask her how she is feeling and was her morning bearable since she feels lonely from
time to time. I always try to cheer her up with a compliment. During the interview, She always answers the questions honestly and doesn’t hesitate to ask questions that she doesn’t understand. I would also try my
best to translate the question in tagalog because she always has a hard time conversing in English. After the interview I would take her vital signs for each day to determine if there are any significant changes
during the 4 day care plan I conducted for her and so far there has been slight changes with her vital signs and has a significant understanding about her disorder.
Vital signs :

Oct 19, 2020

Temp= 36.5

BP = 140/80

RR= 20

Pulse = 89

Oct 20, 2020

Temp= 36.9

BP = 150/90

RR= 22

Pulse= 90

Oct 21, 2020

Temp= 36.8

BP = 130/ 80

RR= 20

Pulse= 88

Oct 22, 2020

Temp= 36.3

BP = 130/80

RR= 18

Pulse= 85
 FUNCTIONAL ASSESSMENT OF OLDER PERSONS
Patient Name:  _Victoria Paor___________   Rater: ______Angelo Gabriel Regalado______________  Date:   10   /  19   /  20          10  :  30 am    
Directions : Encircle the number that fits to the description of your client’s level of functioning
according to the given categories

Activity Score
Feeding
0 = unable
5 = needs help or requires modified diet 0     5    10
10 = independent
Bathing
0 = dependent 0        5
5 = independent
Grooming
0 = needs to help with personal care 0        5
5 = independent
Dressing
0 = dependent
5 = needs help but can do about half unaided 0     5    10
10 = independent (including buttons, zips, laces, etc.)
Bowels
0 = incontinent (or needs to be given enemas)
5 = occasional incontinence 0     5    10
10 = independent (continent)
Bladder
0 = incontinent, or catheterized and unable to manage alone
5 = occasional incontinence 0     5    10
10 = independent (continent)
Toilet Use
0 = dependent
5 = needs some help, but can do something alone 0     5    10
10 = independent (on and off, dressing, wiping)
 Transfers (bed to chair and back)
0 = unable, no sitting balance
5 = major help (one or two people, physical), can sit 0      5    10    15
10 = minor help (verbal or physical)
15 = independent
Mobility (on level surfaces)
0 = immobile or < 50 yards
5 = wheelchair independent, including corners, > 50 yards 0      5    10    15
10 = walks with help of one person (verbal or physical) > 50 yards
15 = independent (but may use any aid; for example, stick) > 50 yards
Stairs
0 = unable
5 = needs help (verbal, physical, carrying aid) 0     5    10
10 = independent

TOTAL  (0 - 100) ____100___

Comments : _____Patient is fully capable of taking care of herself_________________________________________________________________

______________________________________________________________________________

Noted : ____________________
Clinical Instructor
 \\

COLLEGE OF HEALTH SCIENCES

DEPARTMENT OF NURSING
HOLY NAME UNIVERSITY
CITY OF TAGBILARAN

NURSING CARE PLAN

Name of Patient: ________________V. P__________________ Age: ___76__ Status:____________Widowed___________

Address: Lindvaille Phase II. Date: ____10/20/20____ Ward: ______N/A________ Bed No: __N/A__
Impression:______Exertional Dyspnea, Fatigue, Activity Intolerance______________________________________________________________________

ASSESSMENT/ DIAGNOSIS PLANNING INTERVENTION EVALUATION

PROBLEM RATIONALE OF THE DESIRED BEHAVIORAL NURSING RATIONALE

CUES/NRSG. DX PROBLEM OUTCOME(S) OUTCOME(S) INTERVENTIONS

Nsg Dx: Decreased When there is an -After 3 days of -After 8hrs of Independent GOAL
Cardiac Output related underlying disease, nursing nursing PARTIALLY
● Monitor Blood ● In order to assess
to altered heart illness, and/or injury intervention, the intervention, the MET:
pressure, Pulse, and how well the
contractility as that affects the heart, patient will patient will be able condition before patient is
manifested by poor the volume of blood demonstrate to demonstrate giving/administering tolerating the
activity tolerance being pumped excellent cardiac improving cardiac medications. current medication Patient was able
throughout the rest of output as evidence output as evidence before
to demonstrate
administering any
the body is usually by: by: improved
cardiac
affected. In the case of medication. cardiac output
 Subjective: Coronary Artery ● improved blood ● stabilized pulse ● Assist the patient in ● Since the patient is as evidenced by
Disease (CAD), the pressure within within normal self-care activities easily fatigued and a stable baseline
● “Maka bati ko aksyon the desired range and during prone to dyspnea,
narrowing and blockage blood pressure
ug ka luya kong range of 100- ● decreased ambulation as assisting them
magpalabi ko ug lihok of the arteries influences 120/80-90 episodes of needed avoids injuries and of 130/85, and
sa mga buhaton diri the amount of blood mmHg fatigue accidents. decreased
sa balay” as flow to the heart, ● normal baseline ● decreased ● Various breathing episodes of
verbalized by the causing the heart to V/S episodes of ● Encourage deep techniques dyspnea.
patient. ● improved exertional breathing exercises supplement oxygen
work harder to
activity dyspnea and breathing to the lungs during
compensate. As a result tolerance. techniques. inspiration and
Objective: of these various factors, prevent difficulty
the heart cannot work in breathing.
● Baseline V/S properly and the ability
○ T- 36.5°C
○ BP- 135/90 to pump blood
● Supplemental
mmHG throughout the rest of oxygen meets the
○ P- 65bpm (weak the body is adversely Dependent body’s demand for
pulse) affected resulting in oxygen and avoids
○ RR- 22bpm ● Administer hypoxia and
decreased tissue
● cold, clammy skin supplemental oxygen ischemia.
● fatigue and dyspnea perfusion. Impaired as prescribed by the ● Diuretics is
upon exertion tissue perfusion affects physician usually prescribed
■ the cells and tissue’s to patients with
ability to stay hypertension and
oxygenated and thus improves the
body’s discharge
manifesting in various ● Administer diuretics
of unnecessary
symptoms such as as prescribed by the
fluid build up.
impaired activity physician
tolerance, fatigue,
dyspnea, etc.
Source:
https://www.medicalnew
stoday.com/articles/150
109#:~:text=Hypertensi
on%20is%20another
%20name%20for,walls
%20of%20their
%20blood%20vessels.
 DRUG STUDY

Generic &
Dose, Strength Indication/Mechanisms of Drug Adverse/Side Effects Nursing Client
Brand Name, Rationale
& Formulation Action Drug Interaction Responsibilities Teaching
Classification

Generic: Ordered: Indications: Adverse effect: Assessment:

LOSARTAN Give 50mg 1tab, Treatment of hypertension, alone CNS: Headache, BEFORE: > Take drug
OD or in combination with other dizziness, syncope,  Assess *To obtain baseline without regard to
antihypertensive insomnia patient’s health data. meals.
Brand: Timing: Agents. C V: Hypotension history. *To obtain >Do not stop
Cozaar 8 am Treatment of diabetic neuropathy Dermatologic: Rash,  Assess precautionary taking this drug
with an elevated serum creatinine urticaria, pruritus, patient’s blood measures without consulting
Duration: and proteinuria in patients with alopecia, dry skin pressure. *To know if the your health care
Classification: unknown type 2 (non–insulin-dependent) GI: Diarrhea, abdominal patient can have this provider.
 Assess
cardiovascular diabetes and a history of pain, nausea, medication. >Tell patient to
patient’s renal
agent; Other forms: hypertension constipation, dry mouth *To indicate renal take drug at
function.
angiotensin Tablets: 25 mg, 50 Respiratory: URI impairment morning to prevent
DURING:
II receptor mg, 100 mg symptoms, cough, sinus *To avoid excessive insomnia at night.
 Monitor
antagonist; Mechanism of Action: disorders urination at night. >Stop medication
patient’s intake
antihypertensive Selectively blocks the binding of Other: Back pain, fever, and output. if adverse reaction
angiotensin II to specific tissue gout, muscle weakness  Administer occur, notify
receptors found in the vascular drug at prescriber
smooth muscle and adrenal gland; Interactions *to establish proper immediately.
daytime. precautionary
this action blocks the Drug-drug AFTER:
vasoconstriction effect of the renin- Decreased serum levels measures.
 Be alert for *To know if the
angiotensin system as well as the and effectiveness if taken adverse
release of aldosterone leading to concurrently with patient can sleep
reaction. well.
 decreased blood pressure. phenobarbital  Monitor
Losartan is converted to patient’s Nursing Diagnosis:
an active metabolite by sleeping >Risk for injury
cytochrome P450-3A4. pattern. related to presence
Drugs that inhibit 3A4 of hypertension
(ketoconazole, >Sleep deprivation
fluconazole, diltiazem) related to drug
may decrease the induced insomnia.
antihypertensive effects of >deficient
losartan. knowledge related
to drug therapy.

Holy Name University College of Health Sciences Department of Nursing

Tagbilaran City HEALTH TEACHING PLAN Title: Discussion about Hypertension

TARGET
TIME DATE/VE RESOURCES/
LEARNING OUTCOME CONTENT AUDIENC EVALUATION
ALLOTMENT NUE MATERIALS
E
After 30 mins of health 1.Definition, Risk factors Time allotted for People who August The resources After 30 mins of health teaching Plan :
teaching Plan : the HTP: have 28,2020, and materials to
Hypertension, also known as high elevated Auditorium be used:  Patients were able to define hypertension and its risk factor
 Patient would be or raised blood pressure, is a in west  Patients were able to understand its Pathophysiology
Hypertensio
able to define  Project  Patients were able to understand the different diagnostic tests
 hypertension and condition in which the blood a.Definition, Risk n in Gallares wing GF in or  Patients were to identify its signs and symptoms
its risk factor vessels have persistently raised factors-5 mins Hospital. Gallares  Videos  Patients were able to follow the preventive and curative
 Patient would be pressure. Hospital about management being discussed.
able to b. Simplified hyperte
understand its (Note: nsion
pathophysiology –
Pathophysiology  Brochu Patients were able to know the different alternative managements
5mins Fictional
 Patient could be res for
Modifiable Risk Factors include: but
able to guide
c. Diagnostic realistic
understand the obesity
different tests-5 mins example)
diagnostic tests Physical Inactivity
 Patient could be d. Signs and
to identify its High Sodium Diet symptoms- 5 mins
signs and Stress
symptoms e. Medical and
Substance Abuse
 Patient could Nursing
follow the Managements
preventive and
curative Non-modifiable risk factors include: (preventive and
management curative
being discussed. Age managements)-
Ethnicity 5mins
 Patient would be Family History
able to know the f. Alternative
different managements
alternative 5mins
managements

2.Simplified pathophysiology

The pathophysiology of
hypertension involves the
impairment of renal
pressure natriuresis, the
 feedback system in which
high blood pressure
induces an increase in
sodium and water
excretion by the kidney
that leads to a reduction
of the blood pressure.

3.Diagnostic tests:

CT scan- A computerized
tomography (CT)  scan combines
a series of X-ray images taken
from different angles around your
body and uses computer
processing to create cross-
sectional images

Ultrasound- sound or other

vibrations having an ultrasonic
frequency, particularly as used in
medical imaging.

Duplex Ultrasound- s a non-

invasive evaluation of blood flow
through your arteries and veins .
This test provides information to
help your vascular surgeon make
a sound diagnosis and outline a
treatment plan.
Doppler Ultrasonography – high
frequency sound waves directed
to artery or veins through a hand-
held transducer moved evenly
across the skin surface, audible
tone produced in proportion to
blood velocity. Measures blood
flow through vessels.

Electrocardiogram- is a medical
test that detects heart problems
by measuring the electrical
activity generated by the heart as
it contracts. ECGs from healthy
hearts have a characteristic
shape. If the ECG shows a
different shape it could suggest a
heart problem.

4.Signs and symptoms

If your blood pressure is

extremely high, there may
be certain symptoms to look
out for, including:
  Severe headaches.
 Nosebleed.
 Fatigue or confusion.
 Vision problems.
 Chest pain.
 Difficulty breathing.
 Irregular heartbeat.
 Blood in the urine.

5.Medical and Nursing

Managements (preventive and
curative managements)

Preventive management to
be taught:

-Maintain a healthy weight, lose

weight if overweight.

-Be more physically active.

-Drink alcoholic beverages in

moderation.

-Reduce the intake of salt and

sodium in the diet to approximately
2400 mg/day.

-Curative Managements but needs to

be prescribed by doctors:

-Diuretics and beta blockers

(initially)

-Thiazides – Chlorothiazide,
Hydrochlorothiazide

-Loop diuretic – Furosemide(Lasix),

Ethacrynic Acid,

Bumetamide

-Potassium-sparing diuretics –
spironolactone,triamterene

-Adrenergic inhibitors

-Beta-adrenergic blockers –
Propanolol (Inderal), pindolol,
atenolol, metoprolol, nadolol,
acebutolol

6.Alternative managements

 Fiber, such as blond

psyllium and wheat bran
 Minerals, such as
magnesium,
calcium and
potassium
 Folic acid
 Supplements or
products that
increase nitric
oxide or widen
blood vessels
(vasodilators),
such as cocoa,
coenzyme Q10,
L-arginine or
garlic
 Omega-3 fatty
acids, found in
fatty fish, high-
 dose fish oil
supplements or
flaxseed

EVALUATION THROUGH HANDWRITTEN NOTE:

DOCUMENTATION: