NAME: AHAMEFULA GOODLUCK CHINAZA

MATRIC NUMBER : 18/0697

COURSE CODE: NRSG 306

COURSE TITLE: MEDSURG 2

LECTURER: Miss Gigi

HYPERTENSION

CO×PR=Hypertension.

CO as Cardiac output.

PR as Peripheral resistance.

Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) as a
systolic blood pressure greater than 140 mm Hg and a diastolic pressure greater than 90 mm Hg based
on the average of two or more accurate blood pressure measurements taken during two or more
contacts with a health care provider, however the range of these figures difers.

BLOOD PRESSURE CATEGORY SYSTOLIC BLOOD PRESSURE DIASTOLIC BLOOD PRESSURE

Normal Less than 120 Less than 80

High blood pressure (not influenced 140 or higher 90 or higher

by other heart risk factors)

High blood pressure (influenced by 130 or higher 80 or higher

other heart risk factors)

Dangerously high blood pressure 180 or higher 120 or higher

Hypertension is sometimes called the “silent killer” because people who have it are often symptom free.

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels
have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels.
Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of
blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the
pressure, the harder the heart has to pump.

Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other
diseases.
Many people with hypertension do not notice symptoms and may be unaware there is a problem.
Symptoms can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes,
and buzzing in the ears. More severe forms may exhibit fatigue, nausea, vomiting, confusion, anxiety,
chest pain, and muscle tremors. If left untreated, hypertension can cause persistent chest pain (also
called angina), heart attacks, heart failure, and an irregular heartbeat, which can lead to a sudden death.

Hypertension can also cause strokes by blocking or bursting arteries that supply blood and oxygen to the
brain, as well as kidney damage, which can lead to kidney failure. High blood pressure causes damage to
the heart by hardening arteries and decreasing the flood of blood and oxygen to the heart.

Detecting hypertension is done with a quick and painless test of blood pressure. This can be done at
home, but a health professional can help assess any risks or associated conditions.

TYPES OF HYPERTENSION

1. Primary, or essential, high blood pressure is the most common type of high blood pressure. For
most people who get this kind of blood pressure, it develops over time as you get older.
2. Secondary high blood pressure is caused by another medical condition or use of certain
medicines( like aspirin, ibuprofen, acetaminophen, e t c). It usually gets better after you treat
that condition or stop taking the medicines that are causing it. Examples include:
a. Sleep problems like sleep apnea.
b. Blocked renal arteries in the kidneys.
c. Unusual levels of hormones controlling blood pressure.

BRIEF PATHOPHYSIOLOGY USING A FLOW CHART

Various causes of hypertension( examples may include stress, obesity)

Stimulation of vasomotor center of the brain

Leading to the release of acetylcholine, epinephrine and norepinephrine

There's Vasoconstriction

Increased peripheral resistance

Increased blood pressure

 |

Compensatory mechanism of heart

Increased heart rate and cardiac output if the vasoconstriction persists

Hypertrophy of myocardial tissue and arteriosclerotic changes

Tiny blood vessels rupture to cause epistaxis, retinal damage and stroke

Occlusion of blood vessels

Reduced blood flow to vital organs

Frontal headache, dyspnea, confusion, and release of renin

Formation of angiotensin 1 and angiotensin 2

Frontal constriction

Release of aldosterone

Reabsorption of sodium and water

Further elevation of blood pressure and oliguria

NURSING CARE PLAN

Diagnosis

1. Decreased cardiac output related to increased vascular resistance evidence by

2. Pain(occipital headache) related to cerebral arteries evidence by patients complain
3. Knowledge deficit regarding the relation between the treatment regimen and control of the
disease process evidence by non compliance with therapeutic regimen

NURSING DIAGNOSIS NURSING NURSING INTERVENTION SCIENTIFIC NURSING

OBJECTIV RATIONALE EVALUATI
ES ON

Patient 1. Assess client vital 1. Compariso Patient

will signs with blood n of maintaine
1. Decreased maintain d normal
pressure and pulse pressures
cardiac output Blood blood
rate into provides a
related to pressure pressure
consideration every 5- complete
increased within the within the
10 minutes picture of
vascular normal normal
range 2. Check laboratory tests vascular range
resistance
within 48- (cardiac markers, involveme throughou
evidence by
72 hours complete blood cell nt or the t
lab readings
of nursing count, electrolytes, scope of hospitaliza
interventi ABGs, blood urea the tion.
on nitrogen and problem.
creatinine, cardiac 2. To identify
enzymes, and contributi
cultures, such as ng factors.
blood, wound, or 3. May
secretions). indicate
3. Note presence of heart
edema(dependent failure,
and general) and renal, or
excessive weight gain. vascular
4. Re-evaluate client impairme
vital signs and nt.
document. 4. To
5. Administer prescribed determine
hypertensive effectiven
medication ess of
(carvelelol, propanol, interventi
Indapamine) and on
monitor response of
 medication in 5. Diuretics
controlling the blood are
pressure considere
d first-line
medicatio
ns for
uncomplic
ated stage
I or II
hypertensi
on and
may be
used
alone or in
associatio
n with
other
drugs
(such as
beta-
blockers)
to reduce
BP in
patients
with
relatively
normal
renal
function

6. Pain (occipital Patient 1. Assess patient level of 1. It serves Patient

headache) will pain using a pain as verb
related to verbalize rating scale including baseline
relief of
cerebral the non verbal cues data and
pain
arteries also
within 2-4
constriction facilitates
hours of
evidenced by nursing 2. Encourage and diagnosis
patients interventi maintain bed rest of
verbalization on during the acute problem
phase. and
3. Assess patient history initiation
of pain while noting of
 the client’s attitude appropriat
toward pain and use e therapy.
of pain medications, 2. Rest
including any history minimizes
of substance abuse cardiac
4. Provide stimulatio
nonpharmaceutical n and
measures to relieve promotes
pain such as cool cloth relaxation.
to forehead; back and 3. To assess
neck rubs; quiet, etiology or
dimly lit room; precipitati
relaxation techniques ng
(guided imagery, contributo
distraction); and ry factors
diversional activities. 4. Measures
5. Administer prescribed that
analgesic medications reduce
as indicated cerebral
vascular
pressure
and slow
or block
sympathe
tic
response
effectively
relieve
headaches
and
associated
complicati
ons.
5. Reduce or
control
pain and
decrease
stimulatio
n of the
sympathe
tic
nervous
 system.
May aid in
the
reduction
of tension
and
discomfor
t that is
intensified
by stress.

3. Knowledge Patient 1. Assess readiness and 1. Misconce Patient

deficit related wil blocks to learning. ptions and verbalized
to verbalize Include significant denial of understan
understan ding of
misinformatio other (SO). the
ding of disease
n of disease 2. Define and state the diagnosis
disease process
process and limits of desired BP. because
process and
treatment and Explain hypertension of long- treatment
regimen treatment and its effects on the standing regimen.
evidence by regimen. heart, blood vessels, feelings of
Inaccurate kidneys, and brain. well-being
follow-through 3. Avoid saying “normal” may
of instructions; BP, and use the term interfere
inadequate “well-controlled” to with the
performance describe the patient’s patient
of procedures BP within desired and SO
limits. willingnes
4. Problem-solve with s to learn
the patient to identify about the
ways appropriate disease,
lifestyle changes can progressio
reduce modifiable risk n, and
factors. prognosis.
5. Help patients develop If the
a simple, convenient patient
schedule for taking does not
medications. accept the
6. Instruct and reality of a
demonstrate the life-
technique of BP self- threatenin
monitoring. g
condition
 requiring
continuing
treatment
, lifestyle
and
behavioral
changes
will not be
initiated
or
sustained.
2. Provides
the basis
for
understan
ding
elevations
of BP and
clarifies
frequently
used
medical
terminolo
gy.
3. Because
treatment
for
hypertensi
on is
lifelong,
conveying
the idea
of
“control”
helps the
patient
understan
d the
need for
continued
treatment
and
 medicatio
n
4. Changing
“comforta
ble or
usual”
behavior
patterns
can be
complicat
ed and
stressful.
Support,
guidance,
and
empathy
can
enhance
patient’s
success in
accomplis
hing these
tasks.
5. Individuali
zing
medicatio
n
schedules
to fit the
patient’s
personal
habits and
needs
may
facilitate
cooperati
on with
the long-
term
regimen.
6. Monitorin
g BP at
 home is
reassuring
to
patients
because it
provides
visual and
positive
reinforce
ment for
following
the
medical
regimen
and
promotes
early
deleteriou
s changes.

REFERENCES:

1. organization w. h. (Ed.) (2021). HYPERTENSION . http://www.https://www.who.int/health-

topics/hypertension
2. org S. h. (Ed.) (2021). TYPES .
http://www.https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/
resistant-hypertension/types.html
3.