Hypertension

BScN 1st Semesters

(JCON)

Prepared by SHAMSHAD

26/12/2016 1
Objectives
1. Describe Hypertension(HTN)

2. Identify classifications of HTN

3. Explain the list of readings of Blood Pressure

4. Discuss cardiac output and peripheral vascular

resistance in the mechanism of HTN

5. Explain Pathophysiology of HTN

26/12/2016 2
Cont.……
6. Identify Prevalence Rates of Globally and Pakistan of
HTN

7. Assess the risk factors contributing in the

development of HTN

8. Discuss Clinical Manifestations of Hypertension.

9. Recognize the Medical and Nursing management of

patient with HTN

10. Describe the Nursing diagnosis and Care Plan for

HTN 26/12/2016 3
DEFINITION OF HYPERTENSION

● Pressure of the blood against

the walls of the blood vessels is
known as blood pressure.

● Hypertension is sustained
elevation of blood pressure and
the client is not under stress.

● Blood pressure is the force of

blood pushing against the walls
of vessels as it flows through
them.

26/12/2016 4
Systolic blood pressure:

Pressure generated when heart contracts and

pump blood through the arteries. It is the
maximum pressure in blood system.

Diastolic Blood pressure :

Pressure of blood when heart is at rest. This is

minimum pressure in the blood system.

26/12/2016 5
Readings of Blood Pressure

Normal blood pressure is < 120/80 mmHg

Prehypertension 120/80 > and <140/90 mmHg

Hypertension is > 140/90 mmHg

26/12/2016 6
Classification of Hypertension

Primary (Essential) Hypertension

Elevated BP with unknown cause 90% to 95% of all cases.
Required lifestyle changes and sometime drug if indicated.

Secondary Hypertension
Elevated BP with a specific cause 5% to 10% in adults
Conditions include:
Renal, arteries disease and pregnancy etc.

26/12/2016 7
PERIPHERAL VASCULAR
RESISTANCE
It is vascular resistance
to the flow of blood in
peripheral vessels that
is typically a function
of the internal vessel
diameter.

26/12/2016 8
CARDIAC OUTPUT MECHANISM OF
HYPERTENSION
Cardiac Output
Volume of blood pumped per minute by
each ventricle of the heart.
Stroke volume
Amount of blood pump ed from the left
ventricle in a single heart beat.
CO =HR x SV
CO =70bpm x 70ml= 4.9L

26/12/2016 9
PathoPhysiology of HTN

26/12/2016 10
 Prevalence Rate of HTN In WHO
According to Global Health Observatory(2015)
Worldwide, raised blood pressure is estimated
to cause 7.5 million deaths, about 12.8% of the
total of all death.

26/12/2016 11
Prevalence Rate of HTN in
Pakistan
According to Pakistan National Health
Survey (2015):
HTN is less than 10% in 18 - 19 years old
in males and similarly in females is less
than 5% at 18 - 19 years. In both males
and females the prevalence rate increases
steeply after 20 - 29 years
age.

26/12/2016 12
Factors Contributing To HTN

26/12/2016 13
Clinical Manifestation of
Hypertension.
Most of the time, there are no symptoms for
most clients; some present with:
Headache
Fatigue
Dizziness (vertigo)
Palpitations
Dyspnea (difficult breathing.)

26/12/2016 14
 Medical Management of patient
ANTI-HYPERTENSIVE:
It consist of Five categories ACE inhibitors, Beta blockers,
calcium channel blocking agents, diuretics, vasodilators.

26/12/2016 15
NURSING CARE:
1. Check blood pressure(BP) in both supine and standing
positions.
2.Early AM or bedtime administration helps prevent the
drowsiness.
3. Golden rules to prevention from HTN:
Care for Weight, Life Style, Diet
Medical check up
Get your B.P checked up once a year before 30 years,
Once in 6 months after 30 years
Once in 3 months after 40 years.

26/12/2016 16
Cont.
The DASH

Dietary
Approaches
Stop
Hypertension

26/12/2016 17
26/12/2016 18
 Nursing Diagnosis
Acute Pain headache related to increased cerebral
vascular pressure.

Knowledge deficit related to lack of information about the

disease process and self-care.

Ineffective therapeutic regimen(a prescribed course of

medical treatment) management

26/12/2016 19
Nursing Diagnosis and Care plan
Acute Pain
Uncomfortable sensation lasting from 1
second to less than 6 months.

Chronic Pain
Persistent or intermittent(often) and lasts
for more than 6 months.

26/12/2016 20
Assessment

Subjective data
Patient verbalized that pain scale is
5/10.

26/12/2016 21
Cont.……
C = Characteristics
O = Onset
L = Location
D = Duration
E = Exacerbation (worsen)
R = Radiation
R = Relief
A = Associated
26/12/2016 22
Cont.…
Objective Data

Client seems irritable, Facial grimaces

(expression),blood pressure increase,
respiration increased, pulse increased
Diaphoresis, Crying etc.

26/12/2016 23
Nursing Diagnosis

According NANDA (2013)

Impaired comfort that is acute pain related
to tissue trauma and muscle spasms
secondary to vascular disorders as
evidenced by client verbalization.

26/12/2016 24
Goal

26/12/2016 25
Nursing Intervention
Provide adequate rest and comfort

Teach deep breathing exercises

Give optimal pain killer as prescribed

Assess efficacy of pain medication after

30mints
26/12/2016 26
 REFERENCES
Aziz, K. U. (2015). Evolution of systemic hypertension in pakistani population. Journal of the College of Physicians

and Surgeons--Pakistan: JCPSP, 25(4), 286-291.

Beevers, G., Lip, G. Y., & O'Brien, E. (2001). ABC of hypertension: the

pathophysiology of hypertension. BMJ: BritishMedical Journal, 322(7291),

912.Retrived from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120075/

Oparil, S., Zaman, M. A., & Calhoun, D. A. (2003). Pathogenesis of hypertension.

Annals of Internal Medicine, 139(9), 761-776.Retrieved from http://www.the-

aps.org/mm/publications/journals/pim/oparil-pdf.pdf

Understanding Blood Pressure Readings. (2014). Retrieved from

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloo

WHO | Raised blood pressure. (2015). Retrieved from

http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/

26/12/2016 27
Questions and Answers

26/12/2016 28
26/12/2016 29