Module 3A - Hypertension.pdf

UA-CONP: C-NCM112 aidè à vivrè Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory, #HelpLive Immunologic...

UA-CONP: C-NCM112 aidè à vivrè Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory, #HelpLive Immunologic Response, and Cellular Aberration (Acute and Chronic) Lecture [TRANS] UNIT XX: HYPERTENSION Emphasize the need for medication to lower down the Module 3A blood pressure because it may suffer to other Hypertension complications. The older we get, the more risk in acquiring high blood Outline pressure. 1. Define normal blood pressure and the different If a student or a minor has high blood pressure at a very categories of blood pressure. young age, ask their lifestyle and activities. 2. Identify risk factors for hypertension. 3. Explain the differences between normal blood pressure Two Types of Hypertension and hypertension and discuss the significance of hypertension. 4. Use the nursing process as a framework for care of the 1. Primary Hypertension (Essential Hypertension) patient with hypertension. High blood pressure from unidentified cause. 5. Explain hypertensive crises and treatment. 2. Secondary Hypertension Hypertension Occurs when a cause for the high blood pressure can be Defined as systolic blood pressure greater than 140 mm identified. Hg and a diastolic pressure greater than 90 mm Hg based Different Causes of Hypertension on the average of two or more accurate blood pressure measurements. Blood pressure is taken twice in order to validate the result by getting the average if the blood pressure is really elevated. Note: there is no normal high blood pressure. 140/110 mmHg is already considered hypertension. If a nurse got a blood pressure that is high, ask the patient if he or she performed activity that exerts effort and instructing to rest for about 5 minutes in order to settle down. Hypertension (High Blood Pressure) CTTO: https://www.thelancet.com High blood pressure is not only a result of other conditions. Hence, it can be a contributing factor to other diseases like CTTO: https://kidshealth.org renal failure, heart attack, CVA, and stroke. There is no normal blood pressure because an elevation in Two Classification of Hypertension blood pressure can affect the perfusion of the organs A higher elevation in the blood pressure will present more which needs blood. risk to the patient. An increase in blood pressure can also damage the lining 1. Pre-Hypertensive of the blood vessels where blood pass through. The patient is on the way to have high blood pressure. Causes This is not yet considered hypertensive but it has the Renal parenchymal disease possibility of having high blood pressure anytime. Narrowing of the renal arteries Role of the nurse: perform interventions through health Hyperaldosteronism education that will entail changes on the modification of Pheochromocytoma lifestyle (food intake, exercise, habits, etc.). Medications (e.g., prednisone, epoetin alfa) 2. Hypertensive Coarctation of the aorta More interventions are needed because the patient has Difference Between Systolic and Diastolic already the disease condition. Jopar Jose C. Ramos | Bachelor of Science in Nursing 3-A 1  UA-CONP: C-NCM112 aidè à vivrè Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory, #HelpLive Immunologic Response, and Cellular Aberration (Acute and Chronic) Lecture Heart failure Renal failure Stroke Impaired vision o If the blood pressure is high, the very fine retinal arteries can be damaged leading to retinal hemorrhages because of increased pressure. Hypertrophy of the left ventricle of the heart because of the increase in pressure caused by the workload that the heart needs to perform. Same as with for individuals who go to gym, because of the increase in the weight that is being carried by the body, the muscles which make possible to be lift has to be larger or bigger to accommodate the weight. CTTO: https://www.pinterest.ph Systolic blood pressure (first number) - indicates how much pressure your blood is exerting against your artery walls when the heart beats or contracts. o Pressure exerted when the blood moves out of the heart to the aorta down to the different parts of the body. Diastolic blood pressure (second number) - indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats. o Pressure that will remain when the heart relaxes. CTTO: https://www.semanticscholar.org Table 31-1: Classification of Blood Pressure for Adults Age 18 and Older Pathophysiology Cardiac output is the product of the heart rate multiplied by the stroke volume. Blood pressure is the product of cardiac output multiplied by peripheral resistance. The time the heart contracts, pressure is transferred from the contraction of the heart muscle to the blood and then pressure is exerted by the blood as it flows through the blood vessels. o Increases in cardiac output, increases in peripheral resistance. Major Risk Factors Smoking Dyslipidemia (elevated LDL [or total] cholesterol and/or low HDL cholesterol) o High-density lipoprotein (HDL) → “friendly” or “good” lipoprotein; smallest and densest lipoprotein (contains more protein and less fat than the others). o Low-density lipoprotein (LDL) → “bad” lipoprotein; contains 50% to 60% of cholesterol in the bloodstream; Hypertension Can Occur with: high level means greater risks for developing Pregnancy atherosclerotic plaques and heart disease. Kidney disease Diabetes Diabetes Impaired renal function (GFR 55 years for men, >65 years for women) increases. Any factor which changes heart rate will also Other causes of high blood pressure: lack of sleep, anxiety, changes cardiac output. drinking caffein, high alcohol consumption, increased intake Force of contraction of heart. When the force of of sodium, anger, and stress. contraction of the heart increases, stroke volume will o Salt attracts water, so therefore, when an individual increase. Therefore, cardiac output will increase. has increased intake of sodium, it causes an increase Blood volume. When blood volume increases, cardiac volume in the body and the heart will exert more effort output increases. leading to increased blood pressure. Venous return Family history of cardiovascular disease (in female relative Pathogenesis of Essential Hypertension