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m It is described as persistent elevation of the

systolic blood pressure at a level of 140 mmHg or


higher and diastolic blood pressure at a level of 90
mmHg or higher. It is classified based on the
severity from a high normal to malignant
hypertension.
m @  
m 6actors: Diet ± high Na and fat
m Strain on arterial wall
m Loss of elasticity
m Increased collagen and calcification of arterial media
m Atherosclerosis in intima
m Narrowing of blood vessel lumen
m Stiffness of aortic and peripheral arteriae
m Constriction of arterioles
m Elevation of blood pressure
 
 
m d    


     
  
 



        
m Chlorothiazide (Diuril), spironolactone (Aldactone),
Chlorthalidone (Hygroton). Hydrochlorothiazide (Esidrix),
triamterine (dyrenium), metolazone (zaroxolyn) ethacrinic acid
(edicrin), furosemide (lasix),
m  

  
   
  
  

 



m Ôerapamil (Calan), diltiazem (cardizem), Nifedine (procardia)
m î    
   
  


     

   
 
   
      

 
 
  
  


 
  

   

m ëeserpine, methyldopa (aldomet), propanolol (inderal).
m î   
     


 
   


   
  
 

 
  
   

 
m Captopril (capoten), enalapril (vasotec), fosinorel
(monopril)
m Ô 
  
   
     

 
  
  
  

            
  
    
m Diazoxide (hyperstat), amyl nitrate, isosorbide dinitrate
(isordil), Nitroglycerin
NUëSING CAëE
PLAN 1
m CUES

m S
m ^ ± severe occipital headache
m  P140/90 mmHg
m ’URSI’ DIA ’^SIS

m Acute
pain related to increase
cerebral vascular pressure
m @ A’’I’

 T 
m
m After 8 hours of nursing intervention, the client will
be free from pain.

m S T 
m After 2 hours of nursing intervention, the client¶s
headache will be decrease.
m I@ EE’TATI^’
m INDEPENDENT:
m Maintain bed rest during acute phase.
m Provide nonpharmacologic measures to relief of headache. E.g
cool cloth to forehead: back and neck rubs: quiet, dimly lit room,
relaxation techniques (guided imagery, distraction): and
diversional activities.
m Eliminate/minimize vasoconstricting activities that may aggravate
headache, e.g straining at stool, prolonged coughing, bending
over.
m Assist patient with ambulation as needed.

m DEPENDENT:
m Administer medications as indicated: analgesics
m RATI^’A E
m Minimizes stimulation/ promotes relaxation.
m Measures that reduce cerebral vascular pressure and which
slow/block sympathetic response are effective in relieving
headache and associated complications.
m Activities that increase vasoconstriction accentuate the
headache in the presence of increased cerebral vascular
pressure.
m Dizziness and blurred vision frequently are associated with
headache. The patient may also experience episodes of
postural hypotension.
m ëeduces/ controls pain and decreases stimulation of the
sympathetic nervous system.
m EVA UATI^’
m       
NUëSING CAëE
PLAN 2
m CUES

m S ± She said she is fond of eating salty foods.

m She can consume 2 ± 2 ½ cups of rice especially with


pork chop and catsup as her viand.

m O±

m M  Cholesterol borderline
m ’URSI’ DIA ’^SIS
m Altered nutrition more than
body requirements related
to high sodium, fat and total
calorie intake
m SCIE’TIFIC EX@ A’ATI^’
m High Na, fat and calorie intake

m Excessive amount of the Additives


in the circulating body

m Altered nutrition
m @ A’’I’

m  T 
m After 2 days of nursing intervention, the client will be able
to demonstrate change in eating patterns.

m S T 
m After 1 hour of nursing intervention, the client will be able
to:
m  verbalize understanding of proper nutrition
m  state ways on how to change diet appropriate to her
condition
m I@ EE’TATI^’

m Independent:
m Assess patient understanding of direct relationship between
hypertension and diet.
m Discuss necessity for decreased caloric intake and limiting intake of fats
and salt as indicated.
m ëeview usual daily caloric intake and dietary choice.
m Encourage patient to maintain a diary of food intake including when and
where eating takes place and the circumstances and feelings around
which the food was eaten.
m Instruct and assist in appropriate food selection, avoiding foods high in
saturated fat and cholesterol.

m Collaborative:
m ëefer to dietitian as indicated.
m RATI^’A E
m Provides baseline information
m 6aulty eating habits contribute to atherosclerosis and obesity which
predispose to hypertension and subsequent complication.
m Aids in determining individual need for adjustments and teaching.
m Provides a data base for both the adequacy of nutrients eaten as
well as the emotional condition of eating.
m Avoiding foods high in saturated fat and cholesterol is important in
preventing progressing atherogenesis.
m Provides counseling and assistance with meeting individual dietary
needs.
m    

m  T 
m After 2 days of nursing intervention, the client was able
to demonstrate change in eating patterns.

m S T 
m After 1 hour of nursing intervention, the client was able
to:
m  verbalize understanding of proper nutrition
m  state ways on how to change diet appropriate to
NUëSING CAëE
PLAN 
m CUES
mS ±
m O statement of
misconceptions
m ’URSI’ DIA ’^SIS
m [nowledge Deficit related to lack
of understanding of medical
condition
m SCIE’TIFIC EX@ A’ATI^’
l
m Hypertension is symptomfree
l
m It is called the ³silent killer´
l
m lood pressure exceeding 140/90 mmHg were
unaware of their elevated blood pressure
l
m [nowledge Deficit
m @ A’’I’

m  T 
m After 2 days of nursing intervention, the client will be
able to verbalize understanding of the disease and its
longterm effects on target organs.

m S T 
m After 12 hour of nursing intervention, the client will be
able to verbalize and demonstrate understanding of
information given regarding condition, medications and
treatment regimen. To also describe selfhelp activities to
be followed.
m I@ EE’TATI^’

m I    :

m 1. Determine patient¶s baseline of knowledge regarding


disease process, normal physiology, and function of the heart.
m 2. Involve the family or significant others.
m . Provide time for individual interaction with patient.
m 4. Instruct patient on procedures that may be performed.
m 5. Instruct on leg exercises and position changes.
m 6. Instruct to rise slowly, allowing time between position
changes.
m RATI^’A E
m  Provides information regarding patient¶s understanding of condition as well as a baseline
from which to base teaching.

m  So they can effectively provide support upon discharge.

m  Promotes relationship between patient and nurse, and establish trust.

m  Provides knowledge and promotes the ability to make informed choices.

m  Decreases venous pooling can be potentiated by vasodilators and prolonged time in one
position.

m  Assists body to equilibrate and adjust in order to decrease the risk of syncope.
m EVA UATI^’

m    
m  T 
m The client was able to verbalized understanding of the
disease and its long term effects on target organs.

m S T 
m The client was able to verbalized and demonstrated
understanding of information given regarding condition,
medications and treatment regimen and was able to perform
selfhelp activities.
6INITO. Muchas gracias!