HYPERTENSION

PRESENTED BY PREETHY E P MEENU THOMAS MINUMOL JOSEPH NEENU ELDOSE NEETHU P NEETHU R NISHAND Y NIVYA SARA V RAKHI MOL K V RENJINI MOL

INTRODUCTION
Blood pressure as the pressure thats put on the walls of the arteries as blood is pumped by way of the circulatory system.Blood runs through our veins and arteries at a certain preesure.Within natural limits,this pressure is not harmful.However ,if this pressure increses the heart is over worked and the arteries devolep abnormal interior tissue growth.This further blocks the passage of blood,leading to incrasing bp.Finally,the heart muscle I it self thickens making heart progressively weaker

DEFINITION
Hypertension or high blood pressure is a condition

in which the blood pressure in the arteries is chronically elevated. Hypertension is defined as an average systolic blood pressure above 140mmHg and a diastolic blood pressure above 90 mmHg , or both over a sustained period . It is called the silent killer because usually dont have any symptoms when blood pressure is too high.

INCIDENCE
Hypertention is an important medical and public issue.It exists worldwide at epidemic rates affecting an estimated 1 billion people.The prevalence of hypertention in indians is 25% in urban and 10% in rural population. Hypertension is directly responsible for 57%of stroke deaths and 24% of coronary artery disease deaths in india.

CLASSIFICATION
CLASSIFICATION Normal blood pressure Pre-hypertension High BP SYSTOLIC [mmHg] <120 120-139 140--159 BP DIASTOLIC [mmHg] <80 80--89 90--99 BP

TYPES OF HYPERTENSION

Hypertension can be classified as primary or essential hypertension and secondary hypertension ----PRIMARY HYPERTENSION ----SECONDARY HYPERTENSION -PRIM ARY HYPERTENSION Primary or essential hypertension is the most common form of hypertension, which occurs in almost 90percent of cases . The cause of essential hypertension is un known , however , the medical studies and research have identified some factors which cause hypertension

MAINLY
AGE UNHEALTHY DIETARY HABITS INCREASED SALT IN TAKE TENSION STRESS INSUFFICIENT REST LACK OF EXERCISE FAMILY HISTORY OBESITY SMOKING

SECONDARY HYPERTENSION

Some people have high blood pressure caused by an underlying condition .This type of high BP, called SECONDARY HYPERTENSION ,tends to appear suddenly and cause higher BP than does PRIMARY HYPERTENSION. Various condition and medications can lead to secondary hypertension, Including: -Narrowing of the renal arteries -Pregnancy -Oral contraceptive pills - Pituitary or adrenal gland tumors. -cushings syndrome . -Illegal drugs,such as cocaine and amphetamines.

CLINICAL

MANIFESTATIONS

-High BP -Severe headache,dizziness and blurred vision -Nausea and vomiting -Fatigue and confusion -Epistaxis -Chest pain and shortness of breath -Irregular heart beat -Hemiplegia (temporary paralysis of one side ) -Heart attack and heart failure -Stroke -Kidney failure -Eye damage -Claudication(peripheral arterial disease causing leg pain with walking) -aneurysms

DIAGNOSTIC EVALUATION

Focused history to collect important data including symptoms like chest pain Family history of high BP ,DM or cardiovascular diseases Medical history of co existing conditions like diabetes PE CBC Urine analysis Chest x ray ECG Echo cardiogram

COMPLICATIONS
Uncontrolled high BP can lead to: Heart attack or stroke Aneurysms Heart failure Weakened and narrowed blood vessels in kidneys Thickened , narrowed or torn blood vessels in the eyes Metabolic syndrome

MEDICAL MANAGEMENT

The purpose of medical mgt is to maintain BP with in normal ranges by the simplest and safest means Diuretics Eg: chlorthalidone, furosemide Beta blockers Eg: propanolol, atenolol Alpha blockers Eg: prazocin Alpha-beta blockers Eg: labetalol Central acting agents Eg: clonidine Vasodialators Eg: nitroglycerin ACE Eg:captopril , remipril Calcium channel blockers E g: nifedipine, Renin inhibitors

OTHER THERAPY
Meditation Yoga Relaxation training

NURSING MANAGEMENT

NURSING HISTORY -Family history -Dietary habits and salt intake -Cigarette smoking -Episodes of headache , weakness, muscle cramp, tingling, palpitations, sweating, vision disturbances -Medication that could elevate BP: Hormonal contraceptives, steroids, NSAIDs, nasal decongestants , appetite suppresents.

PHYSICAL EXAMINATION Auscultate heart rate and palpate peripheral pulses; determine respirations. Look for edema , spasm, hemorrhage of the eye vessels BP determination , auscultate and record precisely the systolic and diastolic.

NURSING DIAGNOSIS
Deficient knowledge regarding the relationship between the treatment regimen and control of the disease process. Ineffective therapeutic regimen management related to medication adverse effects and difficult lifestyle adjustments Deficient knowledge [lifestyle modificatios] Fatigue Ineffective tissue perfusion : cardiopulmonary Risk for injury

NURSING INTERVENTIONS

Explain the meaning of high BP , risk factors , and explain the influence of high BP on the cardiovascular , cerebral and renal systems. Identify patients modifiable risk factors and lifestyle modifications needs. The nurse can encourage the patients to consult a dietitian to help develop a plan for weight loss. Encourage the patients to increase physical activity . Teach patient to change positions slowly to prevent falls. Instruct client and family on medications side effects , contra indications and signs to report .