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Hypertension concept map

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by dan martinez on 13 February 2013

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Transcript of Hypertension concept map

Definition of Hypertension Etiology Symptoms 1.Family history
2.Age related changes in BP
3.Race
4.Insulin resistance and metabolic abnormalities
5.High salt intake
6.Obesity
7.Excessive alcohol consumption
8. Dietary intake of K, Ca, and Mg Risk Factors Constant headaches
Epistaxis
Tinnitus
Fatigue
Blurry vision Secondary Effects Pathophysiology HTN is determined by repeated BP measurements. Laboratory tests, x-ray films, and other diagnostics tests are given to rule out secondary HTN.BP should be measured on different occasions over a period of several months before HTN is diagnosed. Medical Dx Treatment 1. Fluid volume excess related to excess sodium intake or retention
2. Risk-prone health behavior Nursing Dx & Interventions Primary Secondary Tertiary Prevention Porth, C., & Matfin, G. (2009). Pathophysiology, concepts of altered health states. (8th ed., pp. 510-519). Philadelphia, PA: Lippincott Williams
Ralph, S. S., & Taylor, C. M. (2011). Sparks and taylor's nursing diagnosis reference manual. (8 ed.). WY: Lippincott, Williams & Wilkins. Reference HTN In adults, a condition in which the blood pressure (BP) is higher than 140 mm Hg systolic or 90 mm Hg diastolic on three separate readings recorded several weeks apart. Hypertension results from many different conditions, some curable and others treatable. It can be classified as primary which the cause typically cannot be identified or secondary which the elevation results from other disorder, such as kidney disease. Majority are primary HTN. In long term regulation of BP the kidneys are the main regulators. When body contains an excessive amount of salt and water arterial pressure rises and kidneys attempt to excrete the excess. Excess in the fluid volume can elevate BP directly by cardiac output and indirectly by peripheral vascular resistance. When blood flow to tissue bed is excessive vasoconstriction occurs. With an increase in ECF and cardiac output all tissues of the body experience generally the same amount of pressure and constrict as a result raising peripheral vascular resistance and BP. Lifestyle modifications:
oWeight reduction in people who are obese
oRegular physical activity
oReduction of dietary salt intake
oLimiting alcohol intake
Pharmacological treatment:
oDiuretics
oB-adrenergic blocking agents
oAngiotensin converting enzyme inhibitors
oCalcium blocking agents Primary: Includes regular BP checks, active lifestyle, low sodium intake, and limiting alcohol consumption
Secondary: Maintaining it within 140-159 systolic to keep at stage one using mainly thiazide type diuretics or weight loss in obese patients
Tertiary: Use two-drug medication combination therapy, such as diuretic to decrease fluid volume and ACE or CCB to affect the hormonal aspects. Hypertension is usually a silent (asymptomatic) disease in the first few decades of its course. Because most patients are symptom-free until complications arise, they may have difficulty taking seriously a condition from which they perceive no immediate danger. Occasionally, patients with HTN report headaches. 1.Administer oxygen as ordered to enhance arterial blood oxygenation
2.Measure and record intake and output. Intake greater than output may indicate fluid retention and possibly overload
3.Maintain patient on Sodium-restricted diet, as ordered, to reduce excess fluid volume
4.Collect and evaluate serum electrolyte levels.
5.Help patient identify areas where it’s possible to maintain control
6.Encourage patient to express feelings in a safe nonthreatening environment.
7.Discuss health problems and implications with family members to enable them to participate in patient’s care and to foster a trusting relationship
8.Provide reassurance that patient’s feelings under these circumstances are normal.
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