Hypertension: Pathophysiology, Diagnostic Test, Medical Management, and Nursing Care Plan

HYPERTENSION
PATHOPHYSIOLOGY, DIAGNOSTIC TEST,

MEDICAL MANAGEMENT, AND NURSING
CARE PLAN
PATHOPHYSIOLGY
The pathophysiology of hypertension follows.
 Hypertension is a multifactorial
 When there is excess sodium intake, renal sodium retention occurs, which
increases fluid volume resulting in increased preload and increase in
contractility.
 Obesity is also a factor in hypertension because hyperinsulinemia develops and
structural hypertrophy results leading to increased peripheral vascular
resistance.
 Genetic alteration also plays a role in the development of hypertension
because when there is cell membrane alteration, functional constriction may
follow and also results in increased peripheral vascular resistance.
DIAGNOSTIC TEST
1. Urinalysis 8. Intravenous pyelogram (IVP)
2. Blood chemistry (e.g. analysis of 9. Kidney and renography nuclear scan

sodium, potassium, creatinine, 10. Excretory urography.
fasting glucose, and total and high
11. Chest x-ray
density lipoprotein cholesterol
12. Computed tomography (CT) scan
levels).
13. Electrocardiogram (ECG)
3. Echocardiography.
4. Serum potassium
5. Serum calcium
6. Uric acid
7. Lipid panel (total lipids, high-density

lipoprotein [HDL], low-density
lipoprotein [LDL], cholesterol,
MEDICAL MANAGEMENT
Pharmacologic Theraphy
 The medications used for treating hypertension decrease peripheral resistance, blood volume,
or the strength and rate of myocardial contraction.
 For uncomplicated hypertension, the initial medications recommended are diuretics and beta
blockers.
 Only low doses are given, but if blood pressure still exceeds 140/90 mmHg, the dose is
increased gradually.
 Thiazide diuretics decrease blood volume, renal blood flow, and cardiac output.
 Beta blockers block the sympathetic nervous system to produce a slower heart rate and a
lower blood pressure.
 ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II and lowers peripheral
resistance.
CASE STUDY HYPERTENSION IN ELDERLY
A 62 year old African-American woman with prediabetes

presents for her annual physical. Patient have frequent
complaints of feeling dizzy, and limp. The average of 2 BP
readings her BP 143/88mmHg, her respiratory rate is
24x/mnt and hearth rate is 110x/mnt. Her physical exam is
unremarkable except for obesity. She has no history of
myocardial infarction, stroke, kidney disease, or heart
failure. Her total cholesterol is 260 mg/dL, HDL 42 mg/dL,
and LDL 165 mg/dL. She does not smoke.
ASSESSMENT
 Patient’s health history
Patients complain of frequent feeling dizziness and limp . The average of 2 BP readings her BP
143/88mmHg . She has no history of myocardial infarction, stroke, kidney disease, or heart failure.
 Physical examination
Vital Sign :
BP : 143/88mmHg
RR : 24x/mnt
HR : 110x/mnt
Thamperatuere :37˚C
Her physical exam is unremarkable except for obesity.
 Laboratory tests
CT Scan : the results there are no cerebral tumors, CVA, or encephalopathy.
Electrocardiogram (ECG) : Sinus Thacycardia

DIAGNOSTIC TEST
 Cholesterol : 260 mg/dL

 HDL : 42 mg/dL
 LDL : 165 mg/dL
NURSING DIAGNOSIS :
Activity intolerance related to imbalance between
oxygen supply and demand.
NURSING CARE PLAN
Goals :
 Understanding of the disease process and its treatment.
 Absence of complications.
 Blood Pressure within acceptable limits for individual.
 Cardiovascular and systemic complications prevented/minimized.
 Necessary lifestyle/behavioral changes initiated.
Intervension :
The objective of nursing care focuses on lowering and controlling the blood pressure without
adverse effects .
 Encourage the patient to consult a dietitian to help develop a plan for improving nutrient
intake or for weight loss
 Encourage restriction of sodium and fat
 Emphasize increase intake of fruits and vegetables.
 Implement regular physical activity.

Evaluation :
 Patient’s Blood Pressure 130/80mmHg
 Patient's limp feeling reduced
 Patient can do exercises regularly.
 Patient takes medications as prescribed and reports
side effects.
 Patient exhibits no complications.
DISCHARGE AND HOME CARE GUIDELINES
Following discharge, the nurse should promote self-care and independence of the
patient.
 The nurse can help the patient achieve blood pressure control
through education about managing blood pressure.
 Assist the patient in setting goal blood pressures.
 Provide assistance with social support.
 Encourage the involvement of family members in the education program to support
the patient’s efforts to control hypertension.
 Encourage and teach patients to measure their blood pressures at home.
 Emphasize strict compliance of follow-up check up.

HEALTH AND SOCIAL CARE
NAME : MAULIDIYA FADILA
INTITUTION : UNIVERTAS NASIONAL

Hypertension: Pathophysiology, Diagnostic Test, Medical Management, and Nursing Care Plan

Uploaded by

Copyright:

Available Formats

Hypertension: Pathophysiology, Diagnostic Test, Medical Management, and Nursing Care Plan

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Hypertension: Pathophysiology, Diagnostic Test, Medical Management, and Nursing Care Plan

Uploaded by

Copyright:

Available Formats

HYPERTENSION

PATHOPHYSIOLOGY, DIAGNOSTIC TEST,

2. Blood chemistry (e.g. analysis of 9. Kidney and renography nuclear scan

7. Lipid panel (total lipids, high-density

or the strength and rate of myocardial contraction.

lower blood pressure.

A 62 year old African-American woman with prediabetes

Her physical exam is unremarkable except for obesity.

CT Scan : the results there are no cerebral tumors, CVA, or encephalopathy.

Electrocardiogram (ECG) : Sinus Thacycardia

 Cholesterol : 260 mg/dL

 Blood Pressure within acceptable limits for individual.

 Cardiovascular and systemic complications prevented/minimized.

 Necessary lifestyle/behavioral changes initiated.

intake or for weight loss

 Encourage restriction of sodium and fat

 Emphasize increase intake of fruits and vegetables.

 Implement regular physical activity.

through education about managing blood pressure.

 Assist the patient in setting goal blood pressures.

 Provide assistance with social support.

 Encourage the involvement of family members in the education program to support

the patient’s efforts to control hypertension.

 Encourage and teach patients to measure their blood pressures at home.

 Emphasize strict compliance of follow-up check up.

You might also like