Thursday, January 19, 2012 ·

Nursing Diagnosis for Hypertension

Hypertension is the medical term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of the arteries as blood pumps cycles from the heart through the rest of the body. Blood pressure readings are given as two numbers. The first number is called the systolic blood pressure. Systolic pressure is amount of pressure that blood exerts on vessels while the heart is beating. Diastolic blood pressure measures the pressure in blood vessels between heartbeats, or when the heart is resting. A person with hypertension with has a systolic reading of over 140 and a diastolic reading of over 90.

There is Primary Hypertension - which for the most part causes are unknown and then there is Secondary Hypertension - which could be the result of underlying conditions.
1. High Sodium Intake - Sodium causes smooth vascular muscle to constrict smaller blood vessels creating more resistance to blood flow thereby elevating your pressure. Also Sodium causes the body to retain water, With the additional water, more pressure is exerted against the blood vessels causing your pressure to rise.
The daily recommended salt intake is 5g. Americans consume 2 - 4 times that amount.
2. Genetics - If hypertension runs in the family, it is advisable to see your doctor to monitor your pressure.
3.Medications - Herbal supplements and some allergy medications can also elevate your pressure for e.g. Aleve, Motrin, Advil, nasal decongestants and sprays, also birth control pills. These can interfere with your blood pressure medication.
4. Alcohol - Excessive drinking is another Hypertension Cause, studies have shown that when heavy drinkers reduce their alcohol consumption their high blood pressure drops a couple of points.
5. Smoking - Tobacco nicotine causes narrowing of the blood vessels, whereby putting more strain on the heart making your pressure go up, also smoking causes plaque build up which causes an increase in blood pressure.
6. Aging Factor - This is one factor we have no control over - As you get older your blood pressure tends to increase.
7. Race - Studies have shown that Black Americans are at a higher risk for hypertension than White Americans. Those with the lowest risk are white females, the highest risk black females.
While many patients would prefer just being given a prescription and continuing their current lifestyle, this course of action is not ideal. The best way to treat high blood pressure is through lifestyle changes. The patient needs to begin exercising. The popular opinion is that thirty minutes of exercise three times a week is enough. If a patient needs to lower his blood pressure, this is probably not enough exercise. Aim for at least thirty minutes six days a week. Walking is a great exercise. If you live in an area with cold weather, a treadmill is a wise investment. The second step a patient should take is diet modification. Studies have shown that a diet high in sodium contributes to high blood pressure. Limiting the sodium can help.

In addition to lifestyle changes, there are several types of medications that reduce hypertension. These medications, called antihypertensive drugs, reduce the pressure of blood. Doctors often prescribe multiple types of medications to manage high blood pressure including, ACE inhibitors, alpha blockers, angiotesin II receptor antagonists, betablockers, calcium channel blockers, diuretics, direct rennin inhibitors and glyceryl trinitrates.

NANDA Hypertension

Nursing Diagnosis for Hypertension
  1. Risk for Decreased Cardiac Output related to increased afterload, vasoconstriction, myocardial ischemia, ventricular hypertrophy

  2. Pain: headache related to increased cerebral vascular pressure

  3. Ineffective Tissue perfusion : cerebral, renal, cardiac related to circulatory disorder

  4. Knowledge Deficit related to lack of information about the disease process and self-care.

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