Hypertension

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Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.

1. hypertension MR.SAMBAD JAGDISH.G ASSISTANT PROFESSOR MEDICAL Surgical department BALAJI COLLEGE Of NURSING

2. INTRODUCTION High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. You can have high blood pressure (hypertension) for years without any symptoms. damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

3. CONTI… No specific cause for hypertension is found in 95% of cases Medical guidelines define hypertension as a blood pressure higher than 130/80 millimeters of mercury (mmHg), according to guidelines issued by the American Heart Association (AHA) in November 2017.

4. SYSTOLIC BLOOD PRESSURE when the left ventricle contracts and pushes blood into the aorta, the pressure produced within the arterial system is called the systolic blood pressure. in adult about 120 mmHg

5. Diastolic blood pressure When complete cardiac diastole occur and the heart is resting following the ejection of blood, the pressure within arteries is much lower and is called diastolic blood pressure. In adult 80mmHg Arterial blood pressure is measured with sphygmomanometer and usually expressed with the systolic pressure written above the diastolic pressure BP = 120/80 mmHg

6. Factor determining blood pressure Blood pressure = cardiac × peripheral out put resistance

7. DEFINITION Hypertension : High blood pressure, defined as a repeatedly elevated blood pressure 140 over 90 mmHg -- a systolic pressure above 140 or a diastolic pressure above 90. chronic hypertension is a "silent" condition. stealthy as a cat, it can cause blood vessel changes in the back of the eye (retina), abnormal thickening of the heart muscle, kidney failure, and brain damage.

8. CAUSES According to causes there are two type of hypertension . High blood pressure that is not caused by another condition or disease is called primary or essential hypertension. If it occurs as a result of another condition, it is called secondary hypertension. PRIMARY HYPERTENSION can result from multiple factors, including blood plasma volume and activity of the hormones that regulate of blood volume and pressure. It is also influenced by environmental factors, such as stress and lack of exercise.

9. SECONDARY HYPERTENSION has specific causes and is a complication of another problem, Kidney disease A rare cancer of an adrenal gland Cushing syndrome, which can be caused by corticosteroid drugs Congenital adrenal hyperplasia, a disorder of the cortisol -secreting adrenal glands Hyperthyroidism, or an overactive thyroid gland Hyperparathyroidism, which affects calcium and phosphorous levels Pregnancy Obesity

10. CLASSIFICATION OF HYPERTENSION

11. pathophysiology

12. SIGNS &SYMPTOMS A person with hypertension may not notice any symptoms, and it is often called the "silent killer." While undetected, it can cause damage to the cardiovascular system and internal organs, such as the kidneys. Regularly checking your blood pressure is vital, as there will usually be no symptoms to make you aware of the condition.

13. DIAGNOSTIC EVALUATION History collection Physical examination X-ray Urine examination Blood test ECG

14. MEDICAL MANAGEMENT diuretics.   Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume Beta blockers.   These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. Beta blockers include acebutolol , atenolol and others

15. Angiotensin-converting enzyme (ACE) inhibitors.  These medications — such as benazepril , captopril and others — help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. People with chronic kidney disease may benefit from having an ACE inhibitor as one of their medications. Angiotensin II receptor blockers (ARBs).  These medications help relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. include candesartan , losartan and others. People with chronic kidney disease may benefit from having an ARB as one of their medications.

16. CALCIUM CHANNEL BLOCKERS.  These medications — including amlodipin , diltiazem and others — help relax the muscles of your blood vessels. Some slow your heart rate. Vasodilators.   these medications, including hydralazine and minoxidil , work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing . Aldosterone antagonists.   Examples are spironolactone . These drugs block the effect of a natural chemical that can lead to salt and fluid retention, which can contribute to high blood pressure

17. NURSING MANAGEMENT

18. Decreased cardiac output related to inadequate blood pumped by the heart to meet metabolic demands of the body . INTERVENTIONS: Check patient’s lab data (cardiac markers, blood cell count, electrolytes etc.) To determine contributing factors. Monitor and record blood pressure in both arms and thighs Measure blood pressure in both hands. Auscultation of breath sounds and heart rhythm. Observe patient’s skin color, temperature, and capillary refill time. Advise the patient on reducing sodium intake, if needed. Administer medication, if needed.

19. Activity intolerance related to   insufficient physiological or psychological energy to endure or desired daily activities INTERVENTIONS: Note each of the factors that contribute to fatigue (age, health, illness, etc.). Evaluate the patient’s degree of activity intolerance and when it occurs. Monitor how the patient responds to activity (pulse, heart rate, chest pain, dizziness, excessive fatigue, etc.). Explain energy conserving techniques (shower chairs, sitting to brush teeth, etc.). Assess any emotional factors that may be contributing to activity intolerance (such as depression or anxiety). Encourage the patient to engage in self-care and progressive activity when possible.

20. Ineffective coping related to   inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources. INTERVENTIONS: Determine what specific areas the patient has difficulty coping with. Assess the effectiveness of the patient’s current coping skills and where improvements can be made. Help the patient identify specific stressors and how to cope with them. Work with the patient to develop a care plan, and encourage participation in the plan. Help the patient identify and begin planning for necessary lifestyle changes.

21. Imbalanced nutrition (more than body requirements) related to intake of nutrients that exceeds metabolic needs INTERVENTIONS: Assess the patient’s understanding of the relationship between hypertension and obesity. Discuss the relationship between hypertension and obesity with the patient. Discuss the need for a decreased caloric intake, as well as a limited intake of salt, sugar, and fat. Determine the patient’s desire to lose weight. Help the patient establish a realistic exercise plan. Help the patient establish a realistic nutrition plan. Refer the patient to a nutritionist, if needed.

22. Lifestyle and home remedies By chart