PPT HYPERTENSION(hypetension)0000000.pptx

hypertension

1. PRESENTED BY:- MANISH SUMAN SUB:- MEDICAL SURGICAL NURSING

2. DEFINITION Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long term medical condition in which the arteries is persistently elevated. The SBP (systolic blood pressure) will be more than or equal of 140 mmHg and DBP (diastolic blood pressure)

3. Key facts An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries An estimated 46% of adults with hypertension are unaware that they have the condition. Less than half of adults (42%) with hypertension are diagnosed and treated.

4. Conti… Approximately 1 in 5 adults (21%) with hypertension have it under control. Hypertension is a major cause of premature death worldwide. One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.

5. TYPES Pre-hypertension: SBP: 120-139 mmHg DBP: 80-89 mmHg H ypertension stage I: SBP: 140-159 mmHg DBP: 90-99 mmHg Hypertension stage II: SBP: More or equal to 160 mmHg DBP: More or equal to 100 mmHg Pregnancy induced HTN: because of increased production of hormones and enzyme during pregnancy.

6. ETIOLOGY A number of factors increase BP, including:- Obesity insulin resistance high alcohol intake high salt intake (in salt-sensitive patients) aging and perhaps sedentary lifestyle Stress low potassium intake low calcium intake.

7. CONTI….. Primary HTN:- it is the elevation in BP without and identified Cause. Secondary HTN:- it is the elevation in BP with an exact cause. This type is account for 5-10% of total cases. The causes of secondary HTN includes : Congenital narrowing of aorta. Renal disease Endocrine disorder Neurological disorder like brain tumor

8. Conti…. Sleep apnea. Medication like OCP ,NSAID, and Cocaine. Cirrhosis of liver.

9. RISK FACTOR Modifiable risk factor:- Alcohol intake Obesity Stress Sedentary life style Excessive salt intake Non-modifiable risk factor:- Age Sex Family history Genetic

10. PATHOPHYSIOLOGY The normal blood pressure is maintained by four mechanisms Sympathetic nervous system activities. Activities of vascular endothelium. Activities of renal system. Activities of endocrine system.

11. SYMPATHATIC NERVOUS SYSTEM ACTIVITIES When the BP in decreasing the activation of SNS activity increase the heart rate and cardiac contraction. The increased the heart rate and cardiac contraction produce vasoconstriction in the peripheral arterioles and promotes the release of renin from kidney. The net effect of SNS activation is to increase the arterial blood pressure by increasing cardiac output and systemic vascular resistance . BP = CO X SVR

12. ACTIVITIES OF VASCULAR ENDOTHELIUM The vascular endothelium is a single cell layer that lines the blood vessel. It will produce vasoactive substance and growth factors like nitric acid , endothelia etc. These substance are potent vasoconstriction and causes increase blood pressure level.

13. ACVITIES OF RENAL SYSTEM The kidneys regulate circulatory volume by controlling sodium and water balance, thus maintaining extracellular fluid volume (ECFV) homeostasis. Simply put, an increase in sodium and water consumption leads to an increase in ECFV, which in turn increases blood volume.

14. ACVITIES OF ENDOCRINE SYSTEM The endocrine system is a series of glands that secrete hormones that the body uses for a wide range of functions, including regulating blood pressure. Adrenal glands: If the adrenal glands make too much aldosterone, cortisol, or hormones similar to adrenaline, it can cause high blood pressure.

15. CLINICAL FEATURES S evere headaches C hest pain D izziness D ifficulty breathing N ausea V omiting B lurred vision or other vision changes A nxiety C onfusion B uzzing in the ears N osebleeds A bnormal heart rhythm

16. DIAGNOSTIC TEST History Physical examination ECG Urinalysis C omplete blood count B lood chemistry (potassium, sodium, creatinine , fasting glucose, total and high-density lipoprotein or HDL cholesterol)

17. MANAGEMENT Mainly the management of hypertension is possible by two ways, which includes Life style modification Pharmacological therapy

18. LIFE STYLE MODIFICATION Eat more vegetables and fruits. Sit less. Be more physically active, which can include walking, running, swimming, dancing or activities that build strength, like lifting weights . Lose weight if you’re overweight or obese. Take medicines as prescribed by your health care professional. Keep appointments with your health care professional.

19. PHARMACOLOGICAL TREATMENT Diuretics: it helps the kidney to inhibit the sodium reabsorption in the distal convoluted tubules, ascending limb and loop of henle. Eg : chlorothiazide, furosemide. Beta blockers: these medications reduces the workload of the heart and blood vessels and causing the heart to beat slowly and with less force. Eg : Atenolol, P ropanolol

20. CONTI…. Alpha blockers: T hese medication causes the peripheral vasodilation of blood vessels. Eg : Prazosin Vasodilator: these medication acting directly on the muscles in the wall of arteries and preventing the muscles from tightening and arteries from narrowing. Eg : Nitroglycerin, sodium nitro prusside

21. Conti… ACE Inhibitors: this group of medication will reduce the conversion of A-I to A-II and prevents vasoconstriction. Eg : Captopril, Ramipril Calcium channel blockers: these medicines will block the movement of extra cellular calcium into the cells and causing vasodilation and decreased heart rate. Eg : Amlodipine, Verapamil

22. NURSING MANAGEMENT Proper history collection should be done which includes family history also. Dietary habits should be assessed Identify the medical history such as diabetes, CAD, renal disease etc. Instruct the patient to avoid smoking and alcoholism Auscultate heart rate and palpate peripheral pulses.

23. CONTI…. Identify the use of medications such as contraceptives, steroids, NSAID Etc. Monitor vital sign frequently. Provide diet which is low in sodium and rich with fruits and vegetables. Monitor the blood cholesterol level frequently.