Nursing Management of Hypertension

Hypertension management aims to prevent morbidity and mortality from cardiovascular complications associated with the achievement and maintenance of blood pressure below 140/90 mmHg.

Nursing Management of Hypertension

Without drug therapy

Without drug therapy, are used as measures for mild hypertension and as a supportive action in moderate and severe hypertension. Without drug therapy include:

Diet

The recommended diet for people with hypertension are:

• Moderate salt restriction of 10 g / day to 5 g / day
• Diets low in cholesterol and low saturated fatty acid
• Weight loss
• Decrease in ethanol intake
• Stop smoking
• Diets high in potassium

Physical Exercise
Physical exercise or sports are organized and directed that recommended for patients with hypertension is a sport that has four principles:

• Various forms of exercise that is isotonic and dynamic as running, jogging, cycling, swimming etc.
• A good exercise intensities between 60-80% of aerobic capacity or 72-87% of maximum pulse rate, called the exercise zone. Maximum pulse rate can be determined by the formula 220 - age.
• The duration of training ranged from 20-25 minutes in the training zone
• Training frequency should be 3 x per week, and most preferably 5 x per week.

Psychological Education
Provision of psychological education for hypertensive patients include:
1. Biofeedback techniques
Biofeedback is a technique used to show the signs on the subject of a state body that is consciously by the subjects considered normal.
The application of biofeedback is mainly used to cope with somatic disorders such as headaches and migraines, as well as for psychological disorders such as anxiety and tension.

2. Relaxation techniques
Relaxation is a procedure or technique that aims to reduce tension or anxiety, by training people to be able to learn to make the muscles in the body become relaxed

Health Education (Counseling)
The purpose of health education is to improve patients' knowledge about hypertension and its management so that patients can maintain life and prevent further complications.

Risk for Decreased Cardiac Output related to Hypertension
 
Pathophysiology of Hypertension

Hypertension Nursing Care Plan : Assessment, Diagnosis and Interventions

Nursing Care Plan for Hypertension in Pregnancy

Care Plan Nursing Read more »

Pathophysiology of Hypertension

Pathophysiology of Hypertension

Mechanisms that control the constriction and relaxation of blood vessels located in the vasomotor center, the medulla in the brain. Of the vasomotor center, the sympathetic nerve pathway begins, which continues down the spinal cord and the spinal cord out of the column to the sympathetic ganglia in the thorax and abdomen. Central vasomotor stimulation delivered in the form of impulse which moves downward through the sympathetic nervous system to the sympathetic ganglia. At this point, preganglionic neurons, releasing acetylcholine, which will stimulate post-ganglion nerve fibers to blood vessels, where the release of norepinephrine resulting in constriction of blood vessels. Various factors such as anxiety and fear can affect the response to stimuli vasoconstriction of blood vessels.

Individuals with hypertension is very sensitive to norepinephrine, although it is not clear why this could occur.

At the same time in which the sympathetic nervous system stimulates the blood vessels in response to emotional stimuli, the adrenal glands are also stimulated, resulting in additional vasoconstriction activity. Adrenal medulla secretes epinephrine, which causes vasoconstriction. Adrenal cortex to secrete cortisol and other steroids, which can strengthen the vasoconstrictor response of blood vessels. Vasoconstriction resulting in decreased flow to the kidneys, causing the release of renin. Renin stimulates the formation of angiotensin I is then converted into angiotensin II, a powerful vasoconstrictor, which in turn stimulates the secretion of aldosterone by the adrenal cortex. This hormone causes retention of sodium and water by kidney tubules, causing increased intra-vascular volume. All these factors tend to trigger a state of hypertension.

For consideration of Gerontology. Structural and functional changes in the peripheral vascular system are responsible for changes in blood pressure that occurs in the elderly. These changes include atherosclerosis, loss of elasticity of the connective tissue and a decrease in vascular smooth muscle relaxation, which in turn lowers the ability of distention and tensile strength of blood vessels. Consequently, the aorta and large arteries decreases its ability to accommodate the volume of blood pumped by the heart, resulting in decreased cardiac cheating and increased peripheral resistance. Pathophysiology of Hypertension (Brunner & Suddarth, 2002).

Hypertension Nursing Care Plan : Assessment, Diagnosis and Interventions

Care Plan Nursing Read more »

Hypertension Nursing Care Plan : Assessment, Diagnosis and Interventions

Hypertension Nursing Assessment

Assessment is the main basis of the nursing process. Assessment is the first step in one of the nursing process (Gaffar, 1999). Activities undertaken in the assessment is gathering data and formulating priority issues. In the assessment - a careful collection of data about clients, their families, the data obtained through interviews, observation and examination.

The data collected can be divided into two (Kelliat, Budi Ana., 1995) :

1. Data base
2. Specific data relating to the current situation of the client which can be determined by the nurse, client or family.

The purpose of nursing assessment is to collect data, classify data and analyze the data. Thus concluded a nursing diagnosis (Gaffar, 1999).

Hypertension Nursing Diagnosis

1. Risk for Decreased Cardiac Output related to Increased afterload, vasoconstriction and myocardial ischemia.
2. Acute pain related to increased cerebral vascular pressure.

Hypertension Nursing Intervention

Nursing Diagnosis :

Risk for Ineffective Tissue Perfusion: Peripheral, Renal, Gastrointestinal, Cardiopulmonary related to impaired circulation

Nursing Intervention for Hypertension

• Maintain bed rest, elevate head of bed
• Assess blood pressure at admission in both arms, sleeping, sitting with arterial pressure monitoring if available
• Maintain fluid and drugs.
• Observe the sudden hypotension.
• Measure inputs and expenditures
• Monitor electrolytes, BUN, creatinine.
• Ambulation according to ability; avoid fatigue

Risk for Decreased Cardiac Output related to Hypertension
 
Nursing Care Plan for Hypertension in Pregnancy

Care Plan Nursing Read more »