University Of Cebu COLLEGE OF NURSING Cebu City, Philippines

RESOURCE UNIT ON HYPERTENSION

Presented By: RULETE, ELOINA GRACE O.

Presented To:

CLINICAL INSTRUCTOR

General Objective: After 2 hours of varied-teaching-learning experience, the BSN III students will be able to gain basic knowledge, beginning skills, and positive attitude on the concept of HYPERTENSION. SPECIFIC OBJECTIVE Specifically the students will be able to: 1. Discuss the incidence and prevalenceof Hypertensio n in the Philippines. CONTENT I.Opening Prayer II. Reading of Objectives TIME ALLOTMENT 5mins. METHODOLOGY RESOURCES I. Human Resources: (a) Knowledge and skills of the presentors 20 mins Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated.This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure is summarised by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole). Normal blood pressure at rest is within the range of 100-140mmHg systolic (top reading) and 60-90mmHg diastolic (bottom reading). High blood pressure is said to be present if it is persistently at or above 140/90 mmHg. Hypertension or high blood pressure is a major cause of the development of cardiovascular diseases like coronary heart disease and stroke. Hypertension may also lead to blindness or impaired vision and kidney failure. INCIDENCE AND PREVALENCE Hypertension or high blood pressure affects over 1.5 billion people around http://cdn.nursi ngcrib.com/wp content/upload s/pathophysioInternet resources: Lecture-Discussion (b) Active participation and time of the class (c) Time and effort of our clinical instructor II. Material resources EVALUATION Question and Answer

INTRODUCTION

the world. In the Philippines, according to the National Nutrition and Health Survey (2003), 22 out of 100 Filipino adults are hypertensive. What's worse, an increasing number of hypertensives is becoming younger and more males are most affected by the condition in the 18 39 years old group. However, as population grew older, the females equal the males. . 2. Define related term: a.hypertensi on Hypertension is clinically defined as sustained SBP of 140 mmHg or more and sustained DBP of 90 mmHg or more based on measurements done during at least two visits taken at least one week apart. Thus:

hypertension.

http://www.bria nmac.co.uk/ph ysiolc.htm http://health.wi kipilipinas.org/i ndex.php?title =Hypertension

10 mins

Lecture-Discussion

If under 130/85, your blood pressure is within the normal range for adults. Keep it there by reducing any risks such as eating less salt, losing weight or stopping smoking. Have your blood pressure checked again in one year.

If over 140/90, you may have high blood pressure and be at risk for its complications. See your doctor. If, after several tests on different days your blood pressure is consistently high, your doctor will begin to look for causes and set up a plan to control your blood pressure.

If between 130-140/85-90 you may be in what is called a prehypertension state. If you have several risk factors as mentioned above, you may have to see your doctor for advice.

b. systolic blood pressure or SBP)

pumping of the heart.

c. (diastolic blood pressure or DBP). 3. List all the risk factors and symptoms of Hypertensio n.

resting of the heart.

Why blood pressure rises is not clear. The risk factors include: family history; advancing age (45 years old and over for males and 55 years old or over for females); and high salt intake. Other factors that contribute to the development of hypertension are obesity, sedentary (inactive) lifestyle, smoking, excessive alcohol consumption and stress. Since high blood pressure rarely shows symptoms, the only way to know for sure is to check your blood pressure. A blood pressure reading measures the force of blood as it presses against the wall of the arteries. It is made up of two numbers that measure the heart while pumping (systolic blood pressure or SBP) and while resting (diastolic blood pressure or DBP). Sometimes people with markedly elevated blood pressure may develop:

20mins

Lecture-Discussion

headache, dizziness, blurred vision, nausea and vomiting, and chest pain and shortnes of breath. See Appendix A for the anatomy. 15 mins. Physiology: HEART The function of the heart is to pump blood around the body. The heart is a hollow, muscular organ divided by a vertical wall called the septum. These two chambers are further divided into the thin walled atrium above, and a Lecture-Discussion

4. Examine the anatomy and physiology of cardiovascul ar system.

thick walled ventricle below, making four chambers. Between each pair of chambers are valves preventing any back flow of blood. Blood vessels leaving the heart generally carry oxygenated blood through vessels known as arteries. These are large, hollow elastic tubes with thick muscular walls that are designed to withstand the high pressure with the blood leaving the heart. Their size gradually diminishes as they spread throughout the body, ultimately reaching fine, hair-like vessels known as capillaries. Blood vessels that return blood to the heart are known as veins which generally carry de-oxygenated blood to the heart. They are elastic tubes containing valves to help prevent back flow of blood. Blood is forced through arteries by the pressure from the heart whereas venous flow is aided by muscular contraction. The only two exceptions to the above are the pulmonary artery, which carries de-oxygenated blood from the heart to the lungs, and the pulmonary vein, which carries oxygenated blood from the lungs to the heart. The circulation is divided into two principle systems known as the general or systemic circulation, that is the circulation around the body, and the pulmonary circulation to and from the lungs

5. Illustrate See Appendix B. the pathophysiol ogy of hypertension .

15 mins

Lecture-Discussion

6. Discuss the managemen t of Hypertensio n.

If You Have Hypertension If hypertension is confirmed, a PLAN OF ACTION is necessary to bring it under control. This may include, diet, changes in lifestyle and medication.

20 mins

Lecture-Discussion

Reduce salt and fat intake. While salt causes tissues to retain fluid, putting the squeeze on your arteries, fat creates masses of plaque that

clog your arteries.

Lifestyle changes. For a healthy lifestyle: exercise regularly; watch your weight; manage stress; avoid extra caffeine; stop smoking; and limit alcohol intake.

Medication. Sometimes, making changes in your diet and lifestyle may not be enough to control your high blood pressure. In this case, your doctor may prescribe medication to go with your healthy lifestyle. There are many types of medication and each works to control high blood pressure in a different way.

Here are some tips for taking medication:

Make it a habit. Ask your doctor when you should take your medication. It must be taken at the same time everyday. Never stop taking medication without your doctor's consent. Your medication can cause a sudden, life-threatening increase in your blood pressure.

Do not double the dose of your medication if you miss taking it. Continue a healthy lifestyle even when already taking medication.

7. Explain the ways of preventing Hypertensio n.

Prevention 15 mins. Much of the disease burden of high blood pressure is experienced by people who are not labelled as hypertensive. Consequently, population strategies are required to reduce the consequences of high blood pressure and reduce the need for antihypertensive drug therapy. Lifestyle LecutureDiscussion

changes are recommended to lower blood pressure, before starting drug therapy. The 2004 British Hypertension Society guidelines proposed the following lifestyle changes consistent with those outlined by the US National High BP Education Program in 2002 for the primary prevention of hypertension:

maintain normal body weight for adults (e.g. body mass index 20 25 kg/m2) reduce dietary sodium intake to <100 mmol/ day (<6 g of sodium chloride or <2.4 g of sodium per day) engage in regular aerobic physical activity such as brisk walking (30 min per day, most days of the week) limit alcohol consumption to no more than 3 units/day in men and no more than 2 units/day in women consume a diet rich in fruit and vegetables (e.g. at least five portions per day);

Effective lifestyle modification may lower blood pressure as much an individual antihypertensive drug. Combinations of two or more lifestyle modifications can achieve even better results.

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7 mins