BAKERSFIELD COLLEGE- NURS B20/21

Risk factors Potential complications

-Being overweight or obese
-Too much sodium in diet
-Too little potassium in diet
-not being physically active
-Drinking too much alcohol
-Stress
-Diet low in vitamin D
-Increased risk can come
from certain chronic
condition including
diabetes, kidney disease,
and sleep apnea
-Age
PART III: PATHOPHYSIOLOGY CONCEPT MAP
-Aneurysms
Signs and symptoms -Heart Attack
-Diagnosis is based on BP readings and can go undetected for years as symptoms -Stroke
usually do not appear until the body is damaged from chronic hypertension. -Peripheral Arterial Disease
-Sustained BP reading = SBP of 140mm Hg or more over DBP of 90mm Hg or more -Eye Damage
-Chronic hypertension can produce signs and symptoms including: -Chronic Kidney Disease
-vision changes or blindness (blood vessels in the eyes burst or bleed) -Heart Failure
-chest pain (Heart Attack) -Cognitive Changes
-troubled breathing and swelling (Heart Failure) -Left Ventricular
-memory loss and losing focus (Cognitive Changes) Hypertrophy

Disease Process ______Hypertension________

Pathophysiology (Definition / etiology chronicity and prognosis)

Hypertension - chronic elevation of blood pressure that, in the long-term, causes end-organ damage and results in increased morbidity and mortality.

Etiology Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, and obesity.

- Secondary hypertension is caused by another medical condition that affects the kidneys, arteries, heart or endocrine system. This type can also occur during
pregnancy

Prognosis Hypertension can be controlled with medicine and lifestyle changes if the patient is compliant.
- uncontrolled, patient is at risk for: stroke, heart attack, bleeding, amongst other complications.

Medical interventions, labs and diagnostic studies Nursing interventions

Medical interventions : medications to treat hypertension include:
-diuretics
-angiotensin converting enzyme (ACE) inhibitors
-calcium channel blockers (CCBs)
-angiotensin receptor blockers (ARBs)
-beta-blockers
General Labs that may be ordered:
-urinalysis (asses kidney function)
-albumin, BUN, and creatinine (monitor kidney dysfunction)
-potassium (some meds cause excessive K loss or retention)
-calcium (parathyroid glands produce an increase in serum calcium)
Diagnostic studies:
-ECG (evaluate HR and look for evidence of heart damage)
-Eye exam (look at retina for changes in the blood vessels)
-Physical exam (look for abdominal tenderness, listen for bruits)
-Monitor and record orthostatic BP in both arms and thighs routinely.
-Look for general edema, may indicate heart failure, renal or vascular
impairment
-Check presence and quality of central and peripheral pulses
-Auscultate heart tones and breath sounds (crackles/wheezes may indicate CHF)
-Maintain activity restriction (bed rest/chair rest)
-Observe skin color, moisture, temp, and capillary refill time ( pale, moist skin,
and delayed capillary refill due to vasoconstriction or cardiac decompensation
and decreased output)
-Provide calm, restful surroundings, and instruct in relaxation techniques.