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HYPERTENSION

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PRESENTED BY

PREETHY E P

MEENU THOMAS

MINUMOL JOSEPH

NEENU ELDOSE

NEETHU P

NEETHU R

NISHAND YNIVYA SARA V

RAKHI MOL K V

RENJINI MOL

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INTRODUCTION

Blood pressure as the pressure thats put on thewalls of the arteries as blood is pumped by way of thecirculatory system.Blood runs through our veins andarteries at a certain preesure.Within natural limits,thispressure is not harmful.However ,if this pressure increses

the heart is over worked and thearteries devolep abnormal interiortissue growth.This further blocksthe passage of blood,leading to

incrasing bp.Finally,the heart muscle Iit self thickens making heart progressively

weaker

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DEFINITION

Hypertension or high blood pressure is a conditionin which the blood pressure in the arteries ischronically elevated. Hypertension is defined as an

average systolic blood pressure above 140mmHgand a diastolic blood pressure above 90 mmHg ,or both over a sustained period . It is called thesilent killer because usually dont have any

symptoms when blood pressure is too high.

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INCIDENCE

Hypertention is an important medical andpublic issue.It exists worldwide at epidemicrates affecting an estimated 1 billion

people.The prevalence of hypertention inindians is 25% in urban and 10% in ruralpopulation. Hypertension is directly

responsible for 57%of stroke

deaths and 24% of coronary artery

disease deaths in india.

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CLASSIFICATION

CLASSIFICATION SYSTOLIC BP[mmHg]

DIASTOLIC BP[mmHg]

Normal blood pressure

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TYPES OF HYPERTENSION

Hypertension can be classified as primary oressential hypertension and secondary hypertension

----PRIMARY HYPERTENSION

----SECONDARY HYPERTENSION-PRIM ARY HYPERTENSION

Primary or essential hypertension is the mostcommon form of hypertension, which occurs in

almost 90percent of cases . The cause of essentialhypertension is un known , however , the medicalstudies and research have identified some factorswhich cause hypertension

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MAINLY

AGE

UNHEALTHY DIETARY HABITS

INCREASED SALT IN TAKE

TENSION

STRESS

INSUFFICIENT REST

LACK OF EXERCISE

FAMILY HISTORY

OBESITYSMOKING

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SECONDARY

HYPERTENSION

Some people have high blood pressure caused by anunderlying condition .This type of high BP, calledSECONDARY HYPERTENSION ,tends to appearsuddenly and cause higher BP than does PRIMARYHYPERTENSION. Various condition and medications

can lead to secondary hypertension, Including:-Narrowing of the renal arteries-Pregnancy-Oral contraceptive pills

- Pituitary or adrenal gland tumors.-cushings syndrome .-Illegal drugs,such as cocaine and amphetamines.

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CLINICAL MANIFESTATIONS

-High BP-Severe headache,dizziness and blurred vision-Nausea and vomiting-Fatigue and confusion-Epistaxis-Chest pain and shortness of breath-Irregular heart beat-Hemiplegia (temporary paralysis of one side )-Heart attack and heart failure-Stroke-Kidney failure

-Eye damage-Claudication(peripheral arterial disease causing leg pain with walking)-aneurysms

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DIAGNOSTIC EVALUATION

Focused history to collect important data includingsymptoms like chest pain

Family history of high BP ,DM or cardiovasculardiseases

Medical history of co existing conditions likediabetes

PE CBC

Urine analysis Chest x ray ECG Echo cardiogram

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COMPLICATIONS

Uncontrolled high BP can lead to:

Heart attack or stroke

Aneurysms

Heart failure Weakened and narrowed blood vessels in

kidneys

Thickened , narrowed or torn blood vessels inthe eyes

Metabolic syndrome

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MEDICAL MANAGEMENT

The purpose of medical mgt is to maintain BPwith in normal ranges by the simplest and safestmeans

Diuretics Eg: chlorthalidone, furosemide

Beta blockers Eg: propanolol, atenolol Alpha blockers Eg: prazocin Alpha-beta blockers Eg: labetalol Central acting agents Eg: clonidine

Vasodialators Eg: nitroglycerin ACE Eg:captopril , remipril Calcium channel blockers E g: nifedipine, Renin inhibitors

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OTHER THERAPY

Meditation

Yoga

Relaxation training

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NURSING MANAGEMENT

NURSING HISTORY-Family history-Dietary habits and salt intake

-Cigarette smoking-Episodes of headache , weakness,

muscle cramp, tingling, palpitations, sweating,vision disturbances

-Medication that could elevate BP:Hormonal contraceptives, steroids, NSAIDs,nasal decongestants , appetite suppresents.

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PHYSICAL EXAMINATION

Auscultate heart rate and palpateperipheral pulses; determine respirations.

Look for edema , spasm, hemorrhage of theeye vessels

BP determination , auscultate and recordprecisely the systolic and diastolic.

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NURSING DIAGNOSIS

Deficient knowledge regarding therelationship between the treatment regimenand control of the disease process.

Ineffective therapeutic regimen managementrelated to medication adverse effects anddifficult lifestyle adjustments

Deficient knowledge [lifestyle modificatios]

Fatigue Ineffective tissue perfusion : cardiopulmonary

Risk for injury

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NURSING INTERVENTIONS

Explain the meaning of high BP , risk factors ,and explain the influence of high BP on thecardiovascular , cerebral and renal systems.

Identify patients modifiable risk factors and

lifestyle modifications needs. The nurse can encourage the patients to consult

a dietitian to help develop a plan for weight loss. Encourage the patients to increase physical activity

. Teach patient to change positions slowly to

prevent falls. Instruct client and family on medications side

effects , contra indications and signs to report .

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