SPURTY COLLEGE OF NURSING HYPERTENSION

SPURTY COLLEGE OF NURSING
SUBJECT: Medical Surgical Nursing

ASSINGNMENT ON
TOPIC
HYPERTENSION
SUBMITTED TO:
SUBMITTED BY:
Umar Firdous
M.Sc. Nursing 1st year
SUBMITTED ON:
Hypertension
Introduction:
Hypertension, commonly known as high blood pressure, is a chronic medical

condition where the blood pressure in the arteries is persistently elevated. It is a
major risk factor for cardiovascular diseases such as heart attack, stroke, and
kidney failure. Hypertension often has no obvious symptoms, which makes it a
"silent killer" and necessitates regular monitoring.
Types of Hypertension:
1. Primary (Essential) Hypertension:

Definition: This type of hypertension has no identifiable cause. It is more
common and tends to develop gradually over many years.
Risk Factors: Age, family history, obesity, lack of physical activity, smoking,
excessive alcohol consumption, and high-sodium diet.
2. Secondary Hypertension:
Definition: Hypertension that is caused by another medical condition such as
kidney disease, sleep apnea, or certain medications.
Causes:
 Kidney disease
 Obstructive sleep apnea
 Adrenal gland tumors
 Certain medications (e.g., oral contraceptives, decongestants)
3. Hypertensive Crisis:
Definition: A severe increase in blood pressure that can lead to a stroke. This
condition requires immediate medical attention.
Symptoms: Severe headache, shortness of breath, nosebleeds, and severe
anxiety.
Causes and Risk Factors:

1. Genetics:
Family history of hypertension increases the risk of developing the condition.
2. Obesity:
Excess body weight, particularly abdominal fat, increases the strain on the heart
and contributes to the development of hypertension.
3. Physical Inactivity:
Lack of exercise leads to poor heart function and can contribute to weight gain
and the development of hypertension.
4. Excessive Alcohol Consumption:
Chronic alcohol consumption can increase blood pressure by affecting the
function of the heart and blood vessels.
5. Sodium Intake:
High sodium intake contributes to fluid retention, increasing the volume of
blood in the circulatory system, leading to higher blood pressure.
6. Age:
As a person ages, the elasticity of blood vessels decreases, which can contribute
to increased blood pressure.
Signs and Symptoms:

Hypertension is often referred to as a "silent disease" because it usually does not
present with obvious symptoms. However, some individuals may experience:
1. Headaches
2. Dizziness
3. Shortness of breath
4. Nosebleeds
5. Chest pain
6. Blurred vision
7. Fatigue
Pathophysiology:
Hypertension occurs when the blood vessels are constantly under increased
pressure. This may result from:
1. Increased Cardiac Output: This can occur when the heart pumps more
blood than normal due to factors such as increased blood volume or excessive
fluid retention.
2. Increased Peripheral Resistance: Narrowing or stiffening of the blood
vessels (due to atherosclerosis, for example) increases resistance, leading to
higher pressure on the blood vessels.
3. Renal Dysfunction: The kidneys play a critical role in regulating blood
pressure by balancing salt and water. Kidney disease can impair this process,
leading to fluid retention and increased blood pressure.
Diagnosis of Hypertension:
1. Blood Pressure Measurement:

 Normal Blood Pressure: Less than 120/80 mmHg
 Elevated Blood Pressure: 120-129/80 mmHg
 Hypertension Stage 1: 130-139/80-89 mmHg
 Hypertension Stage 2: 140/90 mmHg or higher
 Hypertensive Crisis: Higher than 180/120 mmHg, requiring emergency
treatment
2. Laboratory Tests:
 Kidney function tests (creatinine, glomerular filtration rate)
 Lipid profile
 Electrolytes
 Urinalysis (to detect protein, which could indicate kidney damage)
3. Electrocardiogram (ECG):
 To assess for damage to the heart caused by high blood pressure.
4. Echocardiogram:
 To evaluate heart function and detect any changes such as left ventricular
hypertrophy (LVH), which can occur due to chronic hypertension.
Management
Medical Management:
1. Lifestyle Modifications:
 Dietary Changes: A diet rich in fruits, vegetables, whole grains, and low-
fat dairy products, such as the DASH (Dietary Approaches to Stop
Hypertension) diet, is recommended.
 Physical Activity: Regular aerobic exercise, such as walking or
swimming, can help lower blood pressure.
 Weight Loss: Achieving and maintaining a healthy weight helps reduce
the burden on the heart and lower blood pressure.
 Smoking Cessation: Smoking damages blood vessels and raises blood
pressure.
2. Pharmacologic Treatment:
 Diuretics: Help eliminate excess sodium and water from the body.
 ACE Inhibitors: Help relax blood vessels by blocking the enzyme that
narrows blood vessels.
 Angiotensin II Receptor Blockers (ARBs): Block the effects of the
hormone that narrows blood vessels.
 Calcium Channel Blockers: Help relax the muscles of blood vessels and
reduce heart rate.
 Beta-Blockers: Decrease heart rate and cardiac output.
 Alpha-Blockers: Help relax certain muscles and help blood flow more
easily.
Surgical Management:
1. Renal Denervation: A procedure that targets nerves in the kidneys, which
can help reduce high blood pressure by disrupting the neural pathways that
regulate blood pressure.
2. Endovascular Aneurysm Repair (EVAR): In cases where hypertension is
related to an aneurysm, surgical intervention may be needed to repair the artery.
Nursing Diagnoses:
1. Ineffective Health Management related to lack of understanding of disease
process and treatment regimen.
Goal: The patient will demonstrate understanding of the importance of
medication adherence, lifestyle changes, and blood pressure monitoring.
2. Risk for Decreased Cardiac Output related to increased peripheral vascular

resistance and left ventricular hypertrophy.
Goal: The patient will maintain optimal cardiac function as evidenced by
normal heart rate, rhythm, and blood pressure readings.
3. Imbalanced Nutrition: More than body requirements related to obesity and

poor dietary habits.
Goal: The patient will follow a heart-healthy diet and reduce body weight by 5-
10% over 6 months.
Health Education:
1. Dietary Guidelines:
 Encourage a low-sodium diet, high in fruits, vegetables, and whole
grains.
 Limit alcohol intake to moderate levels and reduce caffeine consumption.
2. Exercise:
 Advise on regular physical activity, such as 30 minutes of moderate
exercise on most days of the week.
3. Medication Adherence:
 Explain the importance of consistently taking prescribed antihypertensive
medications and following up with healthcare providers.
4. Stress Management:
 Teach relaxation techniques such as meditation, deep breathing exercises,
and yoga to help manage stress.
5. Regular Monitoring:
 Teach the patient how to monitor blood pressure at home and recognize
symptoms of high blood pressure, such as headache or chest pain.
Role of Nurse:
1. Assessment:
Regularly monitor blood pressure and assess for symptoms of hypertension,
such as headaches, dizziness, and blurred vision.
2. Education:
Educate the patient about hypertension, its complications, and how to manage it
through lifestyle changes and medication.
3. Support:
Provide emotional support, especially if the patient is overwhelmed by the
diagnosis or resistant to making lifestyle changes.
4. Collaboration:
Collaborate with the healthcare team to ensure a comprehensive care plan,
including dietitians, exercise specialists, and pharmacists.
Conclusion:
Hypertension is a major public health concern due to its role in causing severe
complications like heart disease, stroke, and kidney failure. Early diagnosis,
lifestyle modification, and appropriate pharmacologic treatment can help
manage blood pressure and reduce the risk of complications. Nurses play an
essential role in the management of hypertension through patient education,
monitoring, and support.
References:
1. American Heart Association. (2020). Hypertension.

https://www.heart.org/en/health-topics/high-blood-pressure
2. National Institute of Health (NIH). (2020). Hypertension.
https://www.nhlbi.nih.gov/health-topics/high-blood-pressure
3. Mayo Clinic. (2020). High Blood Pressure (Hypertension).
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/
symptoms-causes/syc-20373410

SPURTY COLLEGE OF NURSING HYPERTENSION

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SPURTY COLLEGE OF NURSING HYPERTENSION

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SPURTY COLLEGE OF NURSING

SUBJECT: Medical Surgical Nursing

Hypertension, commonly known as high blood pressure, is a chronic medical

1. Primary (Essential) Hypertension:

Causes and Risk Factors:

Signs and Symptoms:

1. Blood Pressure Measurement:

2. Risk for Decreased Cardiac Output related to increased peripheral vascular

3. Imbalanced Nutrition: More than body requirements related to obesity and

1. American Heart Association. (2020). Hypertension.

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