Assessment and Diagnostic Methods include; History and physical examination, including retinal examination: laboratory studies for organ damage, including urinalysis, blood chemistry (sodium, potassium, creatinine, fasting glucose, total and high-density lipoprotein); electrocardiogram (ECG); and echocardiogram to assess left ventricular hypertrophy, Special studies: intravenous pyelography, renal arteriography, slit renal function studies, renin levels, 24-hour urine protein, and creatinine clearance. According to Johnson, Joyce Young, 2004
The goal of any treatment program is to prevent death and complications by achieving and maintaining an arterial blood pressure below 140/90 mmHg (130/85 mmHg for people with diabetes mellitus or proteinuria >1 g/24 hours) whenever possible. Some non pharmacologic approaches are weight reduction; restriction of alcohol, sodium, tobacco; regular exercise and relaxation. A DASH (Dietary Approach to Stop Hypertension) diet with high fruit and vegetables and low dairy products has been shown to lower elevated pressures.
We also can select a drug class that has the greatest effectiveness, fewest side effects, and best chance of acceptance by patient. Two classes of drugs are available as first-line therapy: Diuretics and Beta-Blockers. It is also important to promote compliance by avoiding complicated drug schedules. Potential Complications, if not treated, includes: Retinal hemorrhage, Heart failure, renal insufficiency and failure, Cerebrovascular accident (CVA), Transient ischemic attack (TIA), Myocardial infarction, Left ventricular hypertrophy.
Works Cited
Books – Brunner & Suddarth (2004) Textbook of Medical-Surgical nursing- 10th ed/Suzanne C. Smaltzer, Brenda G. Bare;, Vol. 2. – Guyton & Hall. Textbook of Medical Physiology, 7th Ed. , Elsevier- Saunders, p220. ISBN 0-7216-0240-1. – Johnson, Joyce Young (2004) Handbook for Brunner & Suddarth’s Textbook of Medical- Surgical Nursing 9th Ed.