MedicationsMedicationsAbnormal Labs / Diagnostics
Pathophysiology
Nursing 303L
EtiologyPathogenesisClinical Manifestations
Primary – no known cause and associated risk factors
Secondary – results from specific disease: kidney vascular and kidney disease, primary aldosteronism, Crushing’s disease, coarctation of the aorta, brain tumors, encephalitis, psychiatric disorders, some drugs like estrogen containing oral contreceptives, glucosteriods, minelcorticoids, cyclosporine, and erthyropoietin. Risk factors – family history of hypertension, age older than 60 years, hyperlipidemia, stress, and smoking
Pathogenesis of hypertension is multi-factorial and very complex. Modulators for blood pressure include: Humeral mediators, vascular activity, circulating blood volume, blood viscosity, cardiac output, blood vessel elasticity and neural stimulation. Hypertension, usually, start off as occasional occurrences that become more frequent until it becomes persistent. As you age, elasticity of vessels decreases and the heart must increase pressure to continue to have sufficient tissue perfusion. Headache, dizziness, facial flushing or fainting, edema, nocturia, lethargy, nosebleeds, vision changes. Signs of kidney injury, such as elevated blood urea nitrogen or creatinine levels or low urine output. Physical findings related to vascular damage, including atherosclerosis, acute coronary syndrome, and heart failure. Diagnostic tests that indicate secondary hypertension related to disease. Blood pressure reading systolic greater than 140. When diagnosis is made, most people do not have any symptoms.
Diagnostic Data
Nursing 303L
DateTestResultReference RangeRationale
Blood Pressure in both arms
BUN
Heart Rate
ECG
Cholesterol
Lipoprotiens
Systolic 55 female
LDL
140
Evidences:
Demonstrate stable cardiac rhythm and rate within patient’s normal range
Maintain pressure within, individually acceptable range – 120-140
Participate in activities that reduce blood pressure/cardiac workloadInterventions: Monitor blood pressure in both arms twice daily using correct size cuff and accurate technique 2
Keeps daily record of blood pressure and notes dependent or general edema 2
Records presences, quality of peripheral pulses.2
Participates in yoga/mediation for 30 min/ 3-5x/week 2