Hypertension Care Plan

Definition

According to WHO (1978) limits the blood pressure is considered normal is 140/90 mm ​​Hg and blood pressure equal to or above 160/95 mmHg expressed as hypertension. Hypertension is an increase in blood pressure above normal when the systolic pressure is 140 mmHg or more and diastolic pressure of 90 mmHg or more.

In isolated systolic hypertension, systolic blood pressure to 140 mmHg or more, but the diastolic pressure less than 90 mmHg and diastolic blood pressure was within the normal range. Hypertension is often found in the elderly.

Along with age, almost everyone experienced an increase in blood pressure, systolic pressure continues to increase until age 80 years and diastolic pressures continue to increase until age 55-60 years, then decrease slowly or even decreased dramatically.

In patients with diabetes mellitus or renal disease, studies have shown that blood pressure above 130/80 mmHg should be considered a risk factor and should be given treatment.


Etiology

1. Age

Hypertension increased with increasing age, hypertension at the age of 35 years clearly raise the incidence of arterial disease and premature death.

2. Male / female

Based on the male gender, generally occurs higher incidence than women. But in middle age, the incidence in women begins to rise, so that by the age of 65 years, the incidence is higher in women.

3. Race
Hypertension in the black at least twice on the white.

4. Lifestyle

Factors such as education, income and lifestyle factors of patients have been studied, no clear results. Low income, low education levels and life or stressful work seems related to a higher incidence of hypertension. Obesity is also seen as a major risk factor. Smoking is seen as a high risk factor for hypertension and coronary artery disease. Hypercholesterolemia and hyperglycemia are the main factors for the development of atherosclerosis associated with hypertension.


Based on the cause, hypertension were divided into 2 groups:

1. Primary hypertension

Hypertension is of unknown cause, usually associated with hereditary and environmental factors.

2. Secondary hypertension

Is the cause of hypertension can be known with certainty, such as vascular disorders and kidney disease.


Clinical Manifestations

In most patients, hypertension does not cause symptoms, although some symptoms inadvertently occur simultaneously and reliably associated with high blood pressure (when in fact it is not). Symptoms in question is a headache, bleeding from the nose, dizziness, facial redness and fatigue; that could have occurred both in patients with hypertension, as well as in a person with normal blood pressure.

If hypertension is severe or chronic and untreated, can result in the following symptoms:

• headache
• fatigue
• nausea
• vomiting
• shortness of breath
• restless
• blurred vision that occurs because of damage to the brain, eyes, heart and kidneys.
• sometimes patients with severe hypertension experienced a loss of consciousness and even coma because of brain swelling. This situation is called hypertensive encephalopathy, which require immediate action.

Signs and symptoms of hypertension can be divided into: (Edward K Chung, 1995).

a. No Symptoms

There are no specific symptoms that can be associated with increased blood pressure, in addition to the determination of arterial pressure by the examining physician. This means that arterial hypertension will never be diagnosed if arterial pressure was not measured.

b. Common Symptoms

It is often said that terlazim symptoms that accompany hypertension include headache and fatigue. In fact this is a symptom of the terlazim that most patients who seek medical attention.


Complication

As a result of prolonged hypertension is:

• coronary insufficiency and obstruction
• heart failure
• renal failure
• neurological disorders

Examination Support

1. Laboratory Studies

• Hb / Ht: to examine the relationship of the cells to the volume of fluid (viscosity) and may indicate risk factors such as hypo-coagulability, anemia.
• BUN / creatinine: provides information on perfusion / kidney function.
• Glucose: Hyperglycemia (DM is the originator of hypertension) can be caused by spending ketokolamin levels.
• Urinalysis: blood, protein, glucose, renal dysfunction indicated he fully danada DM.

2. CT Scan: Assessing the presence of cerebral tumor, encefalopati.

3. ECG: may show patterns of strain, where the vast, P wave elevation is one early sign of hypertensive heart disease.

4. IUP: identifying causes of hypertension such as kidney stones, kidney repair.

5. Photo Chest: Shows the destruction of calcification in the valve area, cardiac enlargement.


Nursing Diagnosis for Hypertension

1. Risk for Decreased cardiac output
2. Activity intolerance
3. Acute pain
4. Imbalance Nutrition Less than Body Requirements
5. Ineffective individual coping
6. Knowledge deficit

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