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Saturday, December 24, 2011

Nursing Care Plan for Hypertension : Assessment, Diagnosis and Interventions

 Hypertension

The definition of hypertension, many raised by health experts. WHO suggests that hypertension occurs when blood pressure above 160/95 mmHg, meanwhile, Smelttzer & Bare (2002:896) suggests that hypertension is a persistent blood pressure or continuous thus exceeding the normal limit in which the systolic pressure above 140 mmHg and diastolic pressure above 90 mmHg.

There are differences about the limits of hypertension as proposed by Kaplan (1990:205), namely men, aged less than 45 years, said hypertension when blood pressure when lying above or equal to 130/90 mm ​​Hg, whereas at the age of 45 years, said hypertension when blood pressure above 145/95 mmHg.Whereas in women with blood pressure above 160/95 mmHg.

Based on these definitions can be concluded that hypertension is an increase in blood pressure where systolic pressure over 140 mmHg or diastolic over 90 mmHg.

The classification of hypertension are also expressed by many experts, including WHO set a classification of hypertension into three levels namely:

Level I: increased blood pressure without symptoms of the disorder or damage to the cardiovascular system.
Level II: blood pressure with symptoms of cardiovascular hypertrophy, but without any symptoms of damage or disruption of the appliance or other organs.
Level III: blood pressure increased with obvious symptoms of damage and disruption of the target organ physiology.

The cause of hypertension varied are: stress, obesity, smoking, hypernatremia, water and salt retention that is not normal, sensitivity to angiotensin, obesity, hypercholesterolemia, adrenal gland disease, kidney disease, toxemia gravidarum, increased intra-cranial pressure, caused by brain tumors, influence of certain drugs eg oral contraceptives, high salt intake, lack of exercise, genetics, obesity, atherosclerosis, kidney abnormalities, but largely unknown cause.


Nursing Care Plan for Hypertension

Nursing Assessment Nursing Care Plan for Hypertension


According to Doenges, (2004:41-42) and argued that the assessment of patients with hypertension include:

a. Activity and rest include: weakness, fatigue, shortness of breath, heart frequency increases, changes in heart rhythm.

b. Circulation includes: a history of hypertension, coronary heart disease, episodes of palpitations, increased blood pressure, tachycardia, sometimes sounding S2 heart sounds at the base of S3 and S4.

c. Ego integrity include: anxiety, depression, euphoria, irritability, facial muscle tension, anxiety, respiratory haul, increased speech patterns.

d. Elimination include: history of kidney disease.

e. Food / fluids include: food preferences especially those containing high salt, high fat, and cholesterol, nausea, vomiting, weight changes, a history of diuretic drugs, presence of edema.

f. Neuro-sensory include: complaints headache, throbbing, sub-occipital headache, weakness on one side of the body, visual disturbances (diplopia, blurred vision), epistaxis.

g. Pain / discomfort: include intermittent pain in the limbs, sub-occipital headaches severe abdominal pain, chest pain.

h. Respiratory include: shortness of breath after activity, cough with or without sputum, smoking history, medication use respiratory Bantu, additional breath sounds, cyanosis.

i. Security include: gait disturbance, paresthesia, postural hypotension.

j. Pembalajaran / extension in the presence of family risk factors are arteriosclerosis, heart disease, diabetes, kidney disease.


Nursing Diagnosis Nursing Care Plan for Hypertension (Doengoes, 2004)

a. Decreased cardiac output

b. Activity intolerance

c. Acute pain

d. Imbalanced Nutrition: More Than Body Requirements

e. Ineffective coping


 Nursing Diagnosis and Interventions for Hypertension

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