Posted by Shahzad Khan on Friday, December 09, 2011
Nursing History of Hypertension client
- Family history of high Blood Pressure
- Previous episodes of high Blood Pressure
- Dietary habits and salt intake
- Target organ disease or other disease processes that may place the patient in a high-risk group diabetes, CAD, kidney disease
- Cigarette smoking
- Episodes of headache, weakness, muscle cramp, tingling, palpitations, sweating, vision disturbances
- Medication that could elevate Blood Pressure:
- Hormonal contraceptives, steroids
- Nasal decongestants, appetite suppressants, tricyclic antidepressants
- Other disease processes, such as gout, migraines, asthma, heart failure, and benign prostatic hyperplasia, which may be helped or worsened by particular hypertension drugs.
Physical Examination of Hypertension Client
- Auscultate heart rate and palpate peripheral pulses; determine respirations.
- If skilled in doing so, perform funduscopic examination of the eyes for the purpose of noting vascular changes. Look for edema, spasm, and hemorrhage of the eye vessels. Refer to ophthalmologist for definitive diagnosis.
- Examine the heart for a shift of the point of maximal impulse to the left, which occurs in heart enlargement.
- Auscultate for bruits over peripheral arteries to determine the presence of atherosclerosis, which may be manifested as obstructed blood flow.
- Determine mentation status by asking patient about memory, ability to concentrate, and ability to perform simple mathematical calculations.
- Blood Pressure Determination, Auscultate and record precisely the systolic and diastolic.
Goal for Nursing Care Hypertension Client
Incorporate low-sodium and low-fat foods from a list provided into her/his diet.
• Develop a plan for regular exercise.
• Verbalize understanding of the effects of prescribed drug, dietary restrictions, exercise, and follow-up visits to help control hypertension.
Reduce blood pressure readings to less than 150 systolic and 90
diastolic by return visit next week.
PLANNING AND IMPLEMENTATION of Nursing Care
The following nursing interventions are planned and implemented.
• Teach to take own blood pressure daily and record it, bringing the record to scheduled clinic visits.
• Teach name, dose, action, and side effects of her antihypertensive medication.
• Instruct to walk for 15 minutes each day this week, and to investigate swimming classes at the local pool.
• Discuss strategies for achieving a realistic weight loss goal.
• Refer for a dietary consultation for further teaching about fat and sodium restrictions.
• Discuss stress-reducing techniques, helping identify possible choices.
Nursing Intervention for Hypertension
- Monitor blood pressure
- Note the central and peripheral pulse quality
- Auscultation of heart and breath sounds
- Observe skin color, moisture, temperature and capillary filling time
- Observe the general edema
- Provide quiet environment, comfortable
- Suggest to reduce activity.
- Maintain restrictions on activities such as recess ditemapt bed / chair
- Help perform self-care activities as needed
- Perform actions such as a comfortable back and neck massage
- Encourage relaxation techniques
- Give fluid restriction and sodium diet as indicated.