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Published by Erick Vladd

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Published by: Erick Vladd on Jul 04, 2011
Copyright:Attribution Non-commercial


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Hypertensive crises encompass a spectrum of clinical situations that have in commonseverely elevated blood pressure (BP), usually higher than 180/110 mm Hg, together withprogressive or impending target organ damage. Patients with hypertensive crises may presentwith a range of blood pressures, varied clinical symptoms, and the presence or absence of target organ involvement. Early triage in the emergency department is critical to identify thoseindividuals who may require more aggressive management in the emergency room or admission for parenteral treatment of the true hypertensive emergency. Most hypertensiveemergencies and urgencies are preventable and are the result of untreated or inadequatelytreated stage I or II hypertension, or non-adherence to antihypertensive therapy.During 2005--2008, approximately 68 million (31%) U.S. adults aged ≥18 years hadhypertension, and this prevalence has shown no improvement in the past decade. Of theseadults, 48 million (70%) were receiving pharmacologic treatment and 31 million (46%) had their condition controlled. Although 86% of adults with uncontrolled blood pressure had medicalinsurance, the prevalence of blood pressure control among adults with hypertension wasespecially low among participants who did not have a usual source of medical care (12%),received medical care less than twice in the previous year (21%), or did not have healthinsurance (29%). Control prevalence also was low among young adults (31%) and MexicanAmericans (37%). Although the prevalence of hypertension did not change from 1999--2002 to2005--2008, significant increases were observed in the prevalence of treatment and control.Hypertensive crises affect upward of 500,000 Filipinos each year. Although the incidence of hypertensive crisis is low, affecting no more than 1% of hypertensive adults, it must beremembered that more than 55 million Filipinos currently suffer from hypertension, and controlrates for BP in our society remain poor. To put these numbers into perspective, it is known thathypertension-related emergency department visits place a significant burden on most busymetropolitan emergency departments. Based on current definitions, one study has found thathypertensive crises account for more than 25% of all patient visits to the medical section.Hypertensive emergencies accounted for one third of these cases.The implication of the case study to nursing education is that this would broaden our knowledge of the important facts about hypertensive urgency & hypertension itself and how itaffects a very large population in the country. As student nurses, it is our responsibility to learn
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more about all sorts of diseases and disorders that we may encounter in dealing with our patients. The implication of this study to nursing practice is that this would improve our skills inproviding adequate and reality-based nursing interventions to our patients focusing more ontheir diagnosis. In Nursing Research, this may provide additional data which may aid in thedevelopment of existing researches regarding cases of hypertensive urgency. This study willalso help in formulating related problems that are not yet solved but could be possibly answeredthrough successive researches.In line with this, we have chosen Mrs. JST to be our client for this case study. Thoughher case is not really related to this rotation’s concept, the group has found her case to be verydelicate and very interesting. Hypertensive urgency needs immediate intervention. Thus, wewould like to challenge ourselves in providing immediate and adequate care for the client.Hence, the group has opted her case to be the content of this study.
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Within 4 weeks of exposure to San Lorenzo Ward, the group will be able to obtainawareness about the disease process in relation to cancer and exhibit skills efficiently in takingcare of patient with such disease.
The group was able to formulate objectives that will serve as guides in making this studya success and that the group aims to accomplish the following objectives:
establish rapport with the client and with her family as well, in order to gain trust andobtain reliable information;
gather substantial data concerning the client and family background that will serve as abaseline data about the patient’s condition;
trace the client’s family history, past health history and history of present illness bypresenting a genogram of at least 3 generation history of diseases;
identify the nature of client’s chief complaint and diagnosis as to how it affects her functioning and wellbeing;
relate client’s developmental data with respect to Robert Havighurst’s and ErickErikson’s psychological theories in order to determine whether the client has met theneeds or not;
assess the client’s physical state and holistically conduct a thorough cephalocaudalassessment;
identify definition of diagnosis based on clinical judgment, inferences and review of related information;
discuss the patient’s medical diagnosis and interpret it appropriately;
illustrate the anatomy and physiology of the affected system and organs involve;10.present detailed pathophysiology of the final diagnosis;

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