ASSESSMENT P#1: Hypertension S:  Chest pain rated as 5-6/10 O:> v/s: BPPRRRTO guards the chest when in pain and guards the

head when he feels dizzy  capillary refill at 1 sec.  wit regular rhythm of pulse rate  slightly pale skin, conjunctiva and nail beds  skin is warm to touch, (-) edema, (+) good skin turgor  patient prefers sitting position A: Decreed cardiac output related to increase vascular resistance.

EXPLANATION OF THE PROBLEM

OBJECTIVE STO:  After 8 hours of nursing intervention, the patient will be able to: a. decrease chest pain from 5-6 to 3-4/10. b. decrease his BP from 150/100 to 130-140/8090. LTO:  After 2-3 days of nursing intervention, the patient will be able to maintain BP within is acceptable range such as 130/90.

INTEVENTION Dx:  Monitor vital signs especially BP and PR.

RATIONALE

EVALUATION

 Assess patient’s response to increase activity.

 Assess contributing factors in increasing / elevation of BP.  Note skin color and presence and quality of pulse.

 It serves as baseline data that will help in the evaluation and planning for therapeutic intervention.  Physical activity increases the demand placed on the heart. Close monitoring of patient’s response serves as a guide for optimal progression of activity.  It serves as a guide or baseline data and so appropriate plan of care plan are initiated.  Peripheral circulation is reduced when cardiac output falls,

 Decreases oxygen consumption / demand. patient is dizzy.  Provide for adequate rest periods. reduces workload.giving the skin pale color and diminishing the strength of peripheral pulses. He tends to fall because of it and so to prevent it.  To reduce preload and ventricular filling. reducing myocardial workload and risk of decompensation.  Conserves energy. Assist wit perform self-care activities. we should ensure safety. as indicted. Tx:  Place patient semi-fowler position.  Maintain bed / chair rest in position of comfort during cute episodes.  Administer  .  Ensure safety by  It is when the putting side rails.

 Explain drug regimen.medications prescribed by physician like ******.  To provide him information about his diet and so to gain his cooperation for the planned .  For the ptient to understand and be aware if why those drugs were given to him.  To provide the ptient information about his illness and to be able to gain his cooperation for the planned interventions. For side effects.  Explain diet program for him. it is very important for him to know it because it will help him on how to prevent further problems like the side effects of the specific drug. purpose and side effects. Ed:  Explain symptoms and interventions for the illness.

.  Valsalva maneuver causes vagal stimulation. reducing heart rate which may be followed by rebound tachycardia. Stress importance of avoiding straining especially during defecation. both of which may impair cardiac output. intervention.