XAVIER UNIVERSITY – ATENEO DE CAGAYAN

COLLEGE OF NURSING

IN PARTIAL FULFILLMENT FOR THE REQUIREMENTS OF

NCM 112 – MEDICAL-SURGICAL NURSING

ASSESSMENT & MANAGEMENT OF PATIENTS WITH HYPERTENSION

SUBMITTED BY:

MA. THERESE P. BALLARES

BSN 3 – NB

SUBMITTED TO:

MA. JESSECA P. MONSANTO, RN, MAN

CLINICAL INSTRUCTOR

AUGUST 31, 2020

1. Write a short report on the risk factors for hypertension.

Many factors have been implicated as causes of hypertension. These include an

increased sympathetic nervous system activity related to dysfunction of the autonomic nervous
system; increased renal absorption of sodium, chloride, and water related to a genetic variation
in the pathways by which the kidneys handle sodium; increased activity of the renin-angiotensin-
aldosterone system, resulting in expansion of extracellular fluid volume and increased systemic
vascular resistance; decreased vasodilation of the arterioles related to dysfunction of the vascular
endothelium; resistance to insulin action, which may be a common factor linking hypertension,
type 2 diabetes mellitus, hypertriglyceridemia, obesity, and glucose intolerance.

In some studies, unhealthy diet, physical inactivity, obesity, excessive alcohol

consumption, smoking, age, sex, and race or ethnicity may contribute to the presence of
hypertension. Smoking does not really cause high blood pressure; however, if a person with
hypertension smokes, his or her risk of dying from heart disease increases significantly.

2. Define normal BP and categories of abnormal pressures. Include a short explanation

of the differences between normal BP and hypertension.

Normal blood pressure is where blood pressure of less than 120mmHg (systolic) and less
than 80mmHg (diastolic) is within the normal range. Pre-hypertension is when blood pressure
starts to increase to systolic blood pressure from 120mmHg to 129mmHg, and diastolic pressure
below 80mmHg. Stage 1 of hypertension is when the systolic blood pressure tends to increase
to 130mmHg to 139mmHg, and the diastolic blood pressure ranges from 80mmHg to 89mmHg.

Meanwhile, when the systolic blood pressure is greater than or equal to 140mmHg,
hypertension Stage 2 is the diastolic pressure greater than or equal to 90mmHg. Lastly,
Hypertensive crisis is associated with acute end-organ damage and a life-threatening elevation
in blood pressure, usually higher than 180/100mmHg, which requires an emergency treatment to
prevent severe end-organ damage & death.

Blood Pressure is the product of cardiac output multiplied by peripheral resistance.

Cardiac output is the product of the heart rate multiplied by the stroke volume. In normal
circulation, pressure is transferred from the heart muscle to the blood each time the heart
contracts, and then pressure is exerted by the blood as it flows through the blood vessels.
Hypertension can result from an increase in cardiac output, an increase in peripheral resistance
(constriction of the blood vessels), or both.

3. Review medical and nursing management for the care of the patient with hypertension.

The suggested initial drugs include diuretics, beta-blockers or both for patients with
uncomplicated hypertension and no clear indications for another drug. First, low doses of
medication are administered to patients, otherwise the dosage is gradually increased and
additional drugs are added if required to maintain control.

To achieve these goals, the nurse must support and teach the patient to adhere to the
treatment regimen by implementing necessary lifestyle changes, taking medications as
prescribed, and scheduling regular follow-up appointments with the health care provider to
monitor progress or identify and treat any complications of disease or therapy. Promote weight
loss, reduced alcohol and sodium intake, and regular physical to the patient for research findings
demonstrate effective lifestyle adaptations to reduce blood pressure. Encourage diets high in
fruits, vegetables, and low-fat dairy products for studies also show that they prevent the
development of hypertension and can lower elevated blood pressure.

4. Using the Internet, research the complications associated with hypertensive crises. A
possible avenue to utilize is the website www.clevelandclinicmeded.com

Hypertensive crises is a severe increase in blood pressure that can lead to a stroke. Extremely
high blood pressure can damage blood vessels. The complications associated with hypertensive
crises are Hypertensive Encephalopathy, Intracerebral or Subaracnoid Hemorrhage,
Cardiovascular Dysfunction, and Renal Failure.

REFERENCES

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease
and stroke statistics—2019 update: a report from the American Heart Associationexternal
icon. Circulation. 2019;139(10):e1–e473. doi: 10.1161/CIR.0000000000000659.

High Blood Pressure and Hypertensive Crisis (2019). Retrieved from

https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertensive-crisis

Hypertensive, crisis: What are the symptoms? (2019). Retrived from

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-
answers/hypertensive-crisis/faq-
20058491#:~:text=A%20hypertensive%20crisis%20is%20a,higher%20%E2%80%94%20can%2
0damage%20blood%20vessels.

National High Blood Pressure Education Program. The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure pdf
icon[PDF – 223K]external icon. Bethesda, MD: National Heart, Lung, and Blood Institute; 2003.

Soat, M., Corniello, A. L., & Navaratil, K. M. (n.d.). Hypertensive Crisis. Retrieved August 27,
2020, from https://my.clevelandclinic.org/ccf/media/files/nursing/2013- nursing-ccrn-pccn-
handouts/2013-soat-va

Understanding Blood Pressure Readings. (n.d.). Retrieved August 27, 2020, from
https://www.heart.org/en/health-topics/high-blood-pressure/understanding-bloodpressure-
readings

Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D’ Agostino RB, et al. Residual lifetime
risk for developing hypertension in middle-aged women and men: the Framingham Heart
Studyexternal icon. JAMA. 2002;287(8):1003–1010.