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Medical - Surgical Nursing: College of Nursing - Phinma University of Pangasinan

Hypertension is defined as sustained elevated blood pressure with a diastolic pressure over 90 mmHg. It can be classified as primary (essential) hypertension which is idiopathic or secondary caused by other conditions. Risk factors include family history, age, sex, stress, obesity, diet, and substance use. Four systems control blood pressure: the arterial baroreceptor system, body fluid volume regulation, the renin-angiotensin-aldosterone system, and vascular autoregulation. Treatment involves lifestyle modifications and medications including diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and ARBs. Careful blood pressure monitoring is needed when taking antihypertensive drugs.

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Rosalinda Perigo
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1K views2 pages

Medical - Surgical Nursing: College of Nursing - Phinma University of Pangasinan

Hypertension is defined as sustained elevated blood pressure with a diastolic pressure over 90 mmHg. It can be classified as primary (essential) hypertension which is idiopathic or secondary caused by other conditions. Risk factors include family history, age, sex, stress, obesity, diet, and substance use. Four systems control blood pressure: the arterial baroreceptor system, body fluid volume regulation, the renin-angiotensin-aldosterone system, and vascular autoregulation. Treatment involves lifestyle modifications and medications including diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and ARBs. Careful blood pressure monitoring is needed when taking antihypertensive drugs.

Uploaded by

Rosalinda Perigo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd

Medical – Surgical Nursing

(NUR 155) | BATCH 2023


COLLEGE OF NURSING – PHINMA UNIVERSITY OF PANGASINAN

HYPERTENSION
- Sustained, elevated, systemic, arterial blood pressure; diastolic
elevation more serious, reflecting pressure on arterial wall during
resting phase of cardiac cycle

- Persistent elevation of blood pressure for 2 or more consecutive


readings

CLASSIFICATIONS
(according to type and degree of severity)
1. Systolic and Diastolic Hypertension
a. Systolic HPN is systolic BP of 140 mmHg or higher RISK FACTORS:
b. Diastolic HPN is diastolic BP of 90 mmHg or higher Non-modifiable
- Family history
2. Primary and Secondary HPN - Age
a. Primary/Essential/Idiopathic HPN – occurs in 90-95% of - Sex
patients; etiology unknown; diastolic pressure is > 90
- Ethnic group
mmHg, and other causes of hypertension are absent
b. Secondary HPN – occurs in remaining 5-10% usually of
Modifiable
renal, endocrine, neurogenic or cardiac in origin
- Stress
3. “White-Coat” Hypertension
- Obesity
- HPN in a person who is actually normotensive except when
- Diet
his/her BP is measured by a healthcare professional
- Sedentary Lifestyle
- Substance/Drug Use:
4. Malignant Hypertension
- Cigarette Smoking
- Uncontrollable and may arise from both types and certain
- Alcohol
drugs (e.g., anesthesia)
- An emergency condition characterized by diastolic BP above - Birth Control Pills
120 mmHg - Caffeine
- Smoking cessation
5. Labile (prehypertensive)
- A fluctuating blood pressure increases during stress,
PATHOPHYSIOLOGY:
otherwise normal or near normal
Four control systems that play major roles in maintaining blood pressure
1. Arterial baroreceptor system
2. Regulation of body fluid volume
3. Renin-Angiotensin-Aldosterone system
4. Vascular Autoregulation

Clinical Manifestations:

Subjective

- Headache
- Lightheadedness
- Tinnitus
- Easy fatigability
- Visual disturbances

PADAWAN, ANGELIKA R.| 3BSN3 1


Medical – Surgical Nursing
(NUR 155) | BATCH 2023
COLLEGE OF NURSING – PHINMA UNIVERSITY OF PANGASINAN

- Palpitations 5. Calcium-Channel Blockers (Calcium Antagonists)


- Brief lapses in memory - Action: Inhibit the entry of calcium into the heart and
vascular smooth muscle
Objective Decreases cardiac output
- BP greater than 140/90 Dilate blood vessels
- Retinal changes Lowers blood pressure
- Possible hematuria - Drugs:
- Cardiac hypertrophy  Verapamil
 Nifedipine
 Diltiazem
Medical Management:
- Lifestyle modification
- Weight reduction
5. ACE Inhibitors
- Sodium restriction - Action: Suppress RAAS by blocking conversion of AI to AII
- Dietary fat modification - Drugs: PRIL
- Consideration: First dose – watch for hypotension and loss of taste
- Exercise
6. ARBs
- Relaxation techniques
- Block the vasoconstrictive effect of RAAS by blocking receptor sites
of AII
- Drugs: SARTAN
ANTIHYPERTENSIVE DRUGS
1. Alpha-Adrenergic Blockers GENERAL CONSIDERATIONS ON
- Action: decreases peripheral vascular resistance; relaxes ANTIHYPERTENSIVE MEDICATIONS:
smooth muscle of bladder/prostate Pressure monitoring (blood)
- Drugs: Medications that end in SIN
Rise slowly
2. Central Alpha Agonists Eating must be considered
- Action: decrease the release of adrenergic hormones from the
Stay on medications
brain (medulla oblongata) which decreases peripheral vascular
resistance and reduces cardiac contractility Skipping or stopping is a “No-no”
- Drugs: Clonidine (Catapress); Guanabenz (Wytensin); Undesirable responses assessment
Methyldopa (Aldomet)
- Consideration: Take last dose of the day at bedtime to Remind to exercise
minimize drowsiness during the day Eliminate smoking

3. Beta-Adrenergic Blockers
- Action: these drugs exert antihypertensive effects by:
 Reducing contractility
 Reducing release of renin
 Reducing the cardiac output
- Drugs: medications that end in “olol” (e.g., Metropolol,
Propanolol, Nadolol)

4. Vasodilators
- Action: Direct relaxation of vascular smooth muscle
- Drugs: Hydralazine (Apresoline); Nitroprusside
- Considerations:
 Assess for peripheral edema of the hands and feet
 Take with food
 Review of BP

PADAWAN, ANGELIKA R.| 3BSN3 2

PADAWAN, ANGELIKA R.| 3BSN3 Medical – Surgical Nursing (NUR 155) | BATCH 2023 COLLEGE OF NURSING – PHIN
PADAWAN, ANGELIKA R.| 3BSN3 Medical – Surgical Nursing (NUR 155) | BATCH 2023 COLLEGE OF NURSING – PHIN

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