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Hypertension - Coggle Diagram
Hypertension
Nursing Interventions
Monitor and record BP. Measure in both arms and thighs three times, 3–5 min apart while patient is at rest, then sitting, then standing for initial evaluation. Use correct cuff size and accurate technique.
Check laboratory data (cardiac markers, complete blood cell count, electrolytes, ABGs, blood urea nitrogen and creatinine, cardiac enzymes, and cultures, such as blood, wound or secretions).
Auscultate heart tones and breath sounds.
Evaluate client reports or evidence of extreme fatigue, intolerance for activity, sudden or progressive weight gain, swelling of extremities, and progressive shortness of breath.
Provide calm, restful surroundings, minimize environmental activity and noise. Limit the number of visitors and length of stay.
Encourage the patient to consult a dietitian to help develop a plan for improving nutrient intake or for weight loss.
Encourage restriction of sodium and fat
Emphasize increase intake of fruits and vegetables.
Implement regular physical activity.
Advise patient to limit alcohol consumption and avoidance of tobacco.
Assist the patient to develop and adhere to an appropriate exercise regimen.
Medical Interventions
Lower sodium intake
Medications
Angiotensin-converting enzyme (ACE) inhibitors.
Angiotensin II receptor blockers (ARBs)
Diuretics.
Beta-blockers.
Calcium channel blockers.
Alpha-blockers.
Alpha-agonists.
Renin inhibitors.
Change in diet
Meditation
Lowering the BP
Medication
DIURETICS
Bumetanide (Bumex), Chlorthalidone (Hygroton), Chlorothiazide (Diuril)
Ethacrynate (Edecrin), Furosemide (Lasix), Hydrochlorothiazide HCTZ (Esidrix, Hydrodiuril, Microzide)
Indapamide (Lozol), Methyclothiazide (Enduron), Metolazone (Mykroz, Zaroxolyn)
Torsemide (Demadex)
BETA BLOCKERS
Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol fumarate (Zebeta), Carvedilol (Coreg) -- Combined alpha/beta-blocker
Esmolol (Brevibloc), Labetalol (Trandate, Normodyne) -- Combined alpha/beta-blocker
Metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol-XL), Nadolol (Corgard)
Nebivolol (Bystolic), Penbutolol sulfate (Levatol), Propranolol (Inderal)
Sotalol (Betapace), HCTZ and bisoprolol (Ziac) is a beta blocker plus diuretic
ACE INHIBITORS
Benazepril hydrochloride (Lotensin), Captopril (Capoten), Enalapril Maleate (Vasotec)
Fosinopril sodium (Monopril), Lisinopril (Prinivil, Zestril), Moexipril (Univasc)
Perindopril (Aceon), Quinapril hydrochloride (Accupril), Ramipril (Altace)
Trandolapril (Mavik)
ALPHA BLOCKERS
doxazosin mesylate (Cardura).
prazosin hydrochloride (Minipress).
terazosin hydrochloride (Hytrin).
Nursing Considerations
Assess the Patient BP
Implement plan of care
check the patient Baseline
Pertinent Assessment Findings
Lab values
Chest Xray
symptoms
Patient Education
Educate and demonstrate technique of BP self-monitoring to the patient.
Educate the patient on the need to change lifestyle
Educate the patient about the illness, and how to manage it.
Pathophysiology
Hypertension is a chronic condition marked by an increase in blood pressure, which is measured in terms of systolic blood pressure (higher reading) and diastolic blood pressure (lower reading) during the heart's contraction (systole) (diastole).