Insufficient physiologic or physiological energy to endure or complete required or desired activity. May indicate heart failure, renal or vascular impairment. Observe skin color, moisture, temperature, and capillary refill time. Decreases discomfort and may reduce sympathetic stimulation.
To assess for signs of poor ventricular function or Nursing diagnosis case study of hypertension cardiac failure. If symptoms present, that means the disease process has most likely progressed significantly.
Helps lessen sympathetic stimulation; promotes relaxation. Instruct in relaxation techniques, guided imagery, distractions. Limit the number of visitors and length of stay.
Family history, body weight, sedentary lifestyle, not enough of certain vitamins like Vitamin Dnot enough potassium, too much sodium, or excessive stress can all be a causative factor of primary HTN.
Presence of pallor; cool, moist skin; and delayed capillary refill time may be due to peripheral vasoconstriction or reflect cardiac decompensation and decreased output. Maintain BP within individually acceptable range. African-American patients tend to be less responsive to beta-blockers in general and may require increased dosage or use of another drug monotherapy with a diuretic.
Desired Outome Control blood pressure down to a safe level appropriately. Severe hypertension is classified in the adult as a diastolic pressure elevation to mmHg; progressive diastolic readings above mmHg are considered first accelerated, then malignant very severe.
Note dependent and general edema. Pulses in the legs and feet may be diminished, reflecting effects of vasoconstriction increased systemic vascular resistance [SVR] and venous congestion. Use correct cuff size and accurate technique.
Monitor response to medications to control blood pressure. Can reduce stressful stimuli, produce calming effect, thereby reducing BP. The way it is detected is with a simple blood pressure screening, hopefully done at an annual physical.
Evaluate client reports or evidence of extreme fatigueintolerance for activity, sudden or progressive weight gain, swelling of extremities, and progressive shortness of breath. Your blood pressure will naturally increase during times of stress or pain, but the HTN we are discussing is chronically elevated even during times of relaxation.
Auscultate heart tones and breath sounds. Administer medications as indicated: Secondary HTN comes from an identifiable cause for example, sleep apnea or hyperthyroidism. Please note, if a patient has had chronically elevated blood pressure for years or is in a hypertensive crisisthey may need their blood pressure lowered slowly, as they can have symptoms of hypotension at even normal blood pressure levels.
Presence of crackles, wheezes may indicate pulmonary congestion secondary to developing or chronic heart failure. Primary HTN is caused by a combination of genetic and environmental factors. Systolic hypertension also is an established risk factor for cerebrovascular disease and ischemic heart disease, when diastolic pressure is elevated.
Check laboratory data cardiac markers, complete blood cell count, electrolytesABGs, blood urea nitrogen and creatinine, cardiac enzymes, and cultures, such as blood, wound or secretions. The older a person is, the higher the likelihood of HTN. Implement dietary sodiumfat, and cholesterol restrictions as indicated.
Keep in mind, higher blood pressure for a short period of time is normal. Provide comfort measures back and neck massage, elevation of head. Nursing Interventions Rationale Review clients at risk as noted in Related Factors as well as individuals with conditions that stress the heart.
To identify contributing factors Monitor and record BP. Maintain activity restrictions bedrest or chair rest ; schedule periods of uninterrupted rest; assist patient with self-care activities as needed.
Patients with diabetes should use Corgard and Visken with caution because they can prolong and mask the hypoglycemic effects of insulin.
Many times it has been happening for years undetected. Bounding carotid, jugular, radial, and femoral pulses may be observed and palpated. Measure in both arms and thighs three times, 3—5 min apart while patient is at rest, then sitting, then standing for initial evaluation.
The elderly may require smaller doses because of the potential for bradycardia and hypotension.Start studying HESI Case Studies-Hypertension (Mark Dunn).
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Other possible hypertension nursing care plans: Activity intolerance: frequently occurs as a result of alterations in cardiac output and side effects of medication.
Nutrition: imbalanced, more than body requirements: obesity is often present and a factor in blood pressure control. Whether you are doing case studies on hypothetical patients or real patients you are, in effect, being a detective collecting clues (making an assessment, separating out the abnormal data), then putting the clues together to come up with the problems (determining the patient's problems, determining their nursing diagnoses), and finally solving.
We chose hypertension as a case study topic because regardless of career trajectory, every nurse practitioner will treat patients who display symptoms or have been diagnosed previously with hypertension.
Nursing Case Study I. ASSESSMENT 1. Description of client The patient I am using for my nursing case study is a 53 year old white female. She weighs pounds and her height is 67” tall. She is a well-developed, well nourished female. My patient had been a smoker for ten years; she is currently a 5/5(1).
Risk factors are usually uncontrolled hypertension, connective tissue disorders or chest trauma. Mr. MS has hypertension, but is under control, and .Download