Transcript (hypertension).

SUPERVISED
BY Dr . Essmat Gemeay
Outline:
Interdiction
Definition
Causes
Complication
Risk facture
Sings and symptoms
Diagnostic study
management
Nursing diagnosis
Dash diet
Introduction
When blood pressure is •
high, it starts to damage
the blood vessels, heart,
and kidneys. This can
lead to heart attack,
stroke, and other
problems. High blood
pressure is called a
"silent killer,'' because it
doesn't usually cause
symptoms while it is
causing this damage.
definition
Hypertension: High blood pressure, defined as •
a repeatedly elevated blood pressure exceeding
140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90.
causes
cause. But several things are known to
raise blood pressure, including
1-being very overweight,
2- drinking too much alcohol,
3- having a family history of high blood
pressure,
4-eating too much salt, and getting older.
5-strees
6-decreased vasodilatation of arterioles
related dysfunction of the vascular
endothelium.
7-chronic kidney disease
8-thyroid or parathyroid disease
Your blood pressure may also rise if you •
are not very active, you don't eat
enough potassium and calcium
Sings &symptoms
High blood pressure doesn't usually cause symptoms. Most people •
don't know they have it until they go to the doctor for some other
reason.
Without treatment, high blood pressure can damage the heart, brain, •
kidneys, or eyes. This damage causes problems like coronary artery
disease, stroke, and kidney failure.
Very high blood pressure can cause •
1- headaches, •
2-vision problems, •
3- nausea, and vomiting. Malignant high blood pressure •
(hypertensive crisis), which is blood pressure that rises very fast,
can also cause these symptoms. Malignant high blood pressure is a
medical emergency.
Diagnostic tests
Routine Investigations •
of Hypertensive Patient
should always include.
Chest X-Ray •
ECG •
Echocardiography •
Urinalysis •
Fasting Blood Lipids •
Urea Creatinine and •
Electrolytes
Risk
facture
High blood pressure has many risk factors. Some you can't
•
control. High blood pressure risk factors include:
Age. The risk of high blood pressure increases as you age. •
Through early middle age, high blood pressure is more
common in men. Women are more likely to develop high
blood pressure after menopause.
Race. High blood pressure is particularly common among •
blacks, often developing at an earlier age than it does in
whites. Serious complications, such as stroke and heart
attack, also are more common in blacks.
Family history. •
Being overweight or obese. •
Not being physically active. •
Using tobacco.
•
Too much salt (sodium) in your diet. •
Too little potassium in your diet. •
Too little vitamin D in your diet. •
Drinking too much alcohol. •
Stress. •
Certain chronic conditions. . •
Complications
Uncontrolled high blood •
pressure can lead to:
Damage to your arteries. •
Aneurysm. •
Weakened and narrowed •
blood vessels in your
kidneys
Heart failure. •
A blocked or ruptured blood vessel in your •
brain.
Weakened and narrowed blood vessels in •
your kidneys.
Thickened, narrowed or torn blood vessels in •
the eyes This can result in vision loss.
Metabolic syndrome. •
Trouble with memory or understanding •
How is it treated?
?
1-Treatment depends on how high your blood •
pressure is, whether you have other health problems
such as diabetes, and whether any organs have
already been damaged.
Your doctor will also consider how likely you are to •
.develop other diseases, especially heart disease
You can help lower your blood pressure by making •
healthy changes in your lifestyle. If those lifestyle
changes don't work, you may also need to take pills.
Either way, you will need to control your high blood
.pressure throughout your life
If you have prehypertension, your doctor will likely •
recommend lifestyle changes.
If you have high blood pressure without any •
organ damage or other risk factors for heart
disease, your doctor may recommend that
you take medicine in addition to making
.lifestyle changes
If you have high blood pressure and have •
some organ damage or other risk factors for
heart disease, you may need to try various
combinations of medicines in addition to
.making big lifestyle changes
Most people take more than one pill for high •
blood pressure. Work with your doctor to
find the right pill or combination of pills that
.will cause the fewest side effects
It can be hard to remember to take pills when •
you have no symptoms. But your blood
pressure will go back up if you don't take
your medicine. Make your pill schedule as
simple as you can. Plan times to take them
when you are doing other things, like eating
.a meal or getting ready for bed
Management
Reducing morbidity and mortality is the main •
goal in hypertension management. Blood
pressure reduction is done in a step-wise
approach, often beginning with nonpharmacologic methods that include weight
loss, and dietary and lifestyle modifications.
Should non-pharmacological methods prove •
unsuccessful,
There are four families of drugs from which •
to choose:
1. Diuretics (reduce blood volume by •
inhibiting sodium and water retention)
2. Beta blockers (decrease cardiac output) •
3. Calcium antagonists (induce vasodilation) •
4. ACE inhibitors (decrease peripheral •
vascular resistance)
Medications from each family may be •
combined in order to achieve the desired
pressure reduction
What can you do to prevent high
blood pressure?
There are six lifestyle changes you can make to help prevent high blood
pressure:
Lose extra weight. •
Eat less salt. •
Exercise. •
Manage stress •
Don't smoke •
Practice relaxation or slow, deep breathing •
.
Get 3,500 mg of potassium in your diet every day. Fresh, unprocessed
whole foods have the most potassium. These foods include meat, fish,
nonfat and low-fat dairy products, and many fruits and vegetables.
Follow the DASH eating plan (Dietary Approaches to Stop •
Hypertension). This diet is rich in fruits, vegetables, and low-fat dairy
products and is low in fat
•
•
DASH
Diet
The DASH diet focuses on lowering your •
blood pressure and keeping it under
control. DASH, which stands for Dietary
Approaches to Stop Hypertension, could
lower your blood pressure by a few
points in just two weeks. Over time, your
blood pressure could drop by eight to 14
.points
The DASH diet offers other health •
benefits, too, such as protection against
osteoporosis, cancer, heart disease,
stroke and diabetes. The DASH diet is
especially effective in reducing blood
pressure in older adults. If adopted early
and combined with other lifestyle
changes such as exercising more and
quitting smoking, the DASH diet can
prevent high blood pressure
.)(hypertension
DASH diet
Nursing diagnosis
•
Deficient knowledge
regarding the relation
between the treatment
regimen and control of
the disease process
risk to complication
•
Paling and goal •
Increase knowledge
protective to patient from
any complication
Nursing intervention :
•
The patient needs to •
understand the disease
process and how lifestyle
changes and medications
can control hypertension.
encouraged to patient
for follow up care, all
body systems must be
assessed to detect any
evidence of vascular
damage.
•