MODULE 3 CHAPTER 1E CARDIOVASCULAR EMERGENCIES IN HYPERTENSION.
CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.
-
Upload
rodney-summers -
Category
Documents
-
view
222 -
download
2
Transcript of CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.
![Page 1: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/1.jpg)
CARDIOVASCULAR MODULE: HYPERTENSION
Adult Medical-Surgical Nursing
![Page 2: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/2.jpg)
Hypertension: Description
Blood pressure elevated above recognised normal value for age on several separate occasions
![Page 3: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/3.jpg)
Hypertension: Classification
Primary hypertension (90 – 95% of cases)
Secondary hypertension (5 -10%)
![Page 4: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/4.jpg)
Primary Hypertension: Aetiology
Unknown cause but may relate to:Stress AtherosclerosisHyperlipidaemiaFamily historySmokingObesity Diabetes Mellitus (macrovascular)
![Page 5: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/5.jpg)
Secondary Hypertension: Aetiology
Chronic renal disease
![Page 6: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/6.jpg)
Primary Hypertension: Pathophysiology
Interaction of hyperlipidaemia and atherosclerosis
Hypertension contributes to rate at which plaque develops, therefore:
Prolonged hypertension damages blood vessels supplying target organs: heart, kidneys (renal arteries), brain, eyes, peripheral vessels
![Page 7: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/7.jpg)
Secondary Hypertension: Pathophysiology
Chronic renal disease →Increased fluid volumeSodium retentionImbalance of renin - angiotensin system:→Increased vasoconstriction and blood volume
![Page 8: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/8.jpg)
Hypertension: Clinical
Manifestations
May be asymptomaticHeadache often frontalSymptoms related to associated medical
conditions:Cardiac diseaseRenal diseaseStrokeImpaired vision
![Page 9: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/9.jpg)
Hypertension: Diagnosis
BP: serial measurementECGKidney function testsLiver function testsLipid profileBlood glucoseSerum electrolytes
![Page 10: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/10.jpg)
Hypertension: Management
Calcium channel blockersβ blockersAlpha blockersCentral action anti-hypertensivesACE inhibitorsDiuretics
![Page 11: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/11.jpg)
Hypertension: Management
Calcium channel blockers:
Vasodilation (oppose vasospasm) Reduce peripheral constriction, opening up
peripheral circulation to allow redistribution of blood
↓ afterload
![Page 12: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/12.jpg)
Hypertension: Management
β blockers: Slow heart rate (↓ sympathetic action) Vasodilation
Alpha blockers: Peripheral vasodilation (↓ sympathetic action)
![Page 13: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/13.jpg)
Hypertension: Management
Central acting hypotensives:
Reduce sympathetic activity from the level of the medulla (cardiac centre) in the brain
![Page 14: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/14.jpg)
Hypertension: Management
ACE inhibitors:
Block the conversion of Angiotensin I → II
Vasodilation
↓ Na - retaining effect of Aldosterone
![Page 15: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/15.jpg)
Hypertension: Management
Diuretics:
Diuresis relieves pressure of fluid overload
Frusemide also acts as a vasodilator
Aldactone: inhibits Na re-absorption (competes with Aldosterone)
![Page 16: CARDIOVASCULAR MODULE: HYPERTENSION Adult Medical-Surgical Nursing.](https://reader036.fdocuments.us/reader036/viewer/2022062314/56649e615503460f94b5ccd6/html5/thumbnails/16.jpg)
Hypertension: Nursing
Considerations
Health education related to a healthy lifestyle:
Diet (low salt, low fat, high fruit and fibre)Anti-stress relaxation therapyExerciseAvoid smokingRegular BP check/ adherence to medication