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College of Nursing
NCM501202
A Case Study
of a 44 year old male diagnosed with
Hypertensive
Urgency
Submitted to:
Clinical Instructor
Submitted By:
Student
Several classes of antihypertensive agents are recommended and the choice for the
antihypertensive agent depends on the cause for the hypertensive crisis, the severity of
elevated blood pressure and the patient's usual blood pressure before the hypertensive
crisis. In most cases, the administration of an intravenous sodium nitroprusside
injection which has an almost immediate antihypertensive effect is suitable but in many
cases not readily available. In less urgent cases, oral agents like captopril, clonidine,
labetalol, prazosin, which all have a delayed onset of action by several minutes
compared to sodium nitroprusside, can also be used.
It is also important that the blood pressure is lowered not too abruptly, but smoothly.
The initial goal in hypertensive emergencies is to reduce the pressure by no more than
25% (within minutes to 1 or 2 hours) and then toward a level of 160/100 mm Hg within
2–6 hours. Excessive reductions in pressure may precipitate coronary, cerebral, or renal
ischemia. The diagnosis of a hypertensive emergency is not only based on the absolute
level of blood pressure, but also on the individual regular level of blood pressure before
the hypertensive crisis. Individuals with a history of chronic hypertension may not
tolerate a "normal" blood pressure.
b. Objective of the Study
• Determine the causes, predisposing and precipitating factors that constitute the onset
of the disease process.
• Provide and disseminate important information as teachings to the client and the
significant others to boost the knowing and understanding of the nature of the said
health condition.
• Improve skills and knowledge as health care providers in the clinical area.
a. Data collected via assessment, interviews with the patient and family members.
b. Actual problems for 1 day including appropriate nursing intervention that would be
applied within her stay in the hospital at Polymedic General Hospital.
c. Developing a plan of care that will reduce identified predicaments and complications.
d. Coordinating and delegating interventions within the plan of care to assist the client
to reach maximum functional health.
a. Data collected is limited only to assessment and interview to the patient’s significant
others.
b. The interaction, assessment and care were only limited to a total of 12 hours with
actual nursing intervention done.
II. Heath History
a. Patients Profile
According to his wife, both of the family side has a history of Hypertension.
Abraham Olegario Jr. a 44 yrs old. live in 14th – 21 st. Macasandig, Cagayan de Oro
City. PTA patient suffers nosebleeding, hypertension was noted that it started December
14, 2009 at 1am in the morning. The night before admission patient had experience
sleep difficulties. Consequently, around 3:00 am patient was rushed to the hospital with
the Diagnosis of Hypertensive Urgency.
Chief Complaints
A child at a given stage of development has certain needs and demands, such as the
need of the infant to nurse. Frustration occurs when these needs are not met;
Overindulgence stems from such an ample meeting of these needs that the child is
reluctant to progress beyond the stage. Both frustration and overindulgence lock some
amount of the child's libido permanently into the stage in which they occur; both result
in a fixation. If a child progresses normally through the stages, resolving each conflict
and moving on, then little libido remains invested in each stage of development. But if
he fixates at a particular stage, the method of obtaining satisfaction which characterized
the stage will dominate and affect his adult personality.
Generativity is the concern of establishing and guiding the next generation. Socially-
valued work and disciplines are expressions of generativity. Simply having or wanting
children does not in and of itself achieve generativity.
During middle age the primary developmental task is one of contributing to society
and helping to guide future generations. When a person makes a contribution during
this period, perhaps by raising a family or working toward the betterment of society, a
sense of generativity- a sense of productivity and accomplishment- results. In contrast, a
person who is self-centered and unable or unwilling to help society move forward
develops a feeling of stagnation- a dissatisfaction with the relative lack of productivity.
Swiss biologist and psychologist Jean Piaget (1896-1980) observed his children (and
their process of making sense of the world around them) and eventually developed a
four-stage model of how the mind processes new information encountered. He posited
that children progress through 4 stages and that they all do so in the same order. These
four stages are:
Secondary grades: At the secondary grade, nine (9) developmental tasks have been
similarly identified by Havighurst, which are related mostly to adolescents and adult
behaviors. The list comprises of :
Achieving new and mature relations with age mates of both sexes;
Brand Name:Adalat
Dose/Frequency/Route: 1 capsule OD PO
Brand Name:
Nursing Precaution: Tell your doctor if you have: pre-existing heart disease,
kidney disease, liver disease, high blood pressure, any allergies. Because this
medication contains a large amount of sodium, remind your doctor if you are on a
low sodium diet. This medication should be used only if clearly needed during
pregnancy. Discuss the risks and benefits with your doctor. Since small amounts of
this medication appear in breast milk, consult your doctor before breast-feeding.
V. Pathophysiology
Doenges et al. Nurses pocket guide; nursing diagnoses with intervention: Fourth
Edition
Nursing 2006 Drug Handbook (26th ed.), Philadelphia, J.B. Company, 2006