HYPERTENSION BACKGROUND of the STUDY HYPERTENSION a chronic medical condition in which the blood pressure in the arteries is elevated.

. This requires the heart to work harder than normal to circulate blood through the blood vessels. Blood pressure is summarized by two measurements, systolic and diastolic, which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole). Normal blood pressure at rest is within the range of 100140mmHg systolic (top reading) and 60-90mmHg diastolic (bottom reading). High blood pressure is said to be present if it is persistently at or above 140/90 mmHg. SIGNS and SYMPTOMS Tiredness Irregular heartbeat Blurred vision Confusion Nausea Dizziness.

 Headache irregular heartbeat High Blood Pressure CONTRIBUTING FACTORS Age Race 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 PATIENTS DATA Patients Name: Patient SSS Address: Bagumbayan, Paracale Cam. Norte Chief Complain: Body Malaise, High Blood Pressure Age: 52

 Occupation: housewife Civil Status: Married Religion: Roman Catholic Husbands Name: Alex Delos Santos Date of Admission: Aug. 8, 2012 LABORATORY TEST BLOOD CHEMISTRY- provides information about some common serum laboratory test and the patient with CD. ECG- graphic representation of the electrical occurent of the heart. It diagnose dysrrthmias conduction abnormalities, chamber enlargement & myocardial ischemia, injury or infarction. Echocardiography- non invasive ultrasound test that is used to measure the ejection fraction and examine size, shape & motion of cardiac structures. Laboratory tests might also be ordered to identify: Elevated cholesterol in the blood Echocardiogram or electrocardiogram to identify heart disease. Basic metabolic panel and urinalysis or kidney ultrasound to identify kidney disease MANAGEMENT

 Lifestyle Modification Weight reduction if overweight Reduce sodium intake to ? 100 mmol/day: 2.4 g sodium, 6 g salt Increase aerobic exercise: 3045 min/day Limit alcohol intake to ? 1 oz/day Maintain adequate intake of potassium: 90 mmol/day Eat a diet rich in fruits, vegetables, and low-fat dairy products but reduced in saturated and total fat Discontinue tobacco use (reduce CVD risk) PATHOPHYSIOLOGY
NURSING CARE PLAN

NURSING CARE PLAN ASSESSMENT: S- Madali po akong napapagod at maalas mahilo, as stated by the client. O- tiredness -high blood pressure -bipedal edema -body malaise -disturb sleeping pattern -vital signs of : T: 36.5, P: 88, R: 19, BP: 140/90 DIAGNOSIS Activity intolerance may be related to imbalance between oxygen supply and demand, possibly evidenced by expressed concerned, uncertainty, awareness of psychological symptoms, diminished productivity or ability to problem-solve. PLANNING After rendering nursing care interventions, the client will be able to report measurable increase in energy and will participate in desired activities.

INTERVENTIONS: Assessed response in to activity including pre/post v/s. Provided patient with positive atmosphere Encouraged patients participation in planning of activities. Assisted patient in carrying out self care activities. RATIONALE: To have a baseline data. To assist patient deal with manage factors that contribute to fatigue. To provide patient with a sense of control. To improve mobility. To enhance mobility. To maintain body alignment. EVALUATION At the end of the duty the patient cardiac output is adequate. Goal were partially met. COMPLICATIONS: Aortic dissection

 Blood vessel damage (arteriosclerosis) Brain damage Congestive heart failure Chronic kidney disease Heart attack Hypertensive heart disease Peripheral artery disease Pregnancy complications Stroke Vision loss DRUG STUDY: Drug Name: Ambroxol Classification: Mucolytic Adverse Effect: Occasional gastrointestinal side effects may occur but these are almost invariably mild. Indication: Adjuvant therapy inpatients with abnormal, viscid, or inspissated mucous secretions in acute and chronic bronco pulmonary diseases, and inpulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. Also used in diagnostic bronchial studies and as an antidote for acute acetaminophen poisoning.

 Contraindication: There are no absolute contraindication but inpatients with gastric ulceration relative caution should be observed. Assessment & Drug Effects Monitor for S&S of aspiration of excess secretions, and for broncho spasm (unpredictable);withhold drug and notify physician immediately if either occur. Lab tests: Monitor ABGs, pulmonary functions and pulse oximetry as indicated. Have suction apparatus immediately available. Increased volume of respiratory tract fluid may be liberated; suction or endo tracheal aspiration may be necessary to establish and maintain an open airway. Patient & Family Education Report difficulty with clearing the airway or any other respiratory distress.

Mabini Colleges Daet, Camarines Norte

CASE STUDY: HYPERTENSION

Submitted By: Salve Cristina R. Bobiles BSN III-Ladderized

Submitted To: Mrs. Rose lle G. Laganson RN, MAN Clinical Instructor