Student Nurses Guide to Vascular Disorders: Hypertension

Hypertension (High Blood Pressure) affects approximately 60+ million Americans. For a patient to be considered to have hypertension they must have 2 or 3 separate occasions when their blood pressure is elevated. The systolic pressure will be 140 or greater or diastolic of 90 or greater. Hypertension is considered the silent killer because many people will not even realize that they have high blood pressure due to lack of signs and symptoms of the disease.

Understanding exactly how hypertension can occur: Systolic blood pressure represents the strength of the left ventricle pushing blood into circulation. Diastolic blood pressure represents the relaxation phase between the contractions.

Risk Factors of hypertension include non modifiable (family history, gender and age) and modifiable (smoking, obesity, lack of exercise, hyperlipidemia, emotional stress, diabetes, and hypertension) factors.

There are two types of hypertension:

Primary which carries 90 to 95% of hypertension cases, its possible causes include sedentary lifestyles, improper dieting, obesity, age, hormone influence, heredity and possible alcohol addiction. The treatment of primary hypertension is usually based on the diastolic readings.

Secondary is usually caused by a disease process and with treatment of the underlying cause will usually lower the patient's blood pressure.

Possible side effects of hypertension will include blurred vision, nose bleeds and headache. Untreated high blood pressure can lead to organ damage, left ventricular hypertrophy, MI, TIA's, retinopathy, neuropathy and CVA.

Diagnostic tests of high blood pressure are mainly a blood pressure reading, though to rule out any secondary causes CBC, Renal Scans, CXR, EXG and lipid profiles may be requested.

Medical Management of hypertension falls under two categories non pharmacological and pharmacological. Non-pharmacological means are low fat, low sodium with an increase of potassium, magnesium and calcium diet, weight loss, exercise, quitting smoking, reducing stress and limiting any alcohol intake. Pharmacological means would be the administering of diuretics, angiotension II blockers, ACE inhibitors, Beta-adrenergic blockers and Calcium channel blockers.

Nursing Care and teaching will require the nurse to monitor their patients' blood pressure, observe for any signs of headaches, nose bleeds, blurred vision or dizziness, and encourage eye screenings and physician follow-up appointments and teaching your patient about blood pressure management either by pharmacological needs or non pharmacological needs.

Helping your patient understand high blood pressure can better help them to treat their disorder. Many nurses know that patient teachings can be very hard for a patient who refuses to change their lifestyles to help maintain their health, sometimes it takes the brutal truth to reach these patients by letting them know what other organs can be effected and other complications.