NCP - Nursing Care Plan for Hypertension
Hypertension
Hypertension is one of the most common worldwide diseases afflicting humans. Because of the associated morbidity and mortality and the cost to society, hypertension is an important public health challenge. Over the past several decades, extensive research, widespread patient education, and a concerted effort on the part of health care professionals have led to decreased mortality and morbidity rates from the multiple organ damage arising from years of untreated hypertension.
Hypertension is the most important modifiable risk factor for coronary heart disease (the leading cause of death in North America), stroke (the third leading cause), congestive heart failure, end-stage renal disease, and peripheral vascular disease. Therefore, health care professionals must not only identify and treat patients with hypertension but also promote a healthy lifestyle and preventive strategies to decrease the prevalence of hypertension in the general population.
Assessment
- Activity / Rest
- Symptoms : weakness, fatigue, shortness of breath, monotonous lifestyle.
- Signs: heart rate increases, changes in heart rhythm, Tachypnoea.
- Circulation
- Symptoms : History of hypertension, atherosclerosis, coronary heart disease / valve and cebrocaskuler disease, episodes of palpitations.
- Signs : Increase in blood pressure, pulse throbbing clear from the carotid, jugular, radial, tachycardia, valvular stenosis murmur, jugular venous distension, pale skin, cyanosis, cold temperature (peripheral vasoconstriction) filling the capillary may be slow / delayed.
- Ego Integrity
- Symptoms : History personality changes, anxiety, multiple stress factors (relationship, financial, work related.
- Signs : Explosion hat mood, anxiety, continue narrowing of attention, tears burst, face muscles tense, breathing heaved, increased speech patterns.
- Elimination
- Symptoms : Impaired renal current or (such as obstruction or a history of kidney disease in the past)
- Food / fluid
- Symptoms : The preferred food that includes foods high in salt, fat and cholesterol, nausea, vomiting and changes in body weight lately (up / down) Historical use of diuretics.
- Alert : normal weight or obesity, edema, glikosuria.
- Neurosensory
- Symptoms : Complaints of dizziness dizziness, throbbing, headache, suboksipital (happens when you wake up and eliminate spontaneously after a few hours) Impaired vision (diplobia, blurred vision, epistaxis).
- Signs : mental status, changes in waking, orientation, pattern / talk content, effects, think the process, decreased hand grip strength.
- Pain / discomfort
- Symptoms : Angina (coronary artery disease / heart involvement), headache.
- Breathing
- Symptoms : dyspnea associated from Tachypnoea, orthopnea, dyspnea, cough with or without the formation of sputum, history of smoking.
- Signs : Respiratory Distress / use of accessory respiratory muscles additional breath sounds wheezing), cyanosis.
- Safe
- Symptoms : Impaired coordination / gait, postural hypotension.
- Learning / Extension
- Symptoms : family risk factors: hypertension, heart disease, diabetes mellitus.
Nursing Diagnosis
Activity intolerance related to general weakness, imbalance between supply and demand of oxygen
Nursing Intervention
Result Criteria :
Clients can participate in activities at the desired / required, reported an increase in tolerance activity can be measured.
Intervention
- Assess the patient's tolerance to activity by using the parameters: pulse frequency 20 per minute above the resting frequency, note the increase in blood pressure, dipsnea, or chest pain, severe fatigue and weakness, sweating, dizziness or fainting. (Parameter shows the patient's physiological response to stress, activities and indicators degrees of influence over work / heart).
- Assess readiness to increase activity eg reduction weakness / fatigue, unstable blood pressure, pulse frequency, increased attention to the activity and self care. (Physiological stability at rest is important to advance the level of individual activities).
- Encourage to promote the activity / tolerance of self-care. (Myocardial oxygen consumption during various activities to increase the amount of oxygen available. Progress activity gradually to prevent sudden increase in cardiac work).
- Provide assistance as needed and encourage the use of a shower chair, brush teeth / hair by sitting and so on. (Energy saving techniques reduce energy use and thus help balance supply and demand of oxygen).
- Encourage the patient to participate in choosing the period of activity. (As the schedule to increase tolerance towards the progress of activities and prevent weakness).