Hypertension concept

Student’s Name Rasmussen NPR Concept Plan Date: Clinical Manifestations Subjective:States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication. Objective: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs. Possible Medications -Diuretics (thiazide, loop, potassium-sparing, aldosterone receptor blockers) -adrenergic inhibitors -vasodilators -angiotensin inhibitors, renin inhibitors, calcium channel blockers -Examples:Lisinopril, atenolol, hydrochlorothiazide, and metoprolol. -Medications for his anxiety would be antidepressants such as SSRIs like Prozac, Zoloft or celexa. Possible Nursing Diagnosis · Imbalanced nutrition r/t bad eating habits AEB eating fast foods high in fat content. · High blood pressure r/t stress AEB blood pressure of 142/92 and being overweight. · Risk for decreased cardiac output r/t increased afterload, vasoconstriction, myocardial ischemia and ventricular hypertrophy. · Anxiety r/t high stress levels AEB starting a new job, still attending to school, and planning a wedding. Medical Diagnosis Hypertension Patient Data/Risk Factors Risk for stroke, myocardial infarction, vascular disease, and chronic kidney disease Pathophysiology Hypertension is a chronic elevation of blood pressure that causes end organ damage and inadequate tissue perfusion occurring in the heart, brain, peripheral vessels, kidneys, and eyes. It is defined as a persistent systolic BP of 140 or more, and diastolic BP of 90 or more, or current use of antihypertensive medications. Nursing Interventions Monitor and measure blood pressure, auscultate breath sounds and heart tones, observe skin color, moisture, temperature and capillary refill time, note the presence, quality of central and peripheral pulses, maintain restrictions on activities such as rest in bed or chair, reduce anxiety, mo