1-28
1-28. HYPERTENSION
a. Hypertension (HTN) is defined as persistent levels of blood pressure with the systolic pressure greater than 150 mmHg and the diastolic pressure greater than 90 mmHg. Hypertension is a major cause of heart failure, kidney failure, and stroke.
b. Hypertension is classified as primary and secondary.
(1) Primary (or essential) HTN has no identifiable cause. Increased peripheral resistance is the basic cause for the elevated blood pressure, but the cause of the increased resistance is not understood. Drug therapy is aimed at decreasing the peripheral resistance, thereby lowering the blood pressure.
(2) Secondary HTN is the result of a specific cause or disease process. Kidney disease, adrenal tumors, thyrotoxicosis, and preeclampsia are just a few examples. Therapy is aimed at both treating the elevated pressures and treating the primary cause.
c. Hypertension is called the "silent killer" because it is often symptom free. When symptoms do occur, they are often mistakenly associated with other causes. Symptoms include headache, fatigue, nervousness, irritability, dyspnea, and edema.
d. Continued HTN is damaging to the body. Medical management is aimed at lowering the blood pressure to alleviate the symptoms and to slow the progression of damage to the body.
e. Nursing management involves intensive patient education to help the patient understand the nature of his disease and his role in keeping it under control. The nursing staff should reinforce the importance of the following:
(1) Taking medications as prescribed.
(2) Decreasing the use of tobacco and stimulants, such as caffeine.
(3) Eliminating table salt and avoiding foods high in sodium, such as pickles, potato chips, cold cuts, and processed foods.
(4) Controlling serum cholesterol levels by modifying the diet to avoid saturated fats.
(5) Maintaining a weight appropriate to height and body type.
(6) Altering one's lifestyle to minimize stress.
(7) Following a regular exercise program.
