TRAVA: Intro

Rodilla: Definition

High blood pressure is also referred to as hypertension in some circles. It can result in
serious health consequences, as well as an increased risk of cardiovascular disease, stroke,
and even death in some cases. The force that the blood of a person exerts on the lining of
their blood vessels is referred to as their blood pressure. This pressure is determined by the
resistance of the blood arteries as well as the amount of effort that is required of the heart.

A significant contributor to the development of cardiovascular disease, such as stroke, heart

attack, heart failure, and aneurysm, is high blood pressure, often known as hypertension.
Controlling one's blood pressure is absolutely necessary for maintaining one's health and
lowering one's vulnerability to these potentially fatal illnesses.

Rumbines: Types

Essential hypertension: After ruling out all other potential causes of hypertension, a doctor
can make a diagnosis of this form of the condition if they observe that a patient's blood
pressure has been elevated during three or more visits. Essential hypertension is
characterized by the absence of symptoms in the majority of patients; nonetheless, you may
suffer from recurrent headaches, fatigue, dizziness, or nasal bleeds. Researchers aren't sure
what causes essential hypertension, but they do know that being overweight, smoking,
drinking alcohol, eating poorly, and having a family history of the condition are all factors.

Secondary Hypertension: An irregularity in the arteries that carry blood to the kidneys is the
leading cause of secondary hypertension, and it is also one of the most prevalent causes.
Other causes include an obstruction of the airway when the patient is sleeping, disorders or
tumors of the adrenal glands, hormone imbalances, thyroid disease, and an unhealthy diet
that contains an excessive amount of salt or alcohol. Drugs, including over-the-counter drugs
like ibuprofen (Motrin, Advil, and others), as well as prescription pharmaceuticals like
pseudoephedrine, can cause secondary hypertension (Afrin, Sudafed, and others). The good
news is that hypertension can usually be treated after the underlying cause has been
identified.

Isolated systolic hypertension: Blood pressure is recorded in two numbers: The upper, or
first, number is the systolic pressure, which is the pressure exerted during the heartbeat; the
lower, or second, number is the diastolic pressure, which is the pressure as the heart is
resting between beats. Normal blood pressure is considered under 120/80. With isolated
systolic hypertension, the systolic pressure rises above 140, while the lower number stays
near the normal range, below 90. This type of hypertension is most common in people over
the age of 65 and is caused by the loss of elasticity in the arteries. The systolic pressure is
much more important than the diastolic pressure when it comes to the risk of cardiovascular
disease for an older person.

Malignant hypertension: This hypertension type occurs in only about 1 percent of people
with hypertension. It is more common in younger adults, African-American men, and women
who have pregnancy toxemia. Malignant hypertension occurs when your blood pressure
rises extremely quickly. If your diastolic pressure goes over 130, you may have malignant
hypertension. This is a medical emergency and should be treated in a hospital. Symptoms
include numbness in the arms and legs, blurred vision, confusion, chest pain, and headache.

Resistant hypertension: If your doctor has prescribed three different types of

antihypertensive medications and your blood pressure is still too high, you may have
resistant hypertension. Resistant hypertension may occur in 20 to 30 percent of high blood
pressure cases. Resistant hypertension may have a genetic component and is more
common in people who are older, obese, female, African American, or have an underlying
illness, such as diabetes or kidney disease.

Tueres: Anatomy and Physiology

Nervous system: High blood pressure may play a role in dementia and cognitive decline
over time. Reduced blood flow to the brain causes memory and thinking problems. You
might have trouble remembering or understanding things, or lose focus during conversations.

Skeletal system: High blood pressure can cause bone loss, known as osteoporosis, by
increasing the amount of calcium your body gets rid of when you urinate. Women who have
already gone through menopause are especially at risk.

Respiratory system: Like the brain and heart, arteries in the lungs can be damaged and
blocked. When the artery that carries blood to your lungs gets blocked, it’s called a
pulmonary embolism. This is very serious and requires immediate medical attention. An
aneurysm can also happen in the lung.

Reproductive system: Your sexual organs use extra blood flow during arousal. When high
blood pressure causes blockages to the blood vessels leading to the penis or vagina, sexual
dysfunction may occur.

Urinary system: High blood pressure can damage the larger blood vessels leading to your
kidneys and the smaller vessels inside your kidneys. Over time, this damage prevents the
kidneys from doing their job properly. This is called kidney disease and can lead to kidney
failure.

Trava: Classification

Optimal: Systolic lower than 120 mm Hg and diastolic lower than 80 mm Hg

Normal: Systolic 120-129 mm Hg and/or diastolic 80-84 mm Hg

High normal: Systolic 130-139 mm Hg and/or diastolic 85-89 mm Hg

Grade 1: Systolic 140-159 mm Hg and/or diastolic 90-99 mm Hg

Grade 2: Systolic 160-179 mm Hg or greater and/or diastolic 100-109 mm Hg

Grade 3: Systolic 180 mm Hg or greater and/or diastolic 110 mm Hg or greater

Isolated systolic hypertension: 140 mm Hg or greater and diastolic lower than 90 mm Hg

Rodilla: Causes

The cause of hypertension is often not known. In many cases, it is the result of an underlying
condition.

High blood pressure that is not due to another condition or disease is known as primary or
essential hypertension. If an underlying condition is a cause of increased blood pressure,
doctors call this secondary hypertension.

Primary hypertension can result from multiple factors, including:

- having obesity
- insulin resistance
- high salt intake
- excessive alcohol intake
- having a sedentary lifestyle - smoking

Rumbines: Symptoms

If your blood pressure is exceptionally high, you should be on the lookout for certain
symptoms, some of which include the following:

- Extremely painful headaches

- Nosebleed
- Fatigue or confusion
- Vision problems
- Chest pain
- Having trouble with one's breathing

People sometimes feel that other symptoms may be related to high blood pressure, but they
may not be:

- Dizziness
- Nervousness

- Sweating
- Trouble sleeping - Facial flushing

Tueres: Diagnosis

The best way to diagnose high blood pressure (HBP or hypertension) is to have your blood
pressure measured.

How a blood pressure test works:

 - A blood pressure reading is taken with a pressure cuff (sphygmomanometer).
- During the test, the cuff is placed around the upper arm before being manually or
electronically inflated.
- Once inflated, the cuff compresses the brachial artery, momentarily stopping blood
flow.
- Next, air in the cuff is slowly released while the person performing the measurement
listens with a stethoscope or monitors an electronic readout.

Your blood pressure reading is recorded as two numbers:

- Systolic blood pressure (the top number) — indicates how much pressure your blood
is exerting against your artery walls during heartbeats.
- Diastolic blood pressure (the bottom number) — indicates how much pressure your
blood is exerting against your artery walls while the heart is resting between beats.

Trava: Treatments

Making adjustments to the way you live can assist in the control and management of high
blood pressure. Changes to your lifestyle, such as those listed below, may be recommended
to you by your healthcare professional.

- Consuming a diet low in salt that is excellent for the heart.

- Engaging in consistent physical activity on a regular basis
- Either staying at a healthy weight or dropping some pounds
- Limiting alcohol
- Not smoking
- Maintaining a daily sleep schedule of seven to nine hours

Alterations to one's way of life do not always suffice as a treatment for high blood pressure.
In the event that they are not helpful, your healthcare professional may suggest that you take
medication to lower your blood pressure.

Rodilla: Nursing Interventions and Rationales

Here are the therapeutic nursing interventions for the nursing diagnosis risk for decreased
cardiac output secondary to hypertension.

1. Provide calm, restful surroundings, and minimize environmental activity and noise.
Limit the number of visitors and length of stay.

It helps lessen sympathetic stimulation; promotes relaxation.

2. Maintain activity restrictions (bedrest or chair rest); schedule uninterrupted rest

periods; assist patients with self-care activities as needed.
Lessens physical stress and tension that affect blood pressure and the course of
hypertension.

3. Provide comfort measures (back and neck massage, the elevation of head). Decreases
discomfort and may reduce sympathetic stimulation.
4. Instruct in relaxation techniques, guided imagery, and distractions.
Can reduce stressful stimuli, and produce a calming effect, thereby reducing BP.

5. Monitor response to medications to control blood pressure.

Response to medication therapy (typically diuretics, ACE inhibitors, vascular smooth muscle
relaxants, beta and calcium channel blockers) depends on individual and synergistic effects
of the drugs. Because of adverse effects, pharmacological interactions, and patient
motivation, use the fewest drugs possible.

6. Administer medications as indicated:

- Thiazide diuretics: Diuretics are first-line treatments for uncomplicated stage I or II

hypertension and may be taken alone or with beta-blockers to lower BP in people
with normal renal function. By decreasing fluid retention, these diuretics may
minimize the risk of strokes and heart failure.

- Loop diuretics: By decreasing salt and chloride reabsorption, these medicines

cause substantial diuresis and are effective antihypertensives, especially in thiazide-
resistant or renal-impaired patients.

- Potassium-sparing diuretics: May be given in combination with a thiazide diuretic

to minimize potassium loss.

- Alpha, beta, or centrally acting adrenergic antagonists: Beta-blockers treat

ischemia, cardiogenic hypertension, supraventricular arrhythmias, angina, and
hypertensive cardiomyopathy. They lower TPR, cardiac output, sympathetic activity,
and renin. Corgard and Visken hide insulin effects. Bradycardia and hypotension
lower dosages. Blacks may need stronger beta-blockers (monotherapy with a
diuretic).

- Calcium channel antagonists: May be necessary to treat severe hypertension

when a combination of a diuretic and a sympathetic inhibitor does not sufficiently
control BP.

- Adrenergic neuron blockers: Reduce arterial and venous constriction activity at the
sympathetic nerve endings.

- Direct-acting oral vasodilators: Action is to relax vascular smooth muscle, thereby

reducing vascular resistance.

- Direct-acting parenteral vasodilators: These are given intravenously for the

management of hypertensive emergencies.

- Angiotensin-converting enzyme (ACE) inhibitors: When other methods fail

to regulate BP or when CHF or diabetes are present, a sympathetic inhibitor may be
needed for its cumulative effect.

7. Implement dietary sodium, fat, and cholesterol restrictions as indicated.

These restrictions can help manage fluid retention and, with the associated hypertensive
response, decrease myocardial workload.
8. Prepare for surgery when indicated.
When hypertension is due to pheochromocytoma, removal of the tumor will correct the
condition.