HYPERTENSION

GROUP 2-2 A AND B

 ACKNOWLEDGEMENT
The group would like to express our heartfelt gratitude to our Clinical Instructor, Mr.
FERDINAND GALACIO, RN, for the continuous support and for guiding us during our
Clinical Rotation. The completion of this study could not have been possible without
his help, guidance and support. We are extremely grateful to work and study under
his guidance.

To our dear parents, family, and friends, we would like to thank you for relentless love,
unending support, prayers, and understanding until the completion of this family
case study. To our Almighty God, we thank Him for all the learnings, strength and
wisdom that He has given us for without Him we are nothing. To the members who
whole-heartedly shared their time, talents, effort, skills and ample resources for the
completion of the study. All the sleepless nights are all worth it. Your hard work is
appreciated. Lasty to all the people that are not mentioned we are thankful to you all
that offered us a helping hand in conducting this case study.
IDENTIFICATION
 INTRODUCTION
Essential hypertension, also known as
primary or idiopathic hypertension, is a
chronic medical condition characterized
by persistently elevated blood pressure
levels. Unlike secondary hypertension,
which can be attributed to an underlying
cause such as kidney disease or
hormonal disorders, essential
hypertension often has no identifiable
cause. It is the most common form of
hypertension, affecting a significant
portion of the population worldwide.
BACKGROUND/HISTORY
Patient F a 52 yearso
g age, Filipino male,
Roman Catholic. He who is a
was born on Februar
a non-smoker and n y 13, 1971,
on-drinker. The patie
and his family are cu nce
rrently residing in pu
cabbage, lim extens rok
ion Digos city. Patien
medical history of hy t F has a
pertension and diab
mellitus which is con etes
nected to her presen
t illness.
 HISTORY OF THE PRESENT ILLNESS
Admitted this 52 yr. old male came due to increase BP, went to ER. BP pulse
and was elevated at 180/100, hence the admission was dizziness, Patient R
chemistry result of his creatinine is 69.31 umol/L it was lower from the
normal rate of male 71-115 umol/L her Uric acid is 405.74 umol/L normal
range 208-428 and SGPT 69.08 which is higher than normal range 0-45.
This test result prove that the patient has many complications, he is also at
risk of kidney problem and his high SGPT (ALT) level could indicate liver
damage or injury, this are the caused of the patient diagnose for essential
hypertension.
 PATIENT R IS A WORKER OF
NATIONAL SUPPLY OFFICE AND
RESIDED AT PUROK CABBAGE, LIM
EXTENSION DIGOS CITY. HIS WIFE
WORKS AS A HOUSEWIFE . PATIENT

SOCIO-
R AND HIS FAMILY ARE LESS
FORTUNATE PEOPLE, BUT THEY ARE

ECONOMIC DOING THEIR BEST TO SURVIVE.

THEIR FAMILY BELONG TO A LOWER
BACKGROUND MIDDLE CLASS WITH A MONTHLY
OF 32,000.
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY

MOVEMENTS (SYSTOLIC AND DIASTOLIC MOVEMENT), IT PUSHES THE BLOOD THROUGH THE ARTERIES TO
DISTRIBUTE IT THROUGHOUT OUR BODY. THE HUMAN HEART IS LOCATED IN THE CENTER OF OUR CHEST
CAVITY, RIGHT BETWEEN OUR LUNGS.
THE HEART WALL CONSISTS OF THREE LAYERS:
THE ENDOCARDIUM (THE INTERIOR LAYER OF THE HEART)
MYOCARDIUM (THE MIDDLE LAYER OF THE HEART)
EPICARDIUM (THE THICKEST LAYER OF THE HEART).

THE HEART’S MAIN FUNCTION IS TO PUMP BLOOD

THROUGHOUT THE BODY. IT ALSO SUPPLIES OXYGEN AND
NUTRIENTS TO THE TISSUES AND REMOVES CARBON
DIOXIDE AND WASTE FROM THE BLOOD. FURTHERMORE,
THE HEART HELPS TO MAINTAIN ADEQUATE BLOOD
PRESSURE THROUGHOUT THE BODY
 ETIOLOGY

Essential (primary) hypertension occurs when you

have abnormally high blood pressure that’s not
the result of a medical condition. This form of high
blood pressure is often due to obesity, family
history and an unhealthy diet. The condition is
reversible with medications and lifestyle changes.
SYMPTOMATOLOGY
Checking your blood pressure is the best way to know if you have high blood pressure. If
hypertension isn’t treated, it can cause other health conditions like kidney disease, heart
disease and stroke.

People with very high blood pressure (usually 180/120 or higher) can experience symptoms
including:
severe headaches
chest pain
dizziness
difficulty breathing
nausea
vomiting
blurred vision or other vision changes
anxiety
confusion
buzzing in the ears
nosebleeds
abnormal heart rhythm

If you are experiencing any of these symptoms and a high blood pressure, seek care
PATHOPHYSIOLOGY
LAB FINDING
LAB FINDING
LAB FINDING
LAB FINDING
LAB FINDING
LAB FINDING
 NURSING THEORY

OREM'S SELF-CARE THEORY IS ONE OF THE MOST

IMPORTANT THEORIES ON SELF-CARE EDUCATION. THERE
ARE THREE TYPES OF SELF-CARE REQUISITES INCLUDING
UNIVERSAL SELF-CARE REQUISITES, DEVELOPMENTAL
SELF-CARE REQUISITES, AND HEALTH DEVIATION SELF-CARE REQUISITES.

OREM’S SELF-CARE DEFICIT THEORY IMPORTANT IN EXAMINE OREM’S THEORY

SELF-CARE
SELF-CARE AGENCY
SELF-CARE DEMAND
 NURSING
ASSESSMENT
1.Monitor Blood Pressure: The nurse should regularly monitor the patient’s
blood pressure to assess for changes in blood pressure levels and adjust
medication dosages as needed.
2.Medication Management: The nurse should educate the patient on the
importance of medication compliance and the potential side effects of
medication. The nurse should also monitor the patient for adverse reactions to
medications.
3.Lifestyle Changes: The nurse should educate the patient on lifestyle changes
such as dietary approaches to stop hypertension (DASH) guidelines, exercise,
and stress management techniques.
4.Stress Management: The nurse should teach the patient stress
management techniques such as deep breathing exercises, meditation, and
progressive muscle relaxation.
 5.EDUCATION: THE NURSE SHOULD EDUCATE THE PATIENT ON HYPERTENSION, POTENTIAL
COMPLICATIONS, AND THE IMPORTANCE OF REGULAR MEDICAL CHECK-UPS.
6.HOME BLOOD PRESSURE MONITORING: THE NURSE SHOULD TEACH THE PATIENT HOW TO
MONITOR THEIR BLOOD PRESSURE AT HOME AND PROVIDE THEM WITH A BLOOD PRESSURE
CUFF.
7.RISK FACTOR IDENTIFICATION: THE NURSE SHOULD ASSESS THE PATIENT FOR RISK FACTORS
SUCH AS OBESITY, SMOKING, AND A SEDENTARY LIFESTYLE AND EDUCATE THE PATIENT ON THE
IMPORTANCE OF MANAGING THESE RISK FACTORS.
8.NUTRITIONAL COUNSELING: THE NURSE SHOULD PROVIDE THE PATIENT WITH NUTRITIONAL
COUNSELING AND EDUCATION ON THE DASH GUIDELINES, INCLUDING REDUCING SODIUM
INTAKE. 9.MEDICATION ADHERENCE: THE NURSE SHOULD ASSESS THE PATIENT’S ADHERENCE TO
MEDICATION AND PROVIDE EDUCATION ON THE IMPORTANCE OF TAKING MEDICATION AS
PRESCRIBED.
10.REFERRAL TO A SPECIALIST: THE NURSE SHOULD REFER THE PATIENT TO A SPECIALIST, SUCH
AS A CARDIOLOGIST OR AN ENDOCRINOLOGIST, FOR FURTHER EVALUATION AND MANAGEMENT.
 DRUG STUDY
Generic name : Amlodipine Brand name: Norvasc Classification: Antihypertensive
Action:Binds to dihydropyridine and non dihydropyridine cell membrane receptor
site on myocardial and vascular smooth-muscle cells and inhibits influx of
extracellular calcium ions across slow calcium channels. This decreases
intracellular calcium level, inhibiting smooth-muscle cell contractions and relaxing
coronary and vascular smooth muscles, decreasing peripheral vascular
resistance, and reducing systolic and diastolic blood pressure.Decreased
peripheral vascular resistance also decreases myocardial workload,oxygen
demand and possibly agina.
Indication: management of hypertension,chronic stable angina,
vasospastic(prinzmetal and variant) agina
Contradiction: hypersensitivity to amlodipine or its components.Hepatic
impairment,aortic stenosis, hypertrophic cardiomyopathy with outflow tract
obstruction.
ROUTE: PO
DOSAGE: 10MG
TIME INTERVAL: ONCE DAILY

DRUG INTERACTIONS: AMLODIPINE HAS BEEN SAFELY ADMINISTERED WITH THIAZIDE

DIURETICS, BETA-ADRENOCEPTOR BLOCKING DRUGS, ANGIOTENSIN-CONVERTING
ENZYME INHIBITORS, LONG-ACTING NITRATE, SUBLINGUAL GLYCERYL TRINITRATE,
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS, ANTIBIOTICS, AND ORAL
HYPOGLYCAEMIC AGENTS.

ADVERSE EFFECT:
•SIGNIFICANT: SYMPTOMATIC HYPOTENSION, PERIPHERAL OEDEMA.
•CARDIAC DISORDERS: PALPITATIONS.
•EYE DISORDERS: VISUAL DISTURBANCE.
 GASTROINTESTINAL DISORDERS: ABDOMINAL PAIN, NAUSEA, DYSPEPSIA, DIARRHOEA, CONSTIPATION.
•GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS: OEDEMA, FATIGUE, ASTHENIA.
•MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS: ANKLE SWELLING, MUSCLE CRAMPS.
•NERVOUS SYSTEM DISORDERS: SOMNOLENCE, DIZZINESS, HEADACHE.
•RESPIRATORY, THORACIC AND MEDIASTINAL DISORDERS: DYSPNOEA.
•VASCULAR DISORDERS: FLUSHING.

NURSING RESPONSIBILITIES:
•MONITOR VITAL SIGN
•OBTAIN HISTORY OF PATIENT’S PREVIOUS
MEDICATION TO AVOID INTERACTIONS.
•MONITOR BLOOD PRESSURE WHILE ADJUSTING DOSAGE,ESPECIALLY IN PATIENTS WITH HEART FAILURE OR
SEVERE AORTIC STENOSIS.
•EDUCATE TO TAKE MISSED DOSE AS SOON AS REMEMBERED AND NEXT DOSE IN 24HOURS.
•EDUCATE TO IMMEDIATELY NOTIFY PRESCRIBER OF DIZZINESS, ARM OR LEG SWELLING, DIFFICULTY
BREATHING, HIVES, ORRASH.
•TAKE AMLODIPINE
NCP
NCP
HEALTH TEACHING
1. BLOOD PRESSURE MONITORING: TEACH THE PATIENT HOW TO MONITOR THEIR BLOOD
PRESSURE REGULARLY AT HOME USING A RELIABLE BLOOD PRESSURE MONITOR. EMPHASIZE
THE IMPORTANCE OF TRACKING AND RECORDING READINGS.

2. HEALTHY DIET: ENCOURAGE A WELL-BALANCED, LOW-SODIUM DIET RICH IN FRUITS,

VEGETABLES, WHOLE GRAINS, AND LEAN PROTEINS. DISCUSS THE DASH (DIETARY
APPROACHES TO STOP HYPERTENSION) DIET AS A GUIDELINE.

3. WEIGHT MANAGEMENT: PROVIDE GUIDANCE ON ACHIEVING AND MAINTAINING A HEALTHY

WEIGHT THROUGH A COMBINATION OF A BALANCED DIET AND REGULAR PHYSICAL ACTIVITY.

4. REGULAR EXERCISE: RECOMMEND AT LEAST 150 MINUTES OF MODERATE-INTENSITY

AEROBIC EXERCISE PER WEEK. ACTIVITIES LIKE BRISK WALKING, SWIMMING, OR CYCLING CAN
BE BENEFICIAL.
5. STRESS MANAGEMENT: DISCUSS STRESS REDUCTION TECHNIQUES SUCH AS DEEP BREATHING EXERCISES,
MEDITATION, YOGA, OR OTHER RELAXATION METHODS TO HELP MANAGE STRESS, WHICH CAN CONTRIBUTE TO
HYPERTENSION.

6. LIMIT ALCOHOL INTAKE: ADVISE MODERATION IN ALCOHOL CONSUMPTION. FOR WOMEN, THIS GENERALLY MEANS
UP TO ONE DRINK PER DAY, AND FOR MEN, UP TO TWO DRINKS PER DAY.

7. TOBACCO CESSATION: IF THE PATIENT SMOKES, PROVIDE RESOURCES AND SUPPORT FOR SMOKING CESSATION.
SMOKING CAN RAISE BLOOD PRESSURE AND INCREASE THE RISK OF CARDIOVASCULAR COMPLICATIONS.

8. MEDICATION ADHERENCE: IF PRESCRIBED MEDICATION, STRESS THE IMPORTANCE OF TAKING IT AS DIRECTED BY

THE HEALTHCARE PROVIDER. DISCUSS POTENTIAL SIDE EFFECTS AND THE SIGNIFICANCE OF REGULAR FOLLOW-UP
APPOINTMENTS.

9. REGULAR CHECK-UPS: EMPHASIZE THE NEED FOR REGULAR MEDICAL CHECK-UPS TO MONITOR BLOOD PRESSURE,
ASSESS OVERALL HEALTH, AND ADJUST THE TREATMENT PLAN IF NECESSARY.

10. EDUCATION ON HYPERTENSION: ENSURE THE PATIENT UNDERSTANDS THE NATURE OF ESSENTIAL HYPERTENSION,
ITS POTENTIAL CONSEQUENCES, AND THE ROLE OF LIFESTYLE CHANGES AND MEDICATIONS IN MANAGING THE
CONDITION.
1. MEDICATION MANAGEMENT:
DISCHARGE PLAN
- ENSURE THE PATIENT UNDERSTANDS THE PRESCRIBED MEDICATIONS, INCLUDING NAMES, DOSAGES, AND FREQUENCY.
- PROVIDE DETAILED INSTRUCTIONS ON HOW TO TAKE THE MEDICATIONS, POTENTIAL SIDE EFFECTS, AND THE
IMPORTANCE OF ADHERENCE.
- DISCUSS THE SIGNIFICANCE OF NOT DISCONTINUING MEDICATIONS WITHOUT CONSULTING A HEALTHCARE PROVIDER.

2. LIFESTYLE MODIFICATIONS:
- REINFORCE THE IMPORTANCE OF MAINTAINING A HEART-HEALTHY DIET, INCLUDING THE REDUCTION OF SODIUM
INTAKE.
- ENCOURAGE REGULAR PHYSICAL ACTIVITY, EMPHASIZING AT LEAST 150 MINUTES OF MODERATE-INTENSITY EXERCISE
PER WEEK.
- DISCUSS WEIGHT MANAGEMENT STRATEGIES AND OFFER SUPPORT FOR ACHIEVING AND MAINTAINING A HEALTHY
WEIGHT.
- ADVISE ON STRESS MANAGEMENT TECHNIQUES.

3. HOME BLOOD PRESSURE MONITORING:

- INSTRUCT THE PATIENT ON HOW TO MONITOR BLOOD PRESSURE AT HOME USING A RELIABLE BLOOD PRESSURE
MONITOR.
- EMPHASIZE THE IMPORTANCE OF REGULAR MONITORING AND KEEPING A RECORD OF READINGS.
- PROVIDE GUIDELINES ON WHEN TO CONTACT HEALTHCARE PROVIDERS BASED ON SPECIFIC BLOOD PRESSURE
READINGS OR SYMPTOMS.
 DISCHARGE PLAN
4. FOLLOW-UP APPOINTMENTS:
- SCHEDULE AND EMPHASIZE THE IMPORTANCE OF REGULAR FOLLOW-UP APPOINTMENTS
WITH HEALTHCARE PROVIDERS FOR MONITORING AND ADJUSTMENT OF THE TREATMENT PLAN.
- PROVIDE CONTACT INFORMATION FOR SCHEDULING APPOINTMENTS AND REPORTING
CONCERNS.

5. EDUCATION AND RESOURCES:

- OFFER EDUCATIONAL MATERIALS ON ESSENTIAL HYPERTENSION, ITS POTENTIAL
COMPLICATIONS, AND THE ROLE OF LIFESTYLE MODIFICATIONS AND MEDICATIONS.
- PROVIDE INFORMATION ABOUT LOCAL RESOURCES, SUPPORT GROUPS, OR EDUCATIONAL
PROGRAMS RELATED TO HYPERTENSION.

6. EMERGENCY ACTION PLAN:

- DISCUSS SYMPTOMS THAT MAY INDICATE A HYPERTENSIVE CRISIS AND PROVIDE CLEAR
INSTRUCTIONS ON WHAT ACTIONS TO TAKE IN CASE OF AN EMERGENCY.
- ENSURE THE PATIENT KNOWS WHEN TO SEEK IMMEDIATE MEDICAL ATTENTION.
 DISCHARGE PLAN
7. TOBACCO AND ALCOHOL CESSATION:
- IF APPLICABLE, PROVIDE RESOURCES AND SUPPORT FOR SMOKING CESSATION.
- REINFORCE MODERATION OR CESSATION OF ALCOHOL INTAKE, AS APPROPRIATE.

8. PATIENT AND FAMILY EDUCATION:

- EDUCATE FAMILY MEMBERS OR CAREGIVERS ABOUT THE PATIENT'S CONDITION,
MEDICATIONS, AND THE IMPORTANCE OF SUPPORTING LIFESTYLE CHANGES.

9. COMMUNITY RESOURCES:
- CONNECT THE PATIENT WITH COMMUNITY RESOURCES, SUCH AS NUTRITIONISTS, EXERCISE
PROGRAMS, OR SUPPORT GROUPS, TO ENHANCE THEIR ABILITY TO MANAGE HYPERTENSION
EFFECTIVELY.

10. DOCUMENTATION:
- DOCUMENT THE DISCHARGE PLAN DETAILS IN THE PATIENT'S RECORDS AND PROVIDE A
WRITTEN SUMMARY FOR THE PATIENT TO REFERENCE AT HOME.
 PROGNOSIS
Hypertension (high blood pressure) is when the
pressure in your blood vessels is too high. It is
common but can be serious if not treated.
People with high blood pressure may not feel
symptoms. The only way to know is to get your
blood pressure checked. Lifestyle changes like
eating a healthier diet, quitting tobacco and
being more active can help lower blood
pressure. Some people may still need to take
medicines. Checking your blood pressure is the
best way to know if you have high blood
pressure. If hypertension isn’t treated, it can
cause other health conditions like kidney
disease, heart disease and stroke.
 EVALUATION
In evaluating the patient who is diagnosed with
hypertension. We set goals for the patient to
maintain his blood pressure within the normal
range. Which includes medications being taken
on time, exercised regularly, eat healthy and
nutritious foods and regularly monitoring his
blood pressure. Also, health teachings are being
discussed with the patient to prevent any
serious complications due to hypertension if not
being cured. The patient is very willing to
change his lifestyles and followed the proper
way of maintaining his blood pressure within the
normal range. His efforts in lowering his blood
pressure are commendable.
 AN ALTERNATIVE THE MAJOR NURSING ACTIONS
IDENTIFIED, THOSE ASSOCIATED WITH
INSTRUCTIONAL PRACTICE AND EMPLOYED AS THE
PRIMARY INSTRUMENT FOR HEALTH PROMOTION
BY NURSES WERE PARTICULARLY SIGNIFICANT.
HEALTH EDUCATION IS A STRATEGY CHANGE IN
CARE MODELS THAT IS UTILIZED TO IMPROVE THE
POPULATION'S QUALITY OF HEALTH AND LIFE VIA
INCREASED AWARENESS REGARDING HEALTH AND
DISEASE. INDIVIDUAL AND CONTEXTUALIZED
HEALTH PROMOTION MEASURES IN ANTI
COAGULANT DRUGS THAT WORKS TO BLOOD

IMPLICATION PRESSURE DOWN TO SAFER LEVELS,HYPERTENSION

RANKS AMONG THE MOST COMMON CHRONIC

OF THE MEDICAL CONDITION CHARACTERIZED BY A

PERSISTENT ELEVATION IN ARTERIAL PRESSURE .
STUDY
THANK YOU