Blood Pressure

Hypertension is also called high blood pressure. It is a condition where the blood is pumping harder around the body and the arteries have high blood pressure constantly. Arteriosclerosis is when the artery walls harden and the blood has to be pushed harder to get through the arteries. How are they often related? These two conditions are related because when someone gets arteriosclerosis it will lead to getting hypertension.

With the arterial walls hardening, the heart has to ump faster and harder to get the blood through causing the hypertension. Why is hypertension called the ‘silent killer? Hypertension is called the silent killer because most people do not get any symptoms and could eventually leads to stroke, heart attack, heart failure and kidney failure. Name three changes in your lifestyle that might help to prevent cardiovascular disease in old age. Three things I can do to prevent cardiovascular disease is; No smoking Having a healthy diet Exercising Undesirable clot formation can occur as a result of endothelial damage due to arteriosclerosis.

How does the body form undesirable clots within intact blood vessels? Blood has three factors for it to clot. The three factors are; a hyperbolically state which means the blood can clot quickly because of increased platelets or thick blood due to hydration. Vessel incongruity, meaning there is a disruption in the smooth inner lining in the blood vessel. This can happen because of smoking or naturally due to bends and manipulation of blood vessels over a lifetime. The last thing blood needs to clot is blood stasis which is blood pooling and standing still.

When blood is going through a vessel it is called a parabolic refill. This means that the blood in the middle of the vessel is moving the fastest and the blood on the walls is pretty much at a standstill. This will make the blood clot if it is hyperbolically, not moving, and is contact with a damaged vessel or rough surface. Activity 5. 2: At handover you are told a patient/client is cyanic. What would you expect to observe? Occasions is a sign of tissue hypoxia. Define what this means and name three conditions where this could occur: I would be observing my patient’s skin to see if there are any changes in the color.

Occasions is where the skin turns a bluish or rupee color because the tissue near the skin is low on oxygen. Tissue hypoxia is one part of the body that is not getting anywhere near the correct amount of oxygen supply. Occasions is a late sign of hypoxia but is not always accurate. Three conditions where this could occur is emphysema, chronic bronchitis and can also lead to heart failure and death. Activity 5. 3: Describe the difference between a tracheotomy and endothelial intubations. A tracheotomy is a surgically made incision in the neck into the trachea. This hole is made because there is something blocking the airways.

An endothelial intubations is a medical procedure where a tube gets inserted into the trachea through the mouth or nose. The difference between the two procedures is, a tracheotomy has a surgical incision and an intubations is being placed into the throat with no incisions. Activity 5. 4: Why will a patient who is anemic complain of shortness of breath? People with anemia are complaining of shortness of breath because the body is making fewer red blood cells. Because there is fewer red blood cells, there is fewer oxygen being carried around the body and also less carbon dioxide being removed, therefore causing the shortness of breath.

Activity 5. 5: Paul is 15 years old, he has a known allergy to cashew nuts, but can eat all other types of nuts with no ill effect. He is eating a chocolate bar that contains mixed nuts. He complained of tingling around the mouth and lips, developed a rapid swelling of the face, and experienced difficulty breathing and inspiration, and within a few minutes had an audible wheeze on expiration. The initial diagnosis was asthma, but Paul was also treated for an allergic reaction. What type of allergic reaction is suspected? Paul is suspected of having nonphysical.

Because of how difficult it is for Paul to breath this is also suspected. Nonphysical has a more severe effect on the lungs for people who have asthma. Why has this caused problems with breathing? When you have go into unpatriotic shock, your body will start showing signs within minutes. One sign is the throat swelling up. Due to the throat swelling up it would be quite difficult to breath already but with Paul having asthma, the lungs are being effected quite severely. Activity 6. 1 : Simon is 14 years old, admitted with severe abdominal pain and fever, diagnosed with severe appendicitis.

If he is left untreated what would the result be? If you let appendicitis go untreated it will get worse and rupture, causing organ failure and possibly death. Activity 6. 2: Why does a lack of fiber in the diet encourage the formation of divestiture? Fiber helps prevent constipation. Having a lack of fiber in your diet means that stools will be a lot fuller and harder to pass, causing a strain in the bowel. Straining can cause increased pressure in the colon and this will encourage the formation of divestiture. Activity 6. 3: Explain why obstruction in the common bile duct causes interference with the congestion of some foods?

The bile firstly goes into the liver and then gets broken down by bile salts. The bile is then on the Journey to the gall bladder, passing through the bile ducts. If there is a blockage in the bile ducts, all the bile stays in the liver and will not be able to reach the gall bladder which will then lead to the bile not reaching the small intestine and will not be able to be digested properly. Activity 6. 4: What nursing observations of their skin, faces and urine would support the diagnosis of an obstructed bile duct? Where would these observations be recorded?

Observing the patient’s skin to see if it has gone yellow Induce) is a sign of an obstructed bile duct. Also looking at their urine to see if it is any darker or pale colored stools. These observations would be recorded in their progress notes. Also on fluid balance charts, bowel charts, urinalysis and care plans. Activity 9. 1: Explain why someone who is hemorrhaging. Ii has falling symptoms: blood pressure/volume will have a decreased urine output. (Refer to your Marine textbook and the chapter on the urinary system for a flow chart that will assist you to answer the question. )

When you are hemorrhaging you are losing a lot of blood and in a very short time. Because pressure has dropped, the kidneys are not getting enough blood pumped into them, this is causing the urine output to decrease. The fluid is going other places in the body instead of leaving through the urine.

Blood force per unit area refers to the measuring of force that is applied to the walls of the arterias as the bosom pumps blood through the organic structure. The force per unit area is determined by the force and the sum of blood pumped, and the size and flexibleness of the arterias. High blood force per unit area, besides known as Hypertension, is considered as above 120/80 mmHg ( PubMed Health, 2011 )

Pathophysiology

Arterial blood force per unit area is a merchandise of cardiac end product and systemic vascular opposition. A alteration in the vascular wall thickness affects the elaboration of peripheral vascular opposition in hypertensive patients. This consequences in the contemplation of moving ridges back to the aorta and hence increasing the systolic blood force per unit area ( Medscape, 2011 ) . Although 90 % of high blood pressure instances, the cause is non truly known ( Moser, p.11 ) , harmonizing to the Australian Institute of Health and Welfare ( AIHW ) , the causes of high blood force per unit area are both biomedical and lifestyle oriented. Major causes include ; being overweight, dietetic salt consumption, and nutrition forms which involve low consumption of fruit and veggies and an high consumption of saturated fat ( Australian Institue of Health and Welfare,2010 ) . Although most of the clip there are no marks and symptoms, such may happen ; confusion, ear noise or buzzing, weariness, concern, irregular pulse, epistaxis, vision alterations. These marks are known as marks of complication or perilously high blood force per unit area called malignant high blood pressure

Nursing Appraisal

As a patient is admitted to the infirmary, it is critical to execute a nursing appraisal on admittance to garner baseline readings of the patient. The Systems Approach Framework was used to buttockss Mr Nicholas Manners from caput to toe in a mode of subjective and nonsubjective informations. The classs used are as follows ; Central Nervous System, Cardiovascular System, Respiratory System, Gastrointestinal Tract, Renal System, Integumentary System and Metabolic System.

CNS – patient is able to communicate-states he has a concern, assess motion of limbs, esthesis to fringes and trouble if any.

CVS – HR 95, BP 160/90, assess capillary refill, patient is red in the face – assess circulation of the remainder of the organic structure including warmth and coloring material.

RESP. – RR 19 beats per minute, SaO2 97 % on room air, auscultate his chest- listen for abnormalcies in the lungs as he is a tobacco user, measure his work of external respiration.

GIT – farther buttocks appetency and eating wonts, auscultate for intestine sounds, buttocks and record intestine direction.

RENAL – buttocks input and end product and record observations if needed, utilizing a unstable balance chart.

INTEGUMENTARY – buttocks tegument for cicatrixs, waterlessness, integral and skin turgor.

METABOLIC – buttocks Hb, BGL and liver map through a blood trial.

Education and Psychosocial support

Education and support that can be offered to Nicholas to help him in deriving more information and support for his Hypertension include:

Dieticians which Nicholas can be referred to during his stay in infirmary, to educate him about a healthy diet and besides supply support.

Social worker to supply support for Nicholas and his household if needed.

Information brochures can be retreived from the infirmary, to educate Nicholas on Hypertension.

Web sites such as Better Health Channel, Hypertension Education Foundation and the Heart Foundation, all provide instruction and information about support for patients about high blood pressure.

Diagnostic Trials

Diagnostic trials that will help with the appraisal and direction of Nicholas include:

Electrocardiogram ( ECG ) – This trial determines if the bosom has sustained nay harm due to untreated high blood pressure ( Cardio Connection, n.d ) . This trial assists with the direction of Nicholas ‘ high blood pressure by supplying moving ridges of the electrical current of the bosom.

Urinalysis – This trial is used to test the causes of high blood pressure and expression for any harm to the kidneys as a consequence of untreated high blood pressure ( Cardio Connection, n.d ) . The trial assists with the direction to derive information about the wellness of Nicholas ‘ kidneys.

Blood Glucose – This trial determines the sugar degrees in the blood and screens for secondary causes of high blood pressure and the hazard factors involved with more accelerated diseases such as diabetes. Both diabetes and high blood pressure are associated with the rapid patterned advance of arterial sclerosis and harm to the kidneys ( Cardio Connection, n.d ) . This assists in keeping a stabile sugar degree of the blood to cut down the hazard of harm to the kidneys.

Serum K – This trial looks for a treatable cause of high blood force per unit area and finding the baseline degree prior to utilizing medical specialty for intervention ( Cardio Connection, n.d ) . This assists in finding a baseline to compare to if it were to promote.

Upon admittance, a hazard appraisal must be completed to find the patient ‘s hazard of holding a autumn. This appraisal besides assists the nurses in guaranting the patient has their properties or AIDSs within range to guarantee the patient ‘s safety and to diminish their hazard of hurt. The appropriate appraisal tool for Nicholas would be a Falls Risk Assessment Tool ( FRAT ) . This relates to Nicholas as he complained of giddiness and deficiency of slumber. This is needed to measure his hazard of hurt. Mention to Appendix 1 for a Falls Risk Assessment Tool.

Medicines

Nifedipine – Antihypertensive agent – as stated by Tiziani, 2006

Action: Besides known as Ca adversaries, these agents impede the inflow of Ca ions during depolarization of cardiac and vascular smooth musculus, doing betterment in the myocardial O supply and cardiac end product, and a decrease in myocardial work by cut downing afterload ( Tiziani, 2006 )

Use:

• Angina pectoris
• Mild to chair high blood pressure
• Nicholas has been prescribed this medicine to help with bracing his blood force per unit area.

Interactions:

1. Contraindicated with rifampicin
2. May do bosom failure if used with beta-adrenoceptor-blocking agents
3. Serum concentrations may be increased if given with Tagamet, Quinidex or Cardizem.
4. Excessive cardiovascular depression may happen if given with inspiration anesthetics.

Adverse effects:

• Headache, giddiness, dizziness, flushing, weariness, dizziness.
• Anorexia, sickness, irregularity, abdominal hurting, dry oral cavity.
• Muscle spasms.

Nursing points/precautions:

Note and study thorax hurting because thie requires stoping the drug.

Patient should be advised to avoid drive or operating machinery if giddiness or dizziness is a job.

Caution if used in those with aortal stricture, bosom failure, liver damage, discrepancy or Prinzmental angina, unstable angina, or recent myocardial infarction.

Atorvastatin – lipid-regulating agent – as stated by Tiziani, 2006

Action:

Reduce cholesterin significantly in patients with type II lipemia and hence besides significantly cut down the hazard of coronary arteria disease

Use:

Hypercholesterolaemia

Nicholas has been prescribed this medicine to take down the entire cholesterin and low-density lipoproteins ( LDL )

Interactions:

May addition plasma concentration of Lanoxin, increasing the hazard of toxicity.

Caution if used with Tagamet, Aldactone or ketoconazole.

Adverse effects:

• Headache, insomnia.
• Constipation, flatulency, abdominal hurting, sickness, diarrhea.
• Back hurting

Nursing points/precautions:

• Liver map trial should be performed before get downing therapy and at 6 and 2 hebdomads, so twice annually.
• Advise patient to describe any musculus hurting, spasms, tenderness or failing, unease or febrility.
• Should be withheld if any status occurs that predisposes the patient to rhabdomyolysis, such as injury, sepsis, uncontrolled epilepsy or metabolic, or endocrinal instabilities.