Ateneo de Zamboanga University College of Nursing

Name: Mendoza, Eirees Joy A. Subject: Nursing Elective II (Chronic Illness, Hospice Palliative Care) Module: 1/10

A patient with hypertension. Signs and symptoms:

Headache is the most common symptom of the hypertension which is often nonspecific and is a stressing situation for the patient. Accelerated hypertension on the other hand is usually associated with somnolence, confusion and visual disturbance. Accelerated hypertension if exaggerated and uncontrolled can lead to somnolence, confusion and visual disturbance, nausea and vomiting which may be due to hypertensive encephalopathy. On eye examination retina will show various abnormalities like narrowing of arterial diameter to less than 50% of venous diameter, copper or silver wire appearance, exudates, hemorrhages, or papilledema. Infants and neonates if suffering from the condition will show some important signs like failure to thrive, seizure, irritability or lethargy, and respiratory distress. In older children hypertension may cause headache, fatigue, blurred vision, epitasis, and bell palsy. In some patients suffering with secondary hypertension signs and symptoms of the underlying pathology are also evident like in cases with high Glucocorticoids hormone levels in the blood centripetal obesity, buffalo hump, purple abdominal striae and recent onset of diabetes are the distinctive signs and symptoms. This may be due to Cushings syndrome. Patients suffering from the hypertension secondary to the hyperthyroidism will show specific signs and symptoms like weight loss, tremor, tachycardia or atrial arrhythmia, palmar erythema and sweating. Patients suffering from the hypertension secondary to the growth hormone increased level will have signs and symptoms like coarsening of facial features, prognathism, macroglossia, hypertrichosis, hyperpigmentation, and hyperhidrosis. Patients suffering from hyperaldosteronism can also develop the hypertension secondary to the disease. These patients can be diagnosed with a clinical picture of numbness, polyuria, polydipsia, hypernatraemia, and metabolic alkalosis.

Some patients will develop hypertension secondary to renal artery stenosis which can be differentiated during auscultation in which a systolic bruit is heard over flanks or in abdomen. Patients having coarctation of aorta will show a radio femoral delay i.e. diminished pulse in lower extremities as compared with upper extremity. These patients can also develop hypertension. Patients with Pheochromocytoma will show sustained and episodic hypertension. Signs and symptoms n these patients include headache, anxiety, palpitation, profuse perspiration, pallor, tremor, nausea and vomiting. Angina or acute pulmonary edema may occur if blood pressure elevates in an acute manner. In females signs and symptoms of pre eclampsia and eclampsia includes proteinuria, edema, convulsions, nausea, vomiting, headaches, and blindness.

Sources: http://www.healthcaremagic.com/articles/Signs-and-Symptoms-of-Hypertension/7650