University of Perpetual Help System- Laguna

College of Nursing

Submitted by:

Caberte, Mae Lyn M.

Cablayan, Jessa Marie

Campos, Shane B.

Submitted to:

Mr. Steve Flores

 Introduction

HYPERTENSION, the “silent killer”, as we often call it is a very common cardiovascular

disease world wide. It is called “silent” because it is asymptomatic, making it difficult to detect.

Hypertension is defined as a disease of vascular regulation resulting from malfunction of

arterial pressure control mechanisms. The two major types of hypertension are primary
(essential) hypertension and the secondary hypertension.

In a healthy adult, normal blood pressure is calculated as 120/80 mmHg. If the diastolic
pressure is 90 mmHg or higher and systolic pressure is 140 mmHg or higher in absence of other
causes of hypertension, it is called primary hypertension. Secondary hypertension is results
primarily from renal disease, endocrine disorders coarctation of the aorta.

HYPERTENSION is one of the most prevalent chronic diseases in the Philippines.

According to a survey by the Food and Nutrition Research Institute, one in every four Filipino
adults (25.3%) has hypertension or a blood pressure reading equal to or higher than 140/90
mmHg.

It also shows that 11 in every 100 Filipinos (10.8%) have pre-hypertension or a BP

reading in the range of 130-139/85-89 mmHg. High BP increases from 40-49 y/o, it said.

However, HYPERTENSION is a disease with which treatment is available. With due

management hypertension can be controlled but still a major contributor to morbidity and
mortality in our society
Signs and Symptoms

Hypertension includes the 32 symptoms listed below:

 No symptoms - many people are unaware they have hypertension until it is accidentally
found at a doctor visit or they develop complications of hypertension
 Non-specific symptoms - symptoms of hypertension may be mild and vague
 Headache
 Morning headache
 Tinnitus - ringing or buzzing in ears
 Dizziness
 Confusion
 Papilloedema
 Many symptoms occur from complications of hypertension
 High blood pressure
 Usually asymptomatic
 Fatigue
 Shortness of breath
 Convulsion
 Changes in vision
 Nausea
 Vomiting
 Anxiety
 Increased sweating
 Nose bleeds
 Heart palpitations
 General feeling of unwellness
 Increased urination frequency
 Blurred vision
 Double vision
 Flushed face
 Pale skin
 Red skin
 Chest pains
 Very high blood pressure
Nursing Considerations
Nursing Consideration
monitor BP every 1-2 hours, or every 5
minutes during active titration of vaso active
drugs
encourage patient to decrease intake of
caffeine, cola and chocolates
observe skin color, temperature, capillary refill peripheral vasoconstriction may result in pale,
time and diaphoresis
instruct client and family on fluid and diet
requirements and restrictions of sodium
observe for complaints of blurred vision,
tinnitus or confusion
assist the patient in identifying modifiable risk
factors like diet high in sodium, saturated fats
and cholesterol.
suggest frequent position changes, leg
exercises when lying down.
Stress importance of accomplishing daily rest
periods
monitor for sudden onset of chest pain
administer medicines as prescribed by the
physician
reinforce the importance of adhering to
treatment regimen and keeping follow up
appointments
observe for complaints of blurred vision,
tinnitus or confusion
provide information regarding community
resources, and support patients in making
lifestyle changes
instruct client in signs/symptoms to report to
physician such as headache upon rising
increased blood pressure, chest pain,
shortness of breath, increase heart rate, visual
changes, edema, muscle cramps and nausea
and vomiting
Rationale
changes in BP may indicates changes in
patient status requiring prompt attention
caffeine is a cardiac stimulant and may
adversely affect cardiac function
cool, clammy skin with prolonged capillary
time due to cardiac dysfunction and
decreased cardiac output
restrictions can assist with decrease in fluid
retention and hypertension, thereby
improving cardiac output
may indicate cyanide toxicity from increasing
intracranial pressure
these risk factors have been shown to
contribute to hypertension
decreases peripheral venous pooling that may
be potentiated by vasodilators and prolonged
sitting or standing
alternating rest and activity increases
tolerance to activity progression
may indicate dissecting aortic aneurysm
to promote wellness
lack of cooperation is common reason for
failure of antihypertensive therapy
may indicate cyanide toxicity from increasing
intracranial pressure
community resources like health centers
programs and check ups are helpful in
controlling hypertension
promotes knowledge and compliance with
treatment. Promotes prompt detection and
facilitates prompt intervention
Pathophysiology

Juxtaglomerular apparati (kidneys) liver

Renin Angiotensinogen

Angiotensinogen + renin

Removal of amino acid by Angiotensin Converting Enzyme

Angiotensin II Angiotensin III

Aldosterone

Vasoconstriction Na and fluid retention Risk factors

Inc peripheral resistance Inc cardiac output

Elevation in Blood Pressure