HYPERTENSION

HYPERTENSION
• Most common chronic disease among adults.
• Leading risk factor for premature death, disability, and overall disease
burden worldwide → lead to myocardial infarction, heart failure, stroke,
and chronic kidney disease when not appropriately treated.
WHAT IS NORMAL BLOOD
PRESSURE?
• The JNC 7 and ASH and ISH define a blood pressure of less than
120/80 mm Hg diastolic as normal, 120 to 139/80 to 80 mm Hg as
prehypertension, and 140/90 mm Hg or higher as hypertension.
Classification of Blood Pressure for
Adults Age 18 and Older
BP Classification Systolic BP (mm Hg) Diastolic BP (mm Hg)
Normal <120 <80
Prehypertension 120-139 80-89
Stage 1 hypertension 140-159 90-99
Stage 2 hypertension ≥160 ≥100
HOW DO YOU DEFINE
HYPERTENSION?
• Defined by American Society of Hypertension (ASH) and International
Society of Hypertension (ISH) as systolic blood pressure (SBP) of 140
mm Hg or higher or a diastolic blood pressure (DBP) of 90 mm Hg or
higher.
WORKSHOP
• Identify common risk factors
• Clinical manifestations or assessment (cues)
• Priority nursing care plan or record (NPR), NIC with indicators, NOC
with indicators
• Nursing interventions or activities
STROKE
CEREBROVASCULAR DISORDERS
• An umbrella term that refers to a functional abnormality of the central
nervous system (CNS) that occurs when the normal blood supply to
the brain is disrupted.
• STROKE → primary cerebrovascular disorder after heart disease and
cancer
• Cerebrovascular accident (CVA) or “brain attack” → sudden loss of
function resulting from disruption of the blood supply to a part of the
brain
STROKE
• Two major categories
– Ischemic (85%): vascular occlusion and significant hypoperfusion
occur
– Hemorrhagic (15%): extravasation of blood into the brain or
subarachnoid space
ISCHEMIC STROKE
• Five different types
– Large artery thrombotic strokes (20%): atherosclerotic plaques
large blood vessels of the brain
– Small penetrating artery thrombotic strokes (25%): affect small
vessels → common type
– Cardiogenic embolic stroke (20%): cardiac dysrhythmias (atrial
fibrillation)
– Cryptogenic strokes (30%): no known cause
– Others (5%): illicit drug use, coagulopathies, migraine, and
spontaneous dissection of the carotid or vertebral arteries
HEMORRHAGIC STROKE
• Hemorrhagic strokes account for 15% to 20% of cerebrovascular
disorders and are primarily caused by intracranial or subarachnoid
hemorrhage.
• Primary intracerebral hemorrhage (spontaneous rupture) →
uncontrolled hypertension
• Subarachnoid hemorrhage → ruptured intracranial aneurysm (a
weakening in the arterial wall)
• Secondary intracerebral hemorrhage → arteriovenous malformations
(AVMs), intracranial aneurysms, intracranial neoplasms, or certain
medications (eg, anticoagulants, amphetamines)
WORKSHOP
• Identify risk factors or etiology
• Clinical manifestations or assessment (cues)
• Priority nursing care plan or record (NPR), NIC with indicators, NOC
with indicators
• Include medical management, surgical management, and nursing care
GESTATIONAL
HYPERTENSION
GESTATIONAL HYPERTENSION
• Gestational hypertension → condition in which vasospasm occurs in
both small and large arteries during pregnancy, causing increased
blood pressure.
• Preeclampsia → pregnancy-related disease process evidenced by
increased blood pressure and proteinuria.
WORKSHOP
• Identify risk factors or etiology
• Clinical manifestations or assessment (cues)
• Priority nursing care plan or record (NPR), NIC with indicators, NOC
with indicators
• Include medical management, surgical management, and nursing care