Possible Medications
Diuretics “ide”
Beta-blockers “olol”
ACE inhibitors “Pril”
Angiotensin II receptor blockers
“tan”
Calcium channel blockers “Ine”
Alpha blockers (Cardura, Minipress, Hytrin)
Alpha-2 Receptor Agonists
Pathophysiology
-Persistent elevation of blood pressure exceeding 140 over 90 mmHg.
Pre-HTN: SBP 120-139 OR DBP 80-89
Stage 1 HTN: SBP 140-159 OR DBP 90-99
Stage 2 HTN: SBP ≥ 160 OR DBP ≥ 100
Diagnostic Data
12 lead electrocardiogram
Complete blood count
Basic metabolic profile (serum sodium, potassium, creatinine with estimated/measured
glomerular filtration rate, calcium) Lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides) after 9 to 12 hour fast
Clinical Manifestations
Subjective: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content.
T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having
Possible Nursing Diagnosis
Fasting blood glucose or Hemoglobin A1c
Risk for Decreased Cardiac Output
Activity Intolerance
Acute Pain
Ineffective Coping
Imbalanced Nutrition: More Than Body Requirements Deficient Knowledge
Nursing Interventions
Fluid restriction (if clinically appropriate)
Monitor BP
Review readings from the home blood pressure monitoring journal with the patient. Perform a comprehensive cardiopulmonary assessment: Heart sounds, Lung sounds, Pulses, Edema
Increased vascular resistance, vasoconstriction
Myocardial ischemia Ventricular hypertrophy/rigidity