List of Nursing Diagnosis for Hypertension

Hypertension Nursing Diagnosis List

Definition

Hypertension is defined as persistent blood pressure where the systolic pressure above 140 mmHg and diastolic above 90 mmHg. In the elderly population, hypertension is defined as systolic pressure of 160 mmHg and a diastolic pressure of 90 mmHg. (Smeltzer, 2001).


Etiology

In general, hypertension has no specific cause (idiopathic). Hypertension occurs in response to increased cardiac output or increased peripheral pressure. However, there are several factors that influence the occurrence of hypertension :

1. Genetic response to stress or neurological disorders or transport of Na excretion.
2. Obesity : associated with high insulin levels that result in increased blood pressure.
3. Environmental Stress.
4. The loss of tissue elasticity and atherosclerosis in the elderly as well as dilation of blood vessels.

Based on the etiology hypertension were divided into 2 groups, namely :

a. Essential Hypertension (Primary)
The cause is unknown but many factors that influence such as genetics, environment, hyperactivity, sympathetic nervous system, renin-angiotensin system, the effect of Na excretion, obesity, smoking and stress.

Although primary hypertension is not known with certainty the cause, research data have found several factors that often lead to hypertension. These factors are as follows :

Heredity.

• From the statistical data it is evident that a person will have a greater chance to get hypertension if their parents are hypertensive.

Individual characteristics :

• Individual characteristics that affect the incidence of hypertension is :
• Age (if age increases, blood pressure increases).
• Men is higher than women.
• Race (blacks more than whites).
• Living habits.

Habits often cause hypertension are :

• High salt consumption (in excess of 30 g).
• Obesity or overeating.
• Stress.
• Smoking.
• Drinking alcohol.
• Taking certain medications that increase blood pressure.

b. Secondary Hypertension
Could be due to renal parenchymal disease / renal vascular.
The use of oral contraceptive pills. Endocrine disorders etc..

While the causes of secondary hypertension are :

• Kidney
• Glomerulonephritis
• Pyelonephritis
• Acute tubular necrosis
• Tumors
• Vascular
• Atherosclerosis
• Hyperplasia
• Thrombosis
• Aneurysms
• Cholesterol embolism
• Vasculitis
• Endocrine disorders
• Diabetes Mellitus
• Hyperthyroidism
• Hypothyroidism
• Nerves
• Stroke
• Encephalitis
• Guillain - Barré Syndrome
• Drugs
• Oral contraceptives
• Corticosteroids

The cause of hypertension in the elderly is the occurrence of changes in :

• Decreased elasticity of the aortic wall.
• Valvular heart to thicken and become stiffer.
• Heart's ability to pump blood decreases 1 % every year after the age of 20 years decreases the heart's ability to pump blood causes decreased contraction and volume.
• Loss of elasticity of the blood vessels .

This happens due to lack of efficacy for peripheral vascular oxygenation Increased peripheral vascular resistance.

Risk factors

• Family history of heart disease and hypertension.
• Men aged 35-55 years and women over 50 years of age or after menopause.
• Most consume salt / sodium.
• The blockage of the blood vessels (atherosclerosis) caused by several things such as smoking, lipid levels, and increased serum cholesterol, caffeine, diabetes, etc..
• Emotional factors and stress levels.
• Monotonous lifestyle.
• Sensitive to angiotensin.
• Obesity.
• The use of oral contraceptives, such as estrogen.

Nursing Diagnosis for Hypertension

1. Risk for decreased cardiac output related to :
increased afterload,
vasoconstriction,
hypertrophy / ventricular rigidity,
myocardial ischemia.

2. Activity intolerance related to :
weakness,
imbalance between supply and demand of oxygen.

3. Acute pain related to :
increase in cerebral vascular pressure.

4. Anxiety related to :
situational crisis ; secondary hypertension suffered.

5. Knowledge Deficit related to :
lack of information about the disease process.