Risk for Decrease Cardiac Output related to Hypertensive Heart Disease

Nursing Care Plan for Hypertensive Heart Disease
Nursing Diagnosis : Risk for Decrease Cardiac Output related to increased afterload, vasoconstriction, myocardial ischemia, ventricular hypertrophy.

Goal : Want to participate in activities that lower blood pressure / cardiac workload.

Outcomes :

• Blood pressure within an acceptable range of individuals.
• Rhythm and heart rate stabilized in the normal range.

Interventions :

1. Monitor vital signs.
2. Note the presence, quality central and peripheral pulses.
3. Heart tone auscultation, and breath sounds.
4. Observe skin color, moisture, temperature, and capillary refill time.
5. Note the general edema / certain.
6. Provide a quiet and comfortable environment, reduce the activity / environment commotion, limit the number of visitors and length of stay.
7. Maintain restrictions on activities such as rest in bed / chair ; schedule uninterrupted rest period ; help patients perform self-care as needed.
8. Perform actions as comfortable as back and neck massage, tilt the head of the bed.
9. Encourage relaxation techniques, imagination guide, transfer activity.
10. Monitor response to medication to control blood pressure.

Rationale :

1. Comparison of blood pressure gives a more complete picture of the involvement / field of vascular problems.
2. Throbbing carotid, jugular, radial and femolaris probably observed / palpable. Pulse in the limbs may decrease, reflecting the effect of vasoconstriction (increased SVR) and venous congestion.
3. S4 is commonly heard in patients with severe hypertension due to an increase in atrium volume / pressure. S3 shows the development of ventricular hypertrophy and malfunction, the presence of crackles, wheezes may indicate pulmonary congestion secondary to the onset or chronic renal failure.
4. The presence of pale, cool, moist skin and slow capillary refill time may be related to vasoconstriction or reflect decompensation / decrease in cardiac output.
5. May indicate heart failure, kidney or vascular damage.
6. Helps to reduce sympathetic stimulation ; increase relaxation .
7. Lowering stress and tension which affects blood pressure and hypertensive disease course.
8. Reduce discomfort and can reduce sympathetic stimulation.
9. Can reduce stressful stimuli, making a calming effect, thus reducing BP.
10. Response to drug therapy "stepeed" (consisting of diuretics, sympathetic inhibitors and vasodilators) depends on the individual and synergistic effects of the drug, because of these side effects, it is important to use the drug in the fewest number and lowest doses.