Assessment and Management of Patients with Hypertension

1
Assessment and Management of Patients with
Hypertension

• Chapter 32

2
Blood Pressure

• What is blood pressure?
• Hypertension can result from. . . ?
• JNC7 definition
• Systolic BP gt 140 mm Hg and diastolic BP gt 90 mm
  Hg based on the average of two or more accurate
  blood pressure measurements taken during two or
  more contacts with a HCP

3
Blood Pressure Classifications

• Identify the four blood pressure classifications
  and describe the criteria for each
  classification.
• At which classification stage should lifestyle
  modifications begin?

4
Review

• Describe the difference between essential and
  secondary HTN.
• Identify factors involved in the control of blood
  pressure.
• Discuss how high blood pressure can be used as a
• Sign
• Risk factor for ASCVD
• Disease

5
Target Organ Damage

• What leads to target organ damage?
• Which are the target organs of most concern?
• What are the consequences of target organ damage?

6
Assessment and Diagnostics

• Comprehensive health history
• Risk factor assessment
• Describe the importance of a opthalmoscopic eye
  exam.
• What lab tests would you expect to review?
• What additional diagnostics would you expect?

7
Medical Management

• What is the goal of medical management?
• What should be the considerations for the optimal
  plan of medical management?
• Algorhythm of Treatment Figure 32-2, p. 1024

8
Management of Hypertension

• Identify non-pharmacologic interventions
  important to management.
• Discuss the polypharmacy approach to
  pharmacologic management.
• What is the recommended initial pharmacologic
  treatment for uncomplicated hypertension without
  specific indications for other medications?

9
Gerontologic Considerations

• What is an important gerontologic consideration
  regarding pharmacologic blood pressure
  management?
• Why is this necessary?

10
Nursing Responsibilities

• Discuss the following key nursing
  responsibilities related to control of HTN
• Education
• Assessment
• Barriers
• Evaluation

11
Hypertensive Crises

• Compare and Contrast the two classes of
  hypertensive crises.
• Hypertensive Emergency
• Hypertensive Urgencies
• What type of monitoring is necessary?
• How will you determine frequency of monitoring?
• For what must the nurse closely observe?