Chapter 18 Care of Patients with Hypertension and Peripheral Vascular Disease
Learning Objectives Theory 1. Explain the pathophysiology of hypertension. 2. Identify the complications that can occur as a consequence of hypertension. 3. Briefly describe the treatment program for mild, moderate, and severe hypertension. 4. Contrast the pathophysiology of arteriosclerosis with that of atherosclerosis. 5. Review four factors that contribute to peripheral vascular disease. 6. Recognize the signs, symptoms, and treatment of aneurysm. 7. Prepare a teaching plan for a patient with Raynaud’s syndrome. 8. Compare the etiology and care for thrombophlebitis and deep vein thrombosis. 9. Summarize how venous insufficiency may lead to a venous stasis ulcer. 10. Compare venous stasis ulcer with arterial leg ulcer. 11. List types of surgery performed for problems of the peripheral vascular system. Clinical Practice 12. Develop and implement a teaching plan for a patient who has hypertension. 13. Choose the points to be included in the teaching plan for the patient who has experienced thrombophlebitis. 14. Institute a teaching plan for the patient undergoing anticoagulant therapy. 15. Differentiate between venous and arterial insufficiency during a physical assessment. 16. Prepare a nursing care plan for the patient with arterial insufficiency. 17. Identify three likely nursing diagnoses for patients who have common problems of vascular disease and list the expected outcomes and appropriate nursing interventions for each.
Hypertension Etiology: › Essential (primary or idiopathic) and secondary hypertension › Associated factors: Age, race, obesity, and sodium intake › Contributing factors: Hormone therapy, nicotine, and caffeine consumption, and family history of hypertension › Obesity is also closely related › African Americans tend to have a higher rate too › Rising rates of child obesity (Refer to p. 397 Table 18-1 for AHA blood pressure recommendations and table 18-2 for risk factors.)
Hypertension (HTN) 90% - 95% are essential/primary hypertension Treatment goals are › Reduction of high blood pressure › Long-term control to decrease risk of stroke, heart attach, and kidney disease 5-8% is actually symptom of another disorder › Usual suspects: renal vascular disease, dysfunction of the adrenal cortex and medulla, atherosclerosis of the arteries of systemic circulation, and coarct ion of the aorta
Pathophysiology of HTN Concept Map 18-1 Pg 398
HTN cont. Defined as persistently high blood pressure So, what is high? A systolic pressure equal or greater than 140 mmHg and a diastolic equal to or greater than 90 mmHg when taken at least twice and averaged on two different occasions 2 weeks apart.
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- Fall '19