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Sunday, March 7, 2010

Hypertension: Nursing Management

Some patients may be admitted for the treatment of hypertensive crisis, control of complication or for the establishment of a treatment regimen. When on admission, here are some of the immediate cares that the nursing team could give to the patient to aid his speedy recovery:

1.Observation: Vital signs should be checked 2 hourly with emphasis on Blood pressure and pulse rate.
Monitor patient’s weight daily and keep proper record. This is to help detect oedema or weight loss. Check for side effects of drugs e.g. orthostatic hypotension.

2.Rest: Patient should be advised to avoid stress and tension. He should therefore have physical and mental rest in order to conserve energy.
Encourage moderate exercise e.g. walking if there is no dyspnoea. Mild tranquilizers may be given to enable patient sleep. Should there be dizziness patient should be protected from falls and injury.

3.Diet: Restrict sodium intake to about 4grams daily. Give light, easily digestible diet. Fatty food and excessive carbohydrate that can increase weight and cholesterol should be avoided. Coffee, tea, kola nuts, alcohol should be avoided or minimized.

4.Physical care: Assist patient with physical care if patient is very weak. Where there is blurred vision patient may require the use of medicated eye glasses. If there is bleeding from the nose (epistaxis) apply ice pack to the bridge of the nose and back of the neck. When the ice pack cannot control bleeding the nose may be packed. The pack should however be removed within few days. Make sure patient does not lie on one side of his body for several days in bed. If he is to be admitted for days, his position should be changed every 2-4 hours to prevent pressure sore from developing.

5.Elimination: Constipation should be avoided because it makes the patient strain at defecation thereby further elevating the blood pressure. Food rich in fibre should be given to prevent constipation.

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