Pregnancy is a wonderful and joyous time in a woman’s life, but if you suffer with chronic hypertension, it can also be a scary time. And even if you’ve never suffered from high blood pressure while not with child, you still may experience hypertension during pregnancy. Let’s break it all down and examine the risks.
Chronic Hypertension – Chronic hypertension is when the mother has had an ongoing problem with high blood pressure, even before becoming pregnant. In normal pregnancies, a woman’s blood pressure tends to go down during the first 20 weeks of gestation, so if the patient is getting high readings at their regular prenatal check-ups, it is a good bet that they have chronic hypertension that has gone untreated, rather than gestational hypertension.
Treatment: The patient should consult with her health care practitioner to decide which treatment is best. If the patient is already on an anti-hypertensive medication, the caregiver will determine if the medication should be continued, substituted or stopped altogether. The patient must make certain she follows all of her doctor’s guidelines and does not try to self-treat with counterfeit medications or herbal supplements that have not been approved by her healthcare team.
Gestational Hypertension – This is the type of hypertension that occurs after 20 weeks gestation. If a patient shows readings significantly higher than during the early weeks of pregnancy, she may be exhibiting symptoms of gestational hypertension. Anything greater than 160/110 is considered dangerous and must be carefully observed.
Treatment: Mandatory rest periods, suspension of work and even hospitalization may be required to bring down a patient’s blood pressure. Otherwise, close observation of the mother and fetus will continue. The doctor may order fetal non-stress tests to be given twice weekly and/or ultrasounds to check in on the baby.
Preeclampsia/Eclampsia – The most severe form of pregnancy-induced hypertension is preeclampsia and eclampsia. This is when a patient’s high blood pressure is paired with bodily swelling that can’t be relieved and protein in the patient’s urine. If preeclampsia is not dealt with quickly, it can have dire effects on both the mother and the fetus. Furthermore, eclampsia can also result, which consists of the symptoms listed above plus maternal seizures and/or coma.
Treatment: If a patient gets to this point, the most effective treatment is delivery of the baby. If the fetus is not mature enough to live outside the womb, a medication called magnesium sulfate will likely be given intravenously to stop the progression of preeclampsia into eclampsia.
As always, a healthy diet and a moderate exercise plan even before getting pregnant are keys to keeping blood pressure normalized. Once you become pregnant, regular monitoring of your blood pressure at prenatal visits is essential, and swift action against impending problems is the safest bet.
Be well, take care of yourself, and enjoy your pregnancy.
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Liberty Kontranowski is a freelance writer and blogger with hundreds of articles published online and in print, covering everything from sexual health to parenting to beauty, fashion, entertainment and more. Liberty is the newest member of the Secure Medical team providing the highest quality articles to AccessRx.com.
Wednesday, March 24, 2010
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.
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.
Sunday, February 7, 2010
Hypertension And Stroke: Any Hope?
The words ‘Stroke, apoplexy and cerebro-vascular accident’ all mean the same thing. The hypertensive patient may become prone to this condition as a result of the narrowing of the blood vessels (this time in the brain) coupled with the increasing pressure with which blood is forced through them.
Usually the vessels in the brain are not as prominent as those in the limbs or trunk hence they are liable to rupture so easily. The hypertensive patient may suffer from this condition if he/she does not recognize the warning signs and act fast or if the stroke develops spontaneously without initial warning. Some of the warning signs of impending stroke are sudden severe headache or an increase in the quality or intensity of an already existing headache and a feeling of numbness in the extremities. These signs must be reported to the doctor immediately. Some of the factors that can precipitate this condition include non-adherence to drug regimen, excessive stress, sudden bereavement, loss of job, drug resistance, etc.
Some of the signs that the patient may have had stroke include loss of sensation on one part of the body, inability to move especially the affected side, slurred speech, drooping of one side of the mouth, drooling at the mouth, unequal pupils of the eyes, etc. When you see any of these signs stroke should be suspected and the doctor or the Emergency medical service called immediately. Do not attempt to move the patient to the hospital by yourself as this could end up complicating the situation.
The patient is usually admitted into the hospital for expert medical management; an attempt is made to gradually lower the blood pressure and control the condition from deteriorating rapidly. Some of the things that would be done for the patient include helping him to regain the use of the affected part of the body, regaining his speech, prevention of complication that would set in as a result of long period of confinement in bed and the control of the cause of the apoplexy, which could primarily be haemorrhage or other causes. If urgent and immediate steps are taken in the right direction and treatment commenced as soon as possible the level of damage would be greatly minimized, but if treatment is delayed for more than eight hours after the onset of the stroke extensive damage would have been done.
Usually the vessels in the brain are not as prominent as those in the limbs or trunk hence they are liable to rupture so easily. The hypertensive patient may suffer from this condition if he/she does not recognize the warning signs and act fast or if the stroke develops spontaneously without initial warning. Some of the warning signs of impending stroke are sudden severe headache or an increase in the quality or intensity of an already existing headache and a feeling of numbness in the extremities. These signs must be reported to the doctor immediately. Some of the factors that can precipitate this condition include non-adherence to drug regimen, excessive stress, sudden bereavement, loss of job, drug resistance, etc.
Some of the signs that the patient may have had stroke include loss of sensation on one part of the body, inability to move especially the affected side, slurred speech, drooping of one side of the mouth, drooling at the mouth, unequal pupils of the eyes, etc. When you see any of these signs stroke should be suspected and the doctor or the Emergency medical service called immediately. Do not attempt to move the patient to the hospital by yourself as this could end up complicating the situation.
The patient is usually admitted into the hospital for expert medical management; an attempt is made to gradually lower the blood pressure and control the condition from deteriorating rapidly. Some of the things that would be done for the patient include helping him to regain the use of the affected part of the body, regaining his speech, prevention of complication that would set in as a result of long period of confinement in bed and the control of the cause of the apoplexy, which could primarily be haemorrhage or other causes. If urgent and immediate steps are taken in the right direction and treatment commenced as soon as possible the level of damage would be greatly minimized, but if treatment is delayed for more than eight hours after the onset of the stroke extensive damage would have been done.
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