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Hypertension power point for module
This document provides information about hypertension for nursing students. It defines hypertension and prehypertension according to JNC 7 guidelines. It describes the differences between essential and secondary hypertension and lists some causes of secondary hypertension. It discusses the organ damage that can result from uncontrolled hypertension, including effects on the heart, brain, kidneys, and eyes. The document outlines treatment approaches including lifestyle changes and medications. It presents learning objectives and activities for students, including developing a nursing care plan for a hypertensive patient.
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Hypertension power point for module
- 2. Learning Outcome Students willgain an understanding of hypertension, its disease process and management, and will apply that understanding to planned patient care.
- 3. Learning Objectives By theend of this module students will • Compare and Contrast prehypertension, stage I and stage II parameters according to JNC 7 Guidelines • Differential between essential and secondary hypertension • Describe effects of uncontrolled hypertension on body organs
- 4. Learning Objectives • Namea minimum of four causes of secondary hypertension • Define the term "silent killer“ • Create a nursing care plan for a hypertensive patient using the nursing process and following the provided rubric
- 5. Outline • JNC guidelinesfor prehypertension and stage I & II Hypertension • Types of hypertension • Risk factors • Organ damage • Treatment
- 6.
- 7. Introduction • Nearly 60million Americans, or 1 in 4 adults, have high blood pressure • High blood pressure contributes to the deaths of almost 30 individuals every hour of every day • An additional 45 million adults, or 22% of the population, have prehypertension • Many individuals don’t even know they have hypertension the JNC 7 report. JAMA. 2003;289:2560-72.
- 8. Manifestations of Hypertension •Usually no symptoms other than elevated blood pressure • Symptoms are related to organ damage and are seen late and are very serious
- 9. Parameters According toJNC 7 • Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) U . S . D E PA RT M E N T O F H E A LT H A N D H U M A N S E RV I C E S National Institutes of Health National Heart,Lung,andBlood Institute http://www.nhlbi.nih.gov/guidelines/hypertension/phycard.pdf
- 10. What is HighBlood Pressure? JNC 7 Guidelines for Patients Age ≥18 Years Systolic BP Diastolic BP BP classification (mmHg) (mmHg) Normal <120 and <80 Prehypertension 120–139 or 80–89 Stage 1 hypertension 140–159 or 90–99 Stage 2 hypertension >160 or >100 JNC, Joint National Committee; DBP, diastolic blood pressure; HTN, hypertension; SBP, systolic blood pressure. http://www.nhlbi.nih.gov/guidelines/hypertension/phycard.pdf
- 11. JNC 7 Parameters Key:SBP = systolic blood pressure DBP = diastolic blood pressure
- 12. Types of Hypertension •Essential 90% - 95% – Cause is unknown • Secondary 5% - 10% – High blood pressure that is caused by another medical condition or medication
- 13. Secondary Hypertension Causes •Chronic kidney disease • Disorders of the adrenal gland (pheochromocytoma or Cushing syndrome) • Pregnancy (preeclampsia) • Medications such as birth control pills, diet pills, some cold medications, and migraine medications • Narrowed artery that supplies blood to the kidney (renal artery stenosis) • Hyperparathyroidism
- 14. Risk Factors • Factorsthat cannot be changed –Family history of high blood pressure –Family history of premature CVD –Diabetes –Race (African American)
- 15. Lifestyle Risk Factors • Weight (body mass index > 30 kg/m2) • Stress • Sedentary lifestyle • Diet • Smoking • Alcohol (more than one drink per day for women and more than two drinks per day for men) • Birth control pills
- 16. Blood Pressure >140/90mm Hg Damages Target Organs HBP Hemorrhage, LVH, CHD, HF stroke, dementia Peripheral vascular disease Renal failure Chobanian AV. JAMA. 2003;289:2560-2572. CHD, coronary heart disease.
- 17. Organ Damage • VascularEffects – Artery damage and narrowing – Aneurysm • Cardiac Effects – Coronary artery disease – Enlarged left ventricle – Heart failure
- 18. High Blood PressureIncreases Risk of Ischemic Heart Disease Death 80-89 yrs • Risk of IHD death increases 256 with increasing age 128 70-79 yrs 60-69 yrs • Risk of IHD death increases 64 with increasing BP in each (floating absolute risks & 95% CI) 50-59 yrs 32 decade of life 16 40-49 yrs • Increased risk begins at systolic 8 BP >120 mmHg IHD mortality 4 • Trend begins at 40 years old 2 1 120 140 160 180 Usual SBP (mmHg) CI, confidence interval; SBP, systolic blood pressure. Prospective Studies Collaboration. Lancet. 2002;360(9349):1903-1913.
- 19. Organ Damage • CerebralEffects – Transient ischemic attack (TIA) – Stroke – Mild cognitive impairment – Dementia • retinopathy – Vision impairment – blindness
- 20. High Blood PressureIncreases Risk of Stroke Death 256 80-89 yrs • Risk of stroke death increases 128 70-79 yrs with increasing BP in each decade of life 64 60-69 yrs (floating absolute risks & 95% CI) 32 50-59 yrs • Risk of stroke death increases 16 with increasing age 8 Stroke mortality 4 • Increased risk begins at systolic 2 BP >120 mmHg 1 120 140 160 180 Usual SBP (mmHg) CI, confidence interval; SBP, systolic blood pressure. Prospective Studies Collaboration. Lancet. 2002;360(9349):1903-1913.
- 21. Organ Damage • RenalEffects – Kidney failure – Kidney scarring (glomerulosclerosis). – Kidney artery aneurysm healthtap.com
- 22. Treatment • Lifestyle changes – Weight – Exercise – Diet – Smoking – Alcohol use – Stress • Medication
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- 26. Medications • See additionalinformation on medication video in hypertension module • Refer to Drug and Medication Textbook • Review Medication Online Module
- 27. Nurses Help PatientsSignificantly Reduce Systolic BP Baseline BP 165 P=0.02 After treatment P=0.28 160 Systolic blood pressure (mmHg) 160.7 155 157.6 150 151.1 145 140 141.1 135 130 Nurse-led program Standard care Denver E. Diabetes Care. 2003;26:2256-2260
- 28. Learning Activities • Reviewmodule materials and videos • Form a group of 2-4 • Create a nursing care plan for a hypertensive patient using the nursing process and following the provided rubric as a guide • Review the nursing process and nursing care plans as needed
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- 30. Discussion forum • Reviewhypertension Case scenario • Using critical thinking answer questions in discussion forum • Respond and reply to fellow students concerning case scenario and nursing care
- 31. Hypertensive Crisis This isdiscussed in the next module digplanet.com
Editor's Notes
- #7 Know as the silent killer because most individuals don’t even know they have it