4 Nursing Diagnosis Interventions for Hypertension

Nursing Diagnosis for Hypertension - Nursing Care Plan for Hypertension

1. Risk for decreased cardiac output related to increased afterload, vasoconstriction, myocardial ischemia, ventricular hypertrophy.

Purpose: afterload is not increased, there was no vasoconstriction, and myocardial ischemia does not occur.

Expected outcomes:

• Maintaining blood pressure within an acceptable range.
• Showed stable cardiac rhythm and frequency.
• Participate in activities that lower blood pressure.

Nursing interventions:

• Monitor and measure blood pressure in both hands, using a cuff and proper techniques in terms of measuring blood pressure.
• Auscultation of breath sounds and heart tone. Observe skin color, moisture, temperature and capillary refill time.
• Note the presence, quality of the central and peripheral pulses.
• Maintain restrictions on activities such as rest in bed or chair.
• Assist in performing self-care activities as needed.
• Provide a quiet environment, convenient, and therapeutic and reduce activity. Note the general edema.
• Monitor response to medication to control blood pressure. Give fluid and dietary sodium restriction as indicated.
• Medical collaboration in the provision of drugs as indicated.

2. Acute pain: headache related to increased cerebral vascular pressure.

Purpose: The pressure does not increase cerebral vascular

Expected Outcomes: Patients revealed the absence of headache and looked comfortable.

Nursing interventions:

• Maintain bed rest, quiet neighborhood, a little light.
• Limit of patients in the activity.
• Minimize disruption and environmental stimuli.
• Give a fun action according to indications such as ice packs, the position of comfort, relaxation techniques, counseling imagination, avoid constipation.
• Medical collaboration in providing analgesic and sedative drugs.

3. Ineffective Tissue Perfusion: cerebral, renal, cardiac related to impaired circulation.

Purpose: The circulation of the body is not impaired.

Expected outcomes :

• Patients demonstrating an improved tissue perfusion as indicated by: blood pressure within acceptable limits, no complaints of headache, dizziness, laboratory values ​​within normal limits.
• Stable vital signs.
• Urine output 30 ml / min.

Nursing interventions:

• Maintain bed rest, elevate the head position in bed patients.
• Assess blood pressure at admission in both arms, sleeping, sitting with arterial pressure monitoring if it is available.
• Measure the input and discharge.
• Observe the sudden hypotension.
• Ambulation within your means and avoid fatigue in patients.
• Monitor electrolytes, creatinine according to medical advice.
• Maintain fluids and medications according to medical advice.

4. Knowledge deficit related to lack of information about the disease process and self-care.

Purpose : patients are met in terms of information about hypertension.

Expected outcomes :

• Patients can express their knowledge and skills of the management of early treatment of hypertension.
• Reported the use of drugs according to medical advice.

Nursing interventions:

• Describe the nature of the disease and the purpose of the procedure and the treatment of hypertension.
• Explain the importance of a peaceful environment and theraupetik, and management of stressors.
• Discuss the importance of maintaining a stable weight.
• Discuss the need for low-calorie diet, low in sodium to order.
• Discuss the importance of avoiding fatigue in the activity.
• Explain the need to avoid constipation in the bowel movement.
• Explain penetingnya maintain proper fluid intake, amount allowed, restrictions such as caffeinated coffee, tea and alcohol.
• Discuss the symptoms of relapse or progression of complications reported to the doctor: headache, dizziness, fainting, nausea and vomiting.
• Talk about drugs: the name, dosage, time of administration, purpose and side effects or toxic effects.
• Explain the need to avoid drug-free, without a doctor's examination.

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Family Nursing Process In Hypertension Patients

According to Bailon and Maglaya (1978:2) in the nursing process there are various forms of family health nursing process in which the family health care is the level of public health care is addressed or focused on the family as the smallest unit or a single entity and treated, with a sense as a goal and through health care as the ingredients. Meanwhile, according to Effendi (1998:46) The nursing process is a scientific method that is used systematically to assess and determine the issues of health and family nursing, nursing care plan and implement interventions to families in accordance with the plans that have been compiled and evaluated the quality of nursing care is carried out against family.

Family nursing process there are several steps that are systematically arranged to illustrate the progression from stage to stage. According to Friedman (1998: 55) divided into five stages of the nursing process which consists of an assessment of the family, the identification of an individual or family problems and nursing diagnoses, treatment plans, deployment plans implemntasi sources and evaluation of care.



Family Nursing Process In Hypertension Patients

Nursing Assessment

Nursing assessment is the stage when a nurse is continuously collecting information about the family cultivated. Nursing assessment is the first step in the implementation of family nursing care. In order to obtain an accurate assessment data and in accordance with family circumstances, nurses are expected to use their mother tongue (the language used in everyday life), straightforward and simple.

Activities undertaken in the assessment includes the collection of information in a systematic way by using a family assessment tool, classified and analyzed.

Data Collection On Patients Hypertension

1) Assessment of family identity are: age, occupation, residence, and family type.

In general, patients with hypertension is a disease that is influenced by lifestyle, especially the wrong lifestyle, lifestyle-related negative emotions, such emotions are uncontrollable or temperamental, ambitious, hard worker who is not calm, excessive fear and anxiety.

2) Cultural background / family practice
a. Eating habits
Eating habits include the type of food consumed by the family. In families with hypertension often found improper diet such as eating foods that contain lots of preservatives, the food is salty and negative emotions.

b. Utilization of health facilities
Family behavior in the use of health facilities is an important factor in the management of hypertension. The existence of health care resources are used for prevention and early treatment as it can prevent the onset of complications. (Rokhaeni, 2001:115).

c. Traditional medicine
Families can treat hypertension with traditional medicine, namely drinking juice garlic finely ground and given to drink enough water in the morning and afternoon (Hariadi, 2001:26). Hypertension will become worse and cause complications if the patient does not choose the traditional treatment of hypertension is right and proper it will aggravate and even cause problems in other organs such as liver, kidney and stomach.

3) Socioeconomic Status
a. Education
Family education level affects the family in identifying hypertension and its management. also affect the pattern of thought and the ability to take decisions to tackle the problem properly and correctly.

b. Employment and Income
Unequal income also affects the family in treatment and care to sick family members one of which is caused due to hypertension.

4) The development and family history
Family history from birth to the present. Includes history and development of events and experiences unique health or health-related that occurred in family life unmet psychological effect on a person that can lead to anxiety stress.

5) Activity
Hard physical activity can add to the increase in blood pressure. Hypertension may occur after an attack or when doing physical activities, like sports.

6) Environmental Data
a. characteristics of home
Way modify the physical environment such as the floor of the house is good, good lighting and ventilation factors can lessen the causes of hypertension as well as peace in the household can reduce hypertension attack.

b. Environmental characteristics
According to (friedman, 1998: 22) is influenced by the degree of environmental health. Peace of the environment strongly influences the degree of health is no exception in hypertension

c. Family gatherings and interaction with the community
Problems in the family may be one factor which triggers the occurrence of hypertension will lead to anxiety is a risk factor for hypertension.

7) Family Structure
a. communication patterns
According to (Nursalam, 2001:26) All nurse interaction with patients is based on communication. The term communication is a technique in which teurapetik effort to invite patients and families to exchange ideas and feelings. Engineering skills include verbal and non verbal, empathy and a sense of high concern.

b. The power structure
Power within the family affect the health conditions, authoritarian rule can lead to psychological stress affect the hypertension.

c. The structure of the role
When family members received and made ​​consistent with the role, then this will make the family members are satisfied or not there is conflict in the role, and vice versa when a role is unacceptable and incompatible with the hope it could lead to tensions within the family (Friedman, 1998).

9) The pattern of rest-sleep
Restful sleep will be disturbed when someone is experiencing unresolved problems. In patients with hypertension, sleep disorders are often caused by a break shortness of breath and coughing. Unmet need for bed rest are at risk of worsening the state of hypertension.

10) The physical examination of family members
As a comprehensive assessment procedure, also performed a thorough physical examination from head to nail. Once found health problems, physical examination focused more on examining the respiratory system, especially in patients with hypertension due to the presence of hypertension may increase intra-cranial pressure which can cause abnormalities in the respiratory nerves.

11) Family Coping
If there are stressors in the family, whereas family coping is ineffective, then this will be a family member to prolonged stress. One of the prevention of hypertension attacks are not often appear to prevent the onset of stress (Cape, 2003).

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