Hypertension

Hypertension

Definition

            According to WHO (1978) limits the blood pressure is considered normal is 140/90 mm Hg and blood pressure equal to or above 160/95 mmHg expressed as hypertension. Hypertension is an increase in blood pressure above normal when the systolic pressure is 140 mmHg or more and diastolic pressure of 90 mmHg or more.

Etiology

1. Age

            Hypertension increased with increasing age, hypertension at the age of 35 years clearly raise the incidence of arterial disease and premature death.

2. Male / female

            Based on the male gender, generally occurs higher incidence than women. But in middle age, the incidence in women begins to rise, so that by the age of 65 years, the incidence is higher in women.

3. Race
            Hypertension in the black at least twice on the white.

4. Lifestyle

            Factors such as education, income and lifestyle factors of patients have been studied, no clear results. Low income, low education levels and life or stressful work seems related to a higher incidence of hypertension. Obesity is also seen as a major risk factor. Smoking is seen as a high risk factor for hypertension and coronary artery disease. Hypercholesterolemia and hyperglycemia are the main factors for the development of atherosclerosis associated with hypertension.

Based on the cause, hypertension were divided into 2 groups:

1. Primary hypertension

            Hypertension is of unknown cause, usually associated with hereditary and environmental factors.

2. Secondary hypertension

Is the cause of hypertension can be known with certainty, such as vascular disorders and kidney disease.

If hypertension is severe or chronic and untreated, can result in the following symptoms:

headache
fatigue
nausea
vomiting
shortness of breath
restless
Blurred vision that occurs because of damage to the brain, eyes, heart and kidneys.
Sometimes patients with severe hypertension experienced a loss of consciousness and even coma because of brain swelling. This situation is called hypertensive encephalopathy, which requires immediate action.

Signs and symptoms of hypertension can be divided into: (Edward K Chung, 1995).

            a. No Symptoms

            There are no specific symptoms that can be associated with increased blood pressure, in addition to the determination of arterial pressure by the examining physician. This means that arterial hypertension will never be diagnosed if arterial pressure was not measured.

            b. Common Symptoms

            It is often said that terlazim symptoms that accompany hypertension include headache and fatigue. In fact this is a symptom of the terlazim that most patients who seek medical attention.

Complication

As a result of prolonged hypertension is:

coronary insufficiency and obstruction
heart failure
renal failure
neurological disorders

Examination Support

1. Laboratory Studies

Hb / Ht: to examine the relationship of the cells to the volume of fluid (viscosity) and may indicate risk factors such as hypo-coagulability, anemia.
BUN / creatinine: provides information on perfusion / kidney function.
Glucose: Hyperglycemia (DM is the originator of hypertension) can be caused by spending ketokolamin levels.
Urinalysis: blood, protein, glucose, renal dysfunction indicated he fully danada DM.

2. CT Scan: Assessing the presence of cerebral tumor, encephalopathies.

3. ECG: may show patterns of strain, where the vast, P wave elevation is one early sign of hypertensive heart disease.

4. IUP: identifying causes of hypertension such as kidney stones, kidney repair.

5. Photo Chest: Shows the destruction of calcification in the valve area, cardiac enlargement.

Nursing Diagnosis for Hypertension