Model essay on hypertension nursing 1: medical nursing of hypertensive patients Keywords medical nursing of hypertension
Hypertension is a common clinical syndrome, characterized by the increase of systemic arterial pressure and peripheral arteriole resistance, accompanied by different degrees of cardiac output and blood volume increase. Long-term hypertension can cause serious structural and functional changes in target organs such as heart, brain and kidney, and eventually lead to functional failure. It is an important disease leading to the onset and death of cardiovascular diseases. At present, in the world, hypertension is still a disease with high morbidity, high disability rate, high mortality rate, low awareness rate, low medication rate and low control rate.
Hypertension can be divided into primary hypertension and secondary hypertension. Primary hypertension accounts for more than 95% of hypertension. Secondary hypertension is one of the clinical symptoms of some diseases, and hypertension accounts for about 5% of hypertension.
nurse
(A) Nursing evaluation
1. Nursing history asked patients whether they had symptoms such as dizziness, headache, tinnitus, irritability, palpitation, nausea and vomiting when they were diagnosed with hypertension, and the duration, causes and relief methods of symptoms, including depression, pain, transient aphasia, numbness of limbs, syncope and blurred vision. Daily blood pressure level, understand the types and doses of antihypertensive drugs, whether to insist on taking drugs and the efficacy of drugs. To understand the patients' intake of calories, sodium salt and fat, whether they have smoking and drinking habits, weight and exercise, and whether their families have hypertension, diabetes, coronary heart disease and hyperlipidemia.
2. Psychosocial data to understand the patient's personality characteristics, occupation, lifestyle, self-care knowledge, but also to understand the family's understanding of hypertension and the understanding and support given to patients.
3. Due to blood pressure, physical assessment will be affected by many factors. When measuring blood pressure, we should pay attention to: ① 30 minutes before measuring blood pressure, patients should not smoke and avoid drinking irritating drinks, such as strong tea and coffee; ② Before measuring blood pressure, patients should rest for 5 minutes in a quiet state; ③ Blood pressure should be measured twice continuously and averaged. Evaluate the heart size, heart rate and rhythm, whether there is dry and wet rales in the lungs, and whether there is edema in both lower limbs.
4. Check the patient's blood sugar, blood lipid, serum electrolyte, creatinine, urea nitrogen, electrocardiogram, chest X-ray, echocardiography and other results to judge the damage degree of the target organ.
(2) The main nursing diagnosis
1. Pain: headache: related to the increase of blood pressure.
2. Exercise intolerance: It is related to the decline of cardiac function caused by long-term hypertension.
3. Danger of injury: related to dizziness caused by hypertension; It is related to blurred vision caused by elevated blood pressure.
4. Potential complications: hypertension emergency; Cerebrovascular accident; Heart failure; Renal failure.
5. Poor implementation of treatment plan: related to not knowing the harm of hypertension; It's related to complicated treatment schemes.
(3) Nursing plan and evaluation (for example)
Lack of knowledge: lack of self-care knowledge about hypertension.
1. The target patients can retell the knowledge of self-care and put it into daily life.
2. Nursing measures
(1) Explain to patients and their families that the cause of hypertension is unknown. At present, it is believed that it is caused by some genetic factors and various acquired environmental factors, such as excessive salt intake and long-term mental stress, which can all cause hypertension. Long-term hypertension can lead to heart, brain and kidney damage. It is important to insist on treatment.
(2) Pay attention to rest and moderate workload: ensure adequate sleep and pay attention to the combination of work and rest. Overwork and excessive mental stress can lead to high blood pressure.
(3) Low-salt and low-fat diet: the daily salt limit is less than 6g, and those who are overweight should limit calories.
(4) Quit smoking and limit alcohol.
(5) Moderate activities: Avoid participating in competitive sports, do aerobics, Tai Ji Chuan, walking and other aerobic exercises for 30 minutes every day, 3-5 times a week instead of lifting weights and push-ups. If you feel flustered, short of breath or dizzy during the activity, stop the activity immediately and have a rest. In the future, the amount of activities should be reduced appropriately.
(6) Emotional stability: Anger, anger, pessimism, disappointment and other emotions will make people excited and easily induce blood pressure to rise. Let patients know that it is extremely important to keep optimistic and stable mood to control hypertension, and patients should learn to avoid unpleasant things. (7) Insist on taking medicine: take antihypertensive drugs for a long time according to the doctor's advice, without stopping or reducing the dosage. When the blood pressure drops to near normal or normal level, it can prevent the target organ from being damaged.
(8) Disease monitoring: teach patients and their families to measure blood pressure and make records, and provide suggestions for doctors to adjust medication during regular outpatient review.
(9) Support from family members: Family members who know the basic knowledge of hypertension should give patients spiritual and material support, such as providing, supporting and supervising a low-salt diet to promote patients' mental happiness and help stabilize their emotions.
Step 3 evaluate
Patients know and carry out self-care knowledge.
health education
Hypertension has a long course and uneven development, most of which is a benign and slow process, but hypertension itself is a very important pathogenic factor for the heart, brain and kidney. Active control of blood pressure can prevent or reverse the target organ damage caused by hypertension and delay the occurrence of atherosclerosis.
In order to control blood pressure at an appropriate level, patients should be educated to strictly follow the self-care plan, including:
1. Work and rest to ensure adequate sleep;
2. Emotional excitement, especially anger and anger can induce blood pressure to rise, so we should keep our emotions relaxed and stable;
3. The daily salt intake should be less than 6 grams, and obese people should also limit the intake of calories and lipids;
4. Quit smoking and limit alcohol;
5. Exercise Choose aerobic exercise such as cycling, aerobics and brisk walking according to the illness, and avoid taking part in strength activities such as weightlifting and push-ups, as well as competitions and competitive activities. Exercise should be persistent;
6. Take medicine to prevent target organ damage, even if blood pressure drops to normal, you can't stop taking medicine without authorization. The dosage should be in accordance with the doctor's advice, and should not be increased at will, in case of insufficient blood supply to important organs due to hypotension;
7. Disease surveillance teaches patients or their families to measure their blood pressure so that they can measure their blood pressure regularly at home. In addition, patients need regular outpatient follow-up to check the damage of target organs.
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[1] sheets. Internal medicine nursing, 3rd edition. Shijiazhuang: Hebei Education Press, 200 1.2.
[2] Nursing experience of patients with hypertension in Wang Juan. Health Care and Nutrition in China: Second Half Month, No.7, 20 10.
[3], Zhu, Chen Shaoxing, Du Jian, Lu Xuhui, Wu, Guo, Zhu. Analysis of etiology and risk factors of hospitalized patients with hypertension [J]; Journal of hypertension; Issue 08, 2005.
[4], Zhu Shengchun, Shao, Pan Qingxi. Influence of family intervention on the quality of life of patients with hypertension [J]. China Journal of Nursing; 09 was released in 2005.
[5] Feng Jun 'e, Chen Wuhua. Influence of nursing intervention on patients with hypertension [J]; Family nurse; 32 issues in 2007.
Model paper on hypertension nursing Part II: Characteristics and nursing of elderly patients with hypertension Abstract Hypertension in the elderly is one of the main diseases that threaten the health of the elderly. Therefore, we should fully understand the characteristics of elderly patients with hypertension and give corresponding nursing care.
Keywords nursing care of elderly patients with hypertension
Hypertension is the most common cardiovascular disease in the elderly, which seriously affects their health, longevity and quality of life. Therefore, we should fully understand the characteristics of elderly patients with hypertension and give corresponding nursing care.
1 Characteristics of hypertension in the elderly
Does senile hypertension mean age? 60 years old, measured on different days for three consecutive days, systolic blood pressure? 140mmHg, and/or diastolic pressure? 90mmHg, and exclude false and secondary hypertension. There are two kinds of diseases: (1) simple systolic hypertension, systolic blood pressure? 140mmHg, diastolic pressure
1. 1 Blood pressure fluctuates greatly, mainly due to the wide fluctuation range of systolic blood pressure, which is characterized by high and low blood pressure.
1.2 is mainly due to the increase of systolic blood pressure. Most elderly people show an increase in systolic blood pressure, which is often greater than1.60mmhg. Diastolic pressure is normal or decreased, often lower than 90mmHg. At the same time, exercise is often accompanied by dizziness and precordial discomfort.
1.3 prone to postural hypotension. When elderly patients feel dizzy from supine position to upright position during antihypertensive treatment, it is orthostatic hypotension. Therefore, elderly patients with hypertension should move slowly during taking antihypertensive drugs.
1.4 has many complications and complications. Elderly patients with hypertension often have coronary heart disease, diabetes, heart failure, hyperuricemia, hyperlipidemia, obesity and so on. The existence of these diseases reduces the tolerance of elderly patients with hypertension, and the drug interaction between diseases greatly affects the therapeutic effect of hypertension.
2 Nursing care of senile hypertension
There are no obvious symptoms in the early stage of hypertension, such as dizziness, tinnitus, dizziness, insomnia and fatigue. In severe cases, palpitation, dyspnea and blurred vision occur.
Therefore, when the above symptoms appear, you should go to the hospital in time. If you are diagnosed with hypertension, you should take medicine and take good care of it.
2. 1 Hypertensive patients often have emotional instability, and their families should take care of them to reduce their pressure and maintain psychological balance; Pay attention to keep the room quiet and clean, reduce the factors that affect the emotional excitement of patients, and ensure adequate rest and sleep.
2.2 The daily life of patients with hypertension is very important. Patients with hypertension, more symptoms or complications need to stay in bed, but patients with normal blood pressure and good function of important organs should take appropriate activities, encourage them to participate in physical activities within their power, such as walking and playing Tai Ji Chuan, and ensure adequate sleep. 2.3 The diet of patients with hypertension is mainly to adhere to a low-sodium diet, which can lower blood pressure. What's the average amount of salt? 6g, for obese people, we should also limit the total calories of food and fat diet, and the fat should not exceed 30 per day. 40g, and appropriately increase activities to reduce weight and heart load; Also avoid irritating food, avoid alcohol, tobacco, spicy and too sweet food, eat a small amount of meals, and don't be too full. Usually, we should increase the intake of vegetables, fruits and high-cellulose foods.
2.4 Patients with hypertension should pay attention to avoid the factors of drastic changes in blood pressure, such as not participating in activities that are easy to cause high mental excitement; Pay attention to keep warm in winter; Quit smoking; Prevent constipation; Restrain sexual life, etc.
2.5 Prevention of postural hypotension. Avoid standing still for a long time, suddenly squatting or lowering your head, move slowly when changing positions, and don't have too high water temperature when taking a bath. If hypotension occurs, you should lie flat and raise your feet immediately to relieve it.
2.6 Pay attention to the adverse reactions of drugs. If there are adverse reactions, the use of drugs should be adjusted, and blood pressure should not drop too fast or too low. Supervise patients to take medicine according to doctor's advice, and don't increase or decrease drugs according to their own feelings. Take the medicine on time, don't forget to take the medicine or make up the last dose next time, and don't suddenly change the medicine yourself.
3 abstract
The prevalence of hypertension among the elderly in China is 25% ~ 35%. For senile hypertension, one is to lower blood pressure and control symptoms, and the other is to prevent complications such as coronary heart disease, stroke and renal failure. The third is to provide appropriate care for elderly patients with hypertension. Advocate everyone to develop reasonable and healthy living habits, actively participate in cultural and sports activities, and remain optimistic.
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[1] Cardiovascular Disease Prevention and Research Center of the Ministry of Health of the People's Republic of China. Guidelines for prevention and treatment of hypertension in China (revised in 2005) [M]. Beijing: People's Health Publishing House, 2006: 85-8.
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