Question

case study chapter 31 nursing care plan hypertension

Answer 1

The nursing care plan for hypertension is given below:

Assessment	Diagnosis	Inference	planning	Intervention	Rationale	Evaluation
Subjective data: The patient complaints of feeling dizziness. Objective data: *Decreased performance * Edema, venous distension * vital signs: Temp:37.2 P:86 R:20 BP: 180/112	Fluid volume excess related to renal failure	The decreasd blood flow to kidneys leads to decreased perfusion even leads to decreased urine output leads to water retention results in excess fluid volume.	After 6 to 8 hours of close monitoring, the patient will demonstrate his behaviour to monitor fluid status	* Monitor and record vital signs * Record fluid intake and output * Assess the skin for any evidence of edema. * Assess patient's appetite. * Compare the weight gain with the previous one.	* To identify the presence of naussea and vomiting. * To maintain fluid retention and avoid fluid overload. * The edema is seen in the tissues of the body. * To monitor intake and output. * To maintain fluid status.	The patient has displayed appropriate vital signs, urine output, no evience of edema,stable weight.