Question

Mr. Henderson is a 49-year-old patient who is admitted to the medical-surgical floor in a hypertensive crisis. The patient's vital signs are B/P: 200/98, HR: 62; RR: 12; T: 98.4 F, and oxygen saturation: 96% on room air. The patient is complaining of a headache and blurred vision. The patient's past medical history: hyperlipidemia, borderline diabetes, and gout. The patient takes atorvastatin and allopurinol. The patient states, "l control my diabetes with my diet." He is ordered Cardene, 5 mg/hr., via continuous IV infusion. The pharmacy sends Cardene, 25 mg in 250 ml normal saline to the floor.

• Discuss the difference in primary and secondary hypertension. Based on this information, is Mr. Henderson's hypertension primary or secondary and provide a rationale.
• The patient loses the ability to move his right arm and leg. Identify a possible rationale for this loss of movement and two nursing interventions to implement at this time.
• Identify three organ systems that can be damaged by uncontrolled hypertension and discuss how this damage occurs.
• Develop a discharge teaching plan for Mr. Henderson with rationales.

Answer 1

Hypertensive crisis is defined as severe increase in blood pressure that can leads to attack of stroke. In hypertensive crisis systolic pressure is 180 or more and diastolic pressure120 or more mm of hg we can observe this can damage blood vessels and leads to leakage of blood from blood vessels. Causes of hypertensive emergency are. *Forgetting to take antihypertensive medications *Stroke. *Heart attack. *Heart failure *Renal failure. *Drug interactions. *Rupture of Major blood vessels.

Primary hypertension is also called as essential hypertension. It is a type of high blood pressure that has no clearly identifiable cause. It was linked to genetic history, poor diet, lack of exercise, obesity. It affects majority of population who experience hypertension. Secondary hypertension ,it is a type of high blood pressure ,we can find particular cause. It is caused by another disease or cause.It affect only 5 to 10 percent of population. Causes of secondary hypertension are: Renal problems, cardiac problems like arteriosclerosis (narrowed blood vessels), endocrine problems like hyperthyroidism, hyper para thyroidism where higher level of calcium leads to hypertension,adrenal diseases. It may occur as side effects to certain medications like NSAIDS,hormonal contraceptives ,Diet control pills.

Based on given information Mr.Henderson's hypertension was secondary type of hypertension because patient had past history of hyper lipidemea it causes atherosclerosis that is narrowing of blood vessels due to plaque formation in major blood vessels by low density lipids it leads to increase blood pressure, and patient has history of gout that is type of arthritis, to treat arthritis mostly use NSAIDS, prolonged exposure to these drugs also cause hypertension.

Based on given history patient had loss of ability to movement in right arm and leg ,this is the symptoms of stroke ,that us damage to brain tissue due to damage to blood vessels caused by high blood pressure.

First as a nurse we have to identify the underlying cause for loss of movements, measure vital signs accurately, provide comfortable position, try to reduce blood pressure by interventions like giving ordered medications,avoiding causes,advising low salt diet.

Three Major systems damages by hypertension is renal system that affect kidney ,Cardiac system damaged to blood vessels , Nervous system damaged to brain tissues.