(^36) Medical-Surgical Nursing Demystified
- Stage 2 hypertension: 160 mmHg / systolic 100 mmHg diastolic
- In diabetic patients: hypertension is defined as 130/80 or higher
PROGNOSIS
The vast majority of patients have primary hypertension, or high blood pressure,
that is not caused by other disease. Patients are typically asymptomatic and need
to understand the importance of treatment to avoid long-term complications. End
organ damage can affect the heart, kidneys, brain, or eyes. Adequate control of
blood pressure is possible with medications and lifestyle modification, but these
need to be maintained for the long term, often for the rest of the patient’s life.
Many patients will ultimately need to be on multiple medications to achieve ade-
quate blood pressure control.HALLMARK SIGNS AND SYMPTOMS
- Asymptomatic
- Headache
- Dizziness
INTERPRETING TEST RESULTS
- Blood pressure readings higher than 140/90 mmHg on at least three occasions.
- Ventricular hypertrophy depicted on EKG or chest x-ray.
- Blood test to look for associated cardiovascular risks.
- High cholesterol—often associated with hypertension.
- Check electrolytes for imbalance—sodium, potassium, chloride, CO 2.
- Monitor BUN and creatinine for renal function, a sign of impaired organ
damage. - Chemistry to check for diabetes mellitus.
TREATMENT
Treatment is aimed at decreasing the risk of CVA, CAD, heart failure, renal disease,
and other long-term sequelae of hypertension. Risk factors need to be assessed: