Electronic textbook：Nursing for elderly patients with hypertension

Nursing of HBP（high blood pressure）for elderly

1. Overview

According to China cardiovascular and pediatric disease report 2017, there are

270 million patients with hypertension in China, of which nearly 50% of people aged 60 suffer from hypertension and nearly 90% of people aged 80 suffer from hypertension.

Geriatric hypertension: geriatric hypertension refers to the elderly over 65 years

old, whose blood pressure lasts for more than three times or not on the same day, systolic blood pressure SBP ≥ 140 mmHg and / or diastolic blood pressure DBP ≥ 90 mmHg.

Hypertension is a special type of disease, which is one of the major risk factors for the incidence rate and mortality of elderly people with sudden cerebral infarction, coronary heart disease, heart failure, renal failure. The prevalence rate among

people over 60 years old is 49%, which is a major problem in elderly health care.

Predisposing factors of hypertension:

1) Genetic factors: obvious familial

2) Environmental factors: diet, smoking, mental stress, overweight, others.

2. Nursing evaluation:

(1) health history: general information; Family history of hypertension, high salt  and low potassium intake, etc.

(2) physical condition:

1) Symptoms: the disease progresses slowly, and more than half of the patients have no obvious symptoms.

2) Mostly simple systolic hypertension

3) Blood pressure fluctuates widely

4) Abnormal circadian rhythm, white coat hypertension and pseudohypertension are relatively common.

5) It often coexists with a variety of diseases.

(3) social psychological status: due to the influence of physical symptoms, elderly patients with hypertension can have different degrees of psychological reactions such as tension, anxiety and depression, especially improper treatment or ineffective effect, which will make the patients feel fear and lose confidence.

(4) auxiliary inspection:

1) Blood routine, urine routine, blood glucose, blood cholesterol, etc

2) Special examination: 24h ambulatory blood pressure monitoring (ABPM)

(5) treatment measures:

1) Blood pressure control target value: below 150 / 90mmHg

2) Improve living habits

3) Antihypertensive drug therapy

3. Nursing diagnosis:

(1) chronic pain: headache is related to elevated blood pressure.

The risk of injury is related to dizziness caused by high blood pressure, blurring of things, or lowering blood pressure with antihypertensive drugs.

(3) anxiety is related to physical discomfort caused by hypertension and dissatisfaction with blood pressure control.

(4) lack of knowledge: lack of knowledge about improving life behavior, self-monitoring blood pressure and taking antihypertensive drugs.

(5) potential complications: heart failure, hypertensive emergency, cerebrovascular accident and renal failure.

4. Nursing objectives:

(1) the patient's blood pressure is controlled within a reasonable range, and the headache is reduced.

(2) after reasonable control, there is no accident in blood pressure and medication

⑶ after effective communication with patients and ideal control of blood pressure, patients can adjust their emotions and reduce anxiety.

(4) it can improve health care knowledge and achieve reasonable treatment.

(5) the patient's physical function is improved, and there are no complications or timely detection and treatment.

5. Nursing measures:

(1) rest and activities

1) Ensure reasonable rest time for patients according to their condition

2) Arrange the activity mode and amount according to the condition

⑵Diet care: reduce weight and try to control it below 24kg / m2.

(3) medication nursing: follow the doctor's advice and observe the adverse

reactions.

(4) condition observation: monitor the blood pressure according to the condition, and conduct 24h blood pressure monitoring if necessary

(5) psychological nursing: reduce pressure and guide patients to learn relaxation techniques

(7) health guidance

6. Nursing evaluation:

After treatment and care, do you achieve:

(1) be able to actively cooperate with medical staff for treatment

(2) blood pressure is controlled within a reasonable range and clinical symptoms  are relieved

(3) patients can reasonably control blood pressure through medication and life behavior guidance

(4) no adverse drug reactions occurred

(5) patients can adjust their emotions, reduce anxiety and reduce or avoid complications.