Deciphering Hypertension as a Certified Nursing Assistant

Did you know that hypertension affects approximately seventy-five million people in the United States alone? It plays a vital role in the risk for stroke, myocardial infarction (MI), vascular disease, and chronic kidney disease (CKD).

What is Hypertension?

Hypertension refers to the systolic blood pressure (SBP) of 140 mm Hg or higher, or a diastolic blood pressure (DBP) of 90 mm Hg, or taking anti-hypertensive medication. According to recommendations of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), the blood pressure (BP) classification for adults eighteen years old and older is the following:

• Normal: Systolic lower than 120 mm Hg, diastolic lower than 80 mm Hg
• Pre-hypertension: Systolic 120-139 mm Hg, diastolic 80-89 mm Hg
• Stage 1: Systolic 140-159 mm Hg, diastolic 90-99 mm Hg
• Stage 2: Systolic 160 mm Hg or higher, diastolic 100 mm Hg or higher

There are two types of hypertension. One is primary or essential hypertension; this is the most common and the most misunderstood. Primary, or essential hypertension is responsible for ninety to ninety-five percent of adult cases.The other is secondary hypertension, which has a primary cause such as renovascular disease, endocrine disease, renal disease, and medication. Secondary hypertension is responsible for two to ten percent of cases.

What Is The Impact That Hypertension Have On A Patient/Resident Short-Term and Long-Term?

Although the short-term impact of hypertension is unknown, the long-term impact of hypertension includes heart failure, stroke, coronary disease, and chronic kidney disease (CKD). Hypertensive emergencies include aortic dissection, which can be life-threatening as with hypertensive encephalopathy.

Treatments For Hypertension

In treating hypertension, always begin with limiting sodium intake, reducing alcohol use, increasing physical activity, losing weight (if overweight), and eating healthier foods, as in low-fat foods. If these measures are unsuccessful, then hypertension is likely the cause and may to be further evaluated.

How To Deal With a Patient/Resident With Hypertension

There are medications for the treatment of hypertension; these should be prescribed and administered. The blood pressure should be checked on a regular basis to ensure the medication is working properly. If the blood pressure is low, then the medication can be put on hold. A diet that is rich in fruits and vegetables, low sodium, and low-fat should be given for hypertension.

Providing the Hypertensive Patients/Residents with Much Comfort As Possible

Most people who suffer from hypertension are asymptomatic and no specific measures need to take place. In contrast, if a patient/resident with hypertension have symptoms such as blurry vision, headache, chest pains, or palpitations, then the blood pressure is likely elevated. With an elevated blood pressure, a visit to the emergency room (ER) is likely guaranteed; the blood pressure needs to be controlled in a hospital or an inpatient setting.

To ensure safety and comfort for patients/residents with hypertension, here are the following steps to do:

• Limit sodium intake
• Be physically active for approximately half an hour each day
• Eat a balanced diet, which should include fruits, vegetables, and low-fat dairy foods
• Reduce alcohol intake
• Have lab work drawn annually for cholesterol check, thyroid, kidney function, etc. that is recommended by a primary care provider
• Lose weight (if the patient/resident is overweight)
• Be compliant with every medication and take them as prescribed.
• If symptoms such as headache, chest pain, or blurry vision occur, go to the emergency room (ER) for evaluation immediately

How do you handle hypertension as a Certified Nursing Assistant with patients/residents? Please feel free to add your comments in the Comments box