Question

Case Study chapter 31
Assessment and Management of patients with hypertension

Please how do I formulate a careplan using Nursing careplan Rubic on the 2 topics below

1. Diagnostics and labs
2. head to toe assessment
expected findings for diagnosis

Answer 1

1) Diagnosis and lab tests for Hypertension :-

Diagnosis of Hypertension is done by measuring the blood pressure through sphygmomanometer and by the help of lab tests.

Lab tests required for the diagnosis of Hypertension are :-

• ECG (Electrocardiogram) test.
• Echocardiography.
• Treadmill test.
• Blood glucose test
• Blood urea and serum creatinine.
• Lipid profile ( Cholesterol, LDL, and HDL ).
• Liver profile.
• Serum electrolytes.

2) Head to toe assessment expected findings for diagnosis of Hypertension are :-

• Brain : Hypertensive encephalopathy may be present.
• Eyes (Retina) : Papilledema, Hemorrhage, narrowing of arterial diameter, and exudates.
• Blood pressure : systolic > 139 mm of Hg and diastolic > 89 mm of Hg.
• Pulses : All major peripheral pulses should be evaluated to detect aortic dissection and peripheral atherosclerosis.
• Heart : Enlargement of left ventricle with a left ventricular heave may be present. Calcified aortic sclerosis produces systolic ejection murmurs which may sometimes produce aortic stenosis in some individuals. Pre systolic gallop is common due to decreased compliance of left ventricle.
• Scalp and neck : increased subcutaneous fat thickness.
• Chest : clear but sometimes may show the signs of pulmonary hypertension.

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