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Disease History of a Patient with Hypertension

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Client Background

My client is a 95-year-old male who came into the nursing home with weakness and now presents hypertension. He is widowed and has told me that he has three children. He has shown great interest in watching football and has said that he has played football when he was in high school. My client finished high school and went on to college for one semester. After that, he started to farm. He started with milking just a few cows, and as technology advanced the farm grew. One of his favorite hobbies is to go fishing with his son.

Definition and Pathophysiology

According to Hypertension is a systolic pressure of 140 mm Hg or higher and a diastolic pressure of 90 mm Hg or higher or taking drugs to control blood pressure. When I have taken my client’s blood pressure it is always around 120/76 which is not hypertension but according to the definition if someone is taking drugs to control blood pressure, then that is considered hypertension. There are a few different types of hypertension which include essential, secondary, and malignant. Hypertension is fairly common and can be caused by renal disease. Having hypertension can take a big toll on your body. For example, the book People who have long term hypertension may be at risk for vital organ damage. This is because the blood vessels thicken and as they thicken perfusion decreases. Having said this, some health concerns to be aware of would be MI, stroke, PVP, or renal disease.

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Clinical Manifestation, Signs, and Symptoms

My client’s admitting diagnosis was weakness and he often says that he feels dizzy. The Book states that most people have no symptoms of hypertension but some may experience fatigue or dizziness. Since my client has hypertension this could be an explanation of why he was feeling weak. There is no diagnostic test for essential hypertension, but there are some ways we can tell what is causing secondary hypertension. Kidney disease is one of the major causes of secondary hypertension and diagnostic test that indicate kidney disease are to see if they have an elevated BUN, protein present in the urine, and decreased GFR. When my client had these tests done he showed all of these signs of kidney disease which is what could be causing his hypertension.

Medical Care

You can treat hypertension in nonpharmacological ways as well as pharmacological ways. As a nurse, one of your main jobs is to teach your patients about their disease and what their plan of care is. For hypertension you can teach your patient some lifestyle changes he or she can make such as reduced-sodium diet, losing weight, and exercise. You can also do drug therapy to treat hypertension. The first line of antihypertensive drugs a diuretics, then Calcium channel blockers, and then Angiotensin 2 blockers. My client is taking a diuretic, an ACE 1 inhibitor, and a B-1 Adrenergic blocker. We must teach our clients about the drugs they are taking and what side effects may occur.

Summary

Throughout the process of caring for my client and even writing this paper, I have learned the long term effects of hypertension and what it can do to your body. I have also learned a lot by looking at the diagnostics and seeing how renal function can play a big roll in hypertension. In my client’s case, he has all the abnormal levels that indicate kidney disease and that plays a role in his heart health as well.

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