Academic Master

Health Care

A nurse is taking care of a patient with chronic orthostatic hypotension admitted to a med/surg unit. The nurse identifies a drop in systolic pressure of at least 25 mm of Mercury, and the patient reports dizziness and feeling of being ready to faint. What interventions by the nurse should BE taken to preserve patient safety?

The patient’s BP can be classified as hypertension stage I, where SBP ranges between 140-159 mm Hg, and DBP is between 90-99 mm Hg. In normal BP, SBP is less than 120 mm Hg, and DBP is less than 80 mm Hg. In the case of prehypertension, SBP ranges between 120-139 mm Hg, and DBP is between 80-89 mm Hg. In hypertension stage II, SBP is 160 mm Hg or more, and DBP is 100 mm Hg or more.

Hypertension is one of the most important reasons for the origin of atherosclerosis, and it is caused by mechanisms that have not yet been completely discovered. Once atherosclerosis starts to originate, it harms the walls of arteries and decreases the flow of blood to target organs and tissues.

The nurse’s priority assessments should consist of the deficiency the neurological system Is going through, any kind of loss to the eye, failure of the heart, pulmonary edema, and renal failure. Confusion could be seen with hypertensive encephalopathy, from increased cerebral capillary permeability leading to cerebral edema. Pregnancy can lead to secondary hypertension. Needing to urinate and taking antiseizure medication do not indicate a hypertensive emergency.

The nurse should prescribe antihypertensive medications that are effective at reducing BP; however, the medications should not be stopped abruptly because this can cause a severe hypertensive reaction. The medications should be discontinued only after consulting with the primary healthcare provider. The medication should not be stopped even if the BP measurements show normal readings. Medications should be taken regularly for sustained therapeutic effects. A reduction in the dosage may reduce the efficacy of the drug. Lifestyle modifications are necessary to reduce cardiovascular risks; however, antihypertensive medications should also be used for the effective reduction of BP.

The nurse should advise the subject to reduce the consumption of salt to control hypertension because hypertension can increase by consuming more salt, which can lead to fluid retention. Caffeine and protein intake do not affect hypertension. Calcium supplements are not recommended to lower blood pressure. There is strong scientific evidence that backs the consumption of omega-3 for the treatment of hypertension, hypertriglyceridemia, and cardiovascular disease. Melatonin, green tea, and glucosamine are not indicated for the prevention and treatment of cardiovascular disease. There is unclear scientific evidence for the use of green tea in the treatment of high cholesterol.

The nurse should also advise on lifestyle modifications as they play a vital role in reducing blood pressure and cardiovascular risk. Overweight people are at higher risk of cardiovascular disease. Almost 10kg weight reduction may help in reducing the systolic BP by almost five to twenty mm Hg. It’s essential to maintain your health by keeping yourself indulged in physical activities. It decreases the cardiovascular risk of hypertension. Sodium reduction helps to control blood pressure. A hypertensive patient should lower salt intake to 1500 mg/day. The nicotine in tobacco causes vasoconstriction and increases blood pressure. Therefore smokers who are hypertensive should stop smoking. Excessive alcohol consumption increases the risk of hypertension. Consuming three or more drinks per day increases the risk of cardiovascular disease and stroke.



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