Nursing Care Plan for Elderly with Hypertension
Enter old age means deteriorated physically and psychologically. Physical deterioration characterized by the loosened skin, graying hair, hearing loss, vision deteriorates, slow movement, abnormalities of various functions of vital organs, increased emotional sensitivity and lack of passion.
Although naturally a decline in the function of various organs, but not necessarily cause disease therefore must be healthy old age. Healthy in this case means:
In connection with the change, then Hurlock (1990) says that the changes experienced by every person will affect the interest in these changes and ultimately affects the lifestyle. What is the attitude shown whether satisfactory or unsatisfactory, it depends on the effect of changes to the role and personal experience. Changes in demand by the elderly is associated with changes in health improvement issues, economic / income and social roles (Goldstein, 1992)
In the face of such changes necessary adjustments. The characteristics are not good adjustment of the elderly (Hurlock, 1979, Munandar, 1994) are:
Hypertension
Hypertension is an increase in blood pressure that is persistent. In adults the average systolic blood pressure at or above 140 mm Hg and diastolic pressure equal to or above 90 mm Hg, according to the American Heart Association, the average of the two different tests in two weeks.
Hypertension based on the cause can be divided into two major categories, namely:
Essential hypertension (hypertension primary / idiopathic) that hypertension of unknown cause, as many as 90% of cases.
Secondary hypertension is hypertension caused by other diseases, as much as 10%.
Prevention efforts beneficial for patients with hypertension for the disease from getting worse, of course, must be accompanied by the use of drugs to be prescribed by a doctor. In order to avoid fatal complications of hypertension, precautions must be taken good (Stop high blood pressure), among others :
NCP for Elderly with Hypertension (Diagnosis and Interventions)
1. Activity intolerance related to general weakness, imbalance between supply and demand of oxygen.
Expected outcomes:
2. Pain (acute): headache related to an increase in cerebral vascular pressure.
Expected outcomes: report pain / discomfort is reduced.
Intervention:
3. Impaired physical mobility related to a decrease in motor function secondary to upper motor neuron damage.
Expected outcomes: The client will indicate the action to improve mobility.
Intervention:
1) Teach the client to perform active range of motion exercises on a limb that is not sick at least four times a day.
R /: active range of motion increase mass, tone and muscle strength and improve cardiac and respiratory function.
2) Perform passive range of motion exercises on the affected extremity three to four times a day. Perform exercises slowly to allow time for the muscles to relax and prop limb above and below the joint to prevent strain on the joints and tissues.
R /: voluntary muscles to lose tone and strength when not in use. Contracture of the flexor and adductor muscles can occur because the muscles are stronger than the extensor and abductor.
3) If the client in bed doing the action to straighten posture.
R /: Mobility and prolonged damage neurosensory function can cause permanent contractures.
4) Prepare the progressive mobilization.
R /: Bed rest long or decreased blood volume can cause a drop in blood pressure suddenly (orthostatic hypotension) because the blood back into the peripheral circulation. Increased activity will gradually decrease fatigue and increase in prisoners.
5) Slowly help clients advance of active ROM to functional activity as indicated.
R /: Giving a boost to the client to perform on a regular basis.
4. Risk for injury related to visual field deficits, motor or perceptual.
Expected outcomes:
1) Take action to reduce environmental hazards.
R /: Helps reduce injuries.
2) If the decrease in tactile sensitivity becomes a problem teach clients to do:
Assess the temperature of bath water and heating pads before use.
Assess limb every day of the injury was detected.
Keep feet warm and dry and soothed skin with lotion emoltion.
R /: Damage to sensory post CVA may affect the client's perception of temperature.
3) Take action to reduce the risks relating to the use of tools.
R /: Use of improper tools or do not fit can cause strain or fall.
4) Encourage clients and families to maximize security at home.
R /: Client with mobility problems, requiring the installation of aids.
Enter old age means deteriorated physically and psychologically. Physical deterioration characterized by the loosened skin, graying hair, hearing loss, vision deteriorates, slow movement, abnormalities of various functions of vital organs, increased emotional sensitivity and lack of passion.
Although naturally a decline in the function of various organs, but not necessarily cause disease therefore must be healthy old age. Healthy in this case means:
- Free from physical illness, mental and social,
- Able to perform activities to meet daily needs,
- Social support from family and society (Rahardjo, 1996)
In connection with the change, then Hurlock (1990) says that the changes experienced by every person will affect the interest in these changes and ultimately affects the lifestyle. What is the attitude shown whether satisfactory or unsatisfactory, it depends on the effect of changes to the role and personal experience. Changes in demand by the elderly is associated with changes in health improvement issues, economic / income and social roles (Goldstein, 1992)
In the face of such changes necessary adjustments. The characteristics are not good adjustment of the elderly (Hurlock, 1979, Munandar, 1994) are:
- The narrow interests of the events in the environment.
- Withdrawal into fantasy world.
- Always recalls the past.
- Always worried because of unemployment.
- There is less motivation.
- Sense of loneliness because of the relationship with the family is poor, and
- Undesirable place to live.
Hypertension
Hypertension is an increase in blood pressure that is persistent. In adults the average systolic blood pressure at or above 140 mm Hg and diastolic pressure equal to or above 90 mm Hg, according to the American Heart Association, the average of the two different tests in two weeks.
Hypertension based on the cause can be divided into two major categories, namely:
Essential hypertension (hypertension primary / idiopathic) that hypertension of unknown cause, as many as 90% of cases.
Secondary hypertension is hypertension caused by other diseases, as much as 10%.
Prevention efforts beneficial for patients with hypertension for the disease from getting worse, of course, must be accompanied by the use of drugs to be prescribed by a doctor. In order to avoid fatal complications of hypertension, precautions must be taken good (Stop high blood pressure), among others :
- Reduce salt intake.
- Avoid obesity.
- Limiting fat consumption.
- Exercise regularly.
- Eat plenty of fresh vegetables.
- Do not smoke and do not drink alcohol.
- Relaxation exercises or meditation.
- Trying to build a positive life.
NCP for Elderly with Hypertension (Diagnosis and Interventions)
1. Activity intolerance related to general weakness, imbalance between supply and demand of oxygen.
Expected outcomes:
- Participate in the activities of the desired / required.
- Reported an increase in activity tolerance that can be measured.
- Showed a decrease in signs of intolerance physiology.
- Assess response to activity.
- Pay attention to blood pressure, pulse during / after the break.
- Note chest pain, dyspnea, dizziness.
- Advise on energy saving techniques, eg using a chair in the shower, comb the hair.
- Activity slowly.
- Give a boost to activity / self-care gradually if it can.
- Give help as needed.
2. Pain (acute): headache related to an increase in cerebral vascular pressure.
Expected outcomes: report pain / discomfort is reduced.
Intervention:
- Maintain bed rest during the acute phase.
- Give non-pharmacologic measures for the relief of pain such as back massage, neck, quiet, relaxation techniques.
- Minimizing the vasoconstriction activity can increase headache, eg bending, straining during bowel movements.
- Collaboration in the administration of analgesic, antianxiety.
3. Impaired physical mobility related to a decrease in motor function secondary to upper motor neuron damage.
Expected outcomes: The client will indicate the action to improve mobility.
Intervention:
1) Teach the client to perform active range of motion exercises on a limb that is not sick at least four times a day.
R /: active range of motion increase mass, tone and muscle strength and improve cardiac and respiratory function.
2) Perform passive range of motion exercises on the affected extremity three to four times a day. Perform exercises slowly to allow time for the muscles to relax and prop limb above and below the joint to prevent strain on the joints and tissues.
R /: voluntary muscles to lose tone and strength when not in use. Contracture of the flexor and adductor muscles can occur because the muscles are stronger than the extensor and abductor.
3) If the client in bed doing the action to straighten posture.
R /: Mobility and prolonged damage neurosensory function can cause permanent contractures.
4) Prepare the progressive mobilization.
R /: Bed rest long or decreased blood volume can cause a drop in blood pressure suddenly (orthostatic hypotension) because the blood back into the peripheral circulation. Increased activity will gradually decrease fatigue and increase in prisoners.
5) Slowly help clients advance of active ROM to functional activity as indicated.
R /: Giving a boost to the client to perform on a regular basis.
4. Risk for injury related to visual field deficits, motor or perceptual.
Expected outcomes:
- Identifying factors that increase the risk of injury.
- Demonstrating the safety measures to prevent injury.
- Ask for help when needed.
1) Take action to reduce environmental hazards.
R /: Helps reduce injuries.
2) If the decrease in tactile sensitivity becomes a problem teach clients to do:
Assess the temperature of bath water and heating pads before use.
Assess limb every day of the injury was detected.
Keep feet warm and dry and soothed skin with lotion emoltion.
R /: Damage to sensory post CVA may affect the client's perception of temperature.
3) Take action to reduce the risks relating to the use of tools.
R /: Use of improper tools or do not fit can cause strain or fall.
4) Encourage clients and families to maximize security at home.
R /: Client with mobility problems, requiring the installation of aids.
