Nursing Care Plan for Hypertension in Aged People

Hypertension in aged people 

High blood pressure is among the severe concerns for the health of aged people. With time, people’s blood vessels tend to lose their elasticity, and other physiological changes can also contribute to a higher chance of developing high blood pressure. The heart has to make an extra effort to move blood, resulting in health issues, including a heart attack or a stroke. Poor diet, a sedentary lifestyle and stress are among lifestyle factors that may worsen hypertension in the elderly. 

Blood pressure checkups must be done regularly, and lifestyle modifications such as eating healthy foods and exercising regularly must be practised. This will help minimise the complications of high blood pressure, especially in old age, and promote general health to the senior population. Furthermore, medicine is given to maintain healthy blood pressure levels where it is required.

Table of Contents

• Hypertension in aged people 

• Type of  Hypertension in aged people

• Primary Hypertension

• Secondary Hypertension

• Isolated Systolic Hypertension (ISH)

• White Coat Hypertension

• Masked Hypertension

• Resistant Hypertension

• Nursing Diagnosis for Hypertension

• Nursing Care Plan for Hypertension

• conclusion 

• frequently asked question 

Type of  Hypertension in aged people

Among the elderly, several forms of hypertension exist; each has unique qualities and considerations.

• Primary Hypertension:

The primary type, essential or idiopathic hypertension, is the most prevalent without any apparent cause. Most often, it occurs slowly over a period of time, caused by ageing, genetics, and poor eating and exercise habits. The management of primary hypertension is usually based on diets and other lifestyles coupled with drugs in certain instances.

• Secondary Hypertension:

It involves primary hypertension, which is more prevalent than secondary hypertension due to another illness for example infections of the kidney or related hormonal disorders. Addressing the root cause of secondary hypertension is more essential than treating the primary form of hypertension. Controlling blood pressure effectively by discovering and treating the underlying cause at its source.

• Isolated Systolic Hypertension (ISH):

Isolated Systolic Hypertension (ISH), or ‘essential hypertension’, is when the systolic blood pressure rises, whereas diastolic pressure falls within the normal range. This scenario is shared among aged persons, whereby many develop changes in their arteries as they grow old.S There is an alarming issue known as ISH, which if not handled with care, might lead to cardiovascular incidences and other related complications.

• White Coat Hypertension:

White coat hypertension is an abnormal higher BP reading among patients undergoing blood pressure monitoring at their doctors’ offices. Such a phenomenon can be related to anxiety or stress because of the hospital environment. Ambulatory or out-of-clinic blood pressure monitoring is usually advised for confirmation of the diagnosis and exclusion of unnecessary medicine for follow-up monitoring of BP outside a clinical setting following initial treatment.

• Masked Hypertension:

Masked hypertension differs from “white coat hypertension” which involves high blood pressure measured in a medical context but remains normal in everyday circumstances. A lot time, such hypertension remains undiagnosed because it is challenging to notice in a routine doctor’s visit, and that is why there is the high necessity of out-of-office pressures to monitor even elderly and old people.

• Resistant Hypertension:

Blood pressure will be classified as resistant hypertension when it remains uncontrolled by an effective three-drug therapy combination, which consists of one diuretic. It is challenging to cope with this condition, and there might be other reasons, including failure to adhere to medications or lifestyle or even secondary ones. Managing this form of essential hypertension involves identifying and addressing the particular reasons of the resistance.

It is essential to understand various forms of age-related hypertension because correct diagnostic procedures and appropriate therapy are dependent upon it. Controlling blood pressure and reducing its complications involves regular monitoring modifying the lifestyle and medication where applicable.

Nursing Diagnosis for Hypertension

Nursing diagnoses of hypertension among aged patients is a way of establishing various health issues or complicating factors that could arise as a result of high blood pressure. Here are some possible nursing diagnoses:

Risk for complications related to hypertension:

• Check the kidneys, heart, and eye signs of organ injury.
• Watch out for symptoms of hypertensive crisis.
• Assess lab findings for evidence of end organ injury.

Ineffective Self-Health Management:

• Evaluate the patients’ understanding of hypertension and its treatment.
• Identify barriers to medication adherence.
• Education on lifestyle changes, medicine compliance and monitoring regularly.

Impaired Tissue Perfusion: Cerebral, Renal, Cardiopulmonary:

• Check blood pressure trends for signs of poor perfusion.
• Laboratory evaluation of renal function.
• Look for reduced cerebral blood flow symptoms (dizziness, confusion etc).

Activity Intolerance:

• Evaluate physical activity/tolerance in a patient.
• Work with the patient in designing a customised exercise regime.
• Observe for indications of exhaustion or exercise-induced breathlessness.

Anxiety related to Hypertension Diagnosis:

• Determine how the patient feels about having been diagnosed with hypertension.
• Give information on how to manage anxiety over this condition.
• Provide psychological help in collaboration with other healthcare professionals, if necessary.

Knowledge Deficit:

• Evaluate the patients’ knowledge regarding hypertension, what leads to it and complications that may result from it.
• Educate on lifestyle changes, medication adherence, and routine follow-up assessments.
• Prompt questions on key issues highlighted in the discussion

Risk for Falls:

• Carry out risk assessments like dizziness and medication side effects.
• Fall prevention strategies like safety environments and assistive devices
• Teach them why to get up slowly in order not to develop the so-called orthostatic hypotension.

Altered Nutrition: Less than Body Requirements:

• Assess the patient’s eating patterns and choices.
• Work with one of the dietitians to come up with an effective low-sodium diet.
• Check for evidence of either malnutrition or unwarranted weight loss.

Nursing Care Plan for Hypertension

• Assessment:

• Perform a thorough health screening targeted at the elderly patient’s past medical record, nutrition, exercise habits, smoking habits and hypertension risk factors.
• It encompasses regular monitoring of vital signs, including blood pressure readings and indicators of organ damage such as kidney failure and cardiovascular issues.

• Nursing Diagnosis:

• Make a nursing diagnosis like “Risk of complications due to hypertension among the elderly”.
• Work with the health care team to identify unique risk factors and personal contributory features responsible for the case.

• Interventions:

• Make simple lifestyle modifications, such as consuming heart-healtly food, exercises on daily basis and reducing stress levels that will match with the age group.
• Educate the patients on proper use and potential side effects while administering prescribed antihypertensive drugs.
• Give health education on managing hypertension and advice such as follow up, medication adherence, and self-monitoring of blood pressure.

• Monitoring and Evaluation:

• Regularly check the blood pressure readings, and evaluate the performance of interventions aimed at controlling hypertension
• Assess elderly person’s comprehension regarding their illnesses and self-care and adapt the treatment regimen.
• Work closely with the health care team to monitor any adverse effects resulting from medications, and revise the care plan when required.

• Follow-up and Referrals:

• Consider making periodical follow-up appointments to monitor the elderly’s advancement and, if needed, make amendments to the care plans.
• Work closely with other medical professionals like dieticians or physiotherapist for an overall strategy into control of hypertension.
• Referrals to other support groups and health, legal and related community services may be considered to help improve the person’s social and emotional wellness.

• Preventive Measures:

• Place more focus on preventive measures like stop smoking, moderate alcohol use, lose weight etc, to lower the total risk of cardiovascular diseases.
• Inform the aged person about the initial symptoms that could indicate problems and urge him/her to report to doctors promptly.
• Conduct regular health checks for conditions such as diabetes and hyperlipidaemia which are known to aggravate hypertension.

Conclusion:

Aging results in physiological changes, often leading to hypertension, worsened by poor lifestyle choices like a bad diet and stress. Regular blood pressure checks, a healthy diet, and exercise help minimise complications, sometimes requiring medication. Understanding various types of hypertension in the elderly is crucial for proper classification and treatment, each requiring unique management strategies. 

Nursing diagnoses pinpoint potential issues, and nursing care plan for hypertension involve lifestyle changes, medication adherence, and close monitoring. Ensuring the health of the elderly requires collaboration with healthcare professionals, routine follow-up visits and preventive measures like smoking cessation and weight management.

Frequently Asked Questions

1. What Causes High Blood Pressure in Elderly?

However, it should be noted that there are several reasons behind high blood pressure in old age. These may include changes with increasing one’s age affecting blood vessels themselves, reduction of elasticity among arteries, cumulative effects of unhealthy eating habits, lack of exercise, and chronic.

2. Can Hypertension be Cured?

While it is possible to manage hypertension rather than cure it, this should be handled with caution. Dietary changes can effectively manage blood pressure with proper medication use and monitoring. Hypertension cannot be fully cured, but some contributors can be treated.

3. What is the Nurses Role in Preventing Hypertension?

Nursing is essential in discouraging hypertension by educating patients about healthy life options, emphasising exercise, measuring and ensuring regular medicine, checking blood pressure, and other related actions. These enhance patients awareness and help make a lasting change towards sustained blood pressure control.