Features of nursing care for hypertensive crisis

Hypertensive crisis (GC) is a serious condition with serious consequences for health and life. The process develops against a background of increased blood pressure. If the tonometer readings are close to 200/100 mm RT. Art. and more, this means that the body is in danger, and it needs emergency medical attention.

The consequences of this serious condition, in the form of varying degrees of damage to vital internal organs, can be the most unpredictable (in 19 cases out of 100, GK causes premature death). The primary targets for high blood pressure are blood vessels and the heart.

The probability of a heart attack and stroke increasing several times is the main danger of a hypertensive crisis. According to statistics, over a thousand cases of stroke ending in severe disability are registered in the Russian Federation over the year, 400% of them lead to premature death.

More than 65 thousand people die every year from myocardial infarction in the country, half of whom do not live up to the arrival of emergency care. The rapid development of the pharmacological industry in recent years does not alleviate the situation, since official medicine can not yet offer an effective way to solve the problem of the most common and fatal ailment.

Competent drug therapy and qualified patient care will help prevent the development of such formidable complications.

Responsibilities of the medical staff

Qualified intervention in GC involves the provision of medical services taking into account the characteristics of the clinical picture of a particular patient. The responsibilities of the medical staff in this case include:

  • First aid for stopping the HA;
  • Organization of conditions for the normalization of pressure and recovery of the patient;
  • Carrying out all medical procedures prescribed by a doctor;
  • Help to the patient in household matters;
  • Patient self-care in new conditions;
  • Raising awareness of the patient and members of his family about the features of his disease.
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Stages of the nursing process

In addition to services, the stages of nursing care include diagnostics, the development of goals for nursing participation, the coordination of a care plan and its implementation, and the analysis of the results achieved.

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  1. Monitoring of subjective information and analysis of real and potential complaints of the patient at the first visit will help to plan care and rehabilitation.
  2. Drawing up a personal care plan for GC involves the detailed development of short-term and long-term goals.
  3. Realization of goals. It is convenient to place all the events in a table where the date of the visit, the current problem, expected results, the list of services provided, the reaction of the body to hypertension are manipulated.
  4. Analysis of the achieved result with adjustment of the patient’s living conditions. At this stage, it is advisable to discuss the results with the medical staff who took part in restoring the patient’s health.

Initial Examination Information Collection

Hypertensive crisis can be recognized by some common signs:

  • Sudden changes in blood pressure;
  • Increasing headache;
  • Dizziness and weakness;
  • The body trembles like a chill;
  • Nausea not relieved by medication;
  • Heartache;
  • Vision problems;
  • Flushed face.

With such symptoms, a nurse using a third person urgently calls a doctor, and while the ambulance team gets to the patient, takes urgent measures to alleviate his condition:

  1. She puts the patient in a position convenient for such an illness: they raise their heads with an extra pillow, while their legs should be lowered.
  2. The soles of the legs and lower legs are covered with a warm blanket, you can attach a heating pad or mustard to the calf muscles.
  3. It is necessary to give the patient an extraordinary dose of the medicine prescribed to him by the doctor for high blood pressure. Additionally, you can drip 30-35 drops of corvalol or valocordin, offer him a diuretic.
  4. Corinfar or clonidine (one tablet) can be placed under the tongue.
  5. If the heart hurts, give nitroglycerin additionally. First you need to find out from the patient how he tolerates it, since the drug can cause side effects in the form of a severe headache. If the patient has nosebleeds, he should be reassured, as this is a good sign.
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After the arrival of the ambulance and all necessary procedures, the patient requires further professional care:

  1. The nurse must monitor strict bed rest.
  2. It is important to control the intake of all prescribed medicines.
  3. The diet should correspond to the diet, all food is prepared without salt.
  4. Provide the patient with conditions for deep and prolonged sleep. If he suffers from insomnia, give him sedatives (as agreed with the doctor).
  5. To control bad habits, preventing the intake of spirits and alcohol, smoking, and dietary disorders.

Planning

To organize the nursing process in hypertensive crisis, the nurse must draw up a plan of treatment measures:

  1. Define the goal: reduction of blood pressure over a certain period of time, which will depend on the patient’s condition and symptoms of the disease;
  2. Set the terms for the implementation of short-term (lowering blood pressure, emergency therapy) and long-term tasks (rehabilitation of the patient after discharge from the hospital or stopping a hypertensive crisis at home).

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To plan a medical intervention for hypertensive crisis, it is important to consider the following nuances:

  • Call a doctor;
  • Elimination of panic in a patient;
  • Compliance with the patient’s reclining posture, with the head turned to the side (if there are attacks of nausea and vomiting);
  • Measurement of heart rate, blood pressure, NPV, heart rate and body temperature;
  • Preparation of tools and materials for performing medical procedures (syringes, tonometer, system for drip of solutions, tourniquet, needles).

When stopping the symptoms of a hypertensive crisis, parenteral preparations are used to stabilize blood pressure such as:

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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