Hypertensive Crisis Case Study

Abstract This paper will discuss a 64 year old African American female by the name of Mildred James who suffered from a hypertensive crisis. She has a history of depression which was treated with electroconvulsive therapy and a deep vein thrombophlebitis which required insertion of a filter. She also has a history of myocardial infraction, and had coronary bypass surgery several years ago.
Objectives
This section of the paper will discuss eight objectives that deal with hypertensive crisis. A hypertensive crisis is a life-threatening disorder. It causes tachycardia with diastolic blood pressure over 120 mm Hg and systolic blood pressure that may rise above 200 mm Hg. Life-threatening clinical manifestations of hypertensive crisis include
Her BUN and creatinine labs, along with total protein, albumin, and bilirubin labs were significant due to hypertensive crisis can lead to organ failure. It was ideal to make sure her liver and kidneys were functioning properly. The electrocardiogram (EKG) was significant to check the electrical heart activity. The computed tomography (CT) scan of the head was ordered which was very important to detect if there was any edema, intracranial bleeding, or a stroke caused by the hypertensive crisis.
Objective three: When obtaining a blood pressure reading, what factors and conditions can hinder correct assessment?
There are several factors that can hinder a correct blood pressure reading. The blood pressure cuff should be the correct size for the patient and placed in the correct location. “Proper size and correct placement of the BP cuff are critical for accurate measurement. Place the patient’s arm at the level of the heart during the BP measurements.” (Lewis, S., 2013). Another factor that can hinder the blood pressure reading is talking. “If you are talking to the nurse/doctor while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg.” (Long, JM., (2004) 5:2: 165-172). Blood pressure cuff placed over clothing, crossed legs, a full bladder, smoking, alcohol intake, and stress or anxiety are other factors that can hinder a correct
Stage 1 hypertension is with a systolic of 140–159 with diastolic between 90–99. Stage 2 hypertension when the systolic is ≥160 and the diastolic is ≥100.
Objective six: Explain the relationship between Mrs. James’s hypertensive and her new onset of seizure.
Her seizure could he been prompted by her electroconvulsive therapy. “Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.” (Kellner C. August 26, 2015).
Objective seven: List the nursing diagnosis and interventions appropriate for the care of a patient in hypertensive crisis.
This patient could have anxiety related to her situational crisis. Interventions would be administering her medications as prescribed. Assessing for signs and symptoms of anxiety. Encourage the patient to verbalize her anxieties or concerns. Make sure to provide care in a calm manner to prevent increasing her anxiety.
Objective eight: Describe the type of diet this patient should be prescribed and why, include food choices that should be included and what type of food should be avoided for a patient with