Hypertension and Peripheral Vascular Disease Overview

Apr 14, 2025

Care of Patients with Hypertension and Peripheral Vascular Disease

Unit Objectives

  • Recognize components of focused assessment for adults with altered cardiac output and tissue perfusion.
  • Apply knowledge of anatomy, physiology, basic pathophysiology, nutrition, and developmental variations for care planning.
  • Identify priority actions for adults with altered cardiac output and tissue perfusion.
  • Apply medication knowledge, including side effects and nursing implications.
  • Discuss use of therapeutic devices supporting cardiac output and tissue perfusion.
  • Describe the nurse’s role in providing quality care.
  • Identify education and safety needs for adults with altered cardiac output and tissue perfusion.

Hypertension

  • Persistently high blood pressure: systolic and diastolic values needed.
  • Causes and types:
    • Primary/Essential
    • Secondary
  • Pathophysiology: smaller vessels, increased volume/viscosity, stress, renin.
  • Risk factors: lifestyle and genetics.

Signs and Symptoms

  • Known as the "silent killer."
  • Can lead to damage to organs.

Diagnosis and Treatment Goals

  • Aim for individualized blood pressure targets.
  • Lifestyle changes: smoking cessation, weight reduction, exercise, sodium/alcohol restriction, low-fat diet, stress control.
  • Medications: diuretics (first line), beta-blockers, ACE inhibitors, ARBs, calcium channel blockers.

Hypertensive Crisis

  • Life-threatening, requires ICU status.
  • Hypertensive urgency: requires emergency department visit and follow-up.

Nursing Management

  • Assessment and diagnosis.
  • Goals, implementation, and evaluation of treatment strategies.

Peripheral Vascular Disease

  • Narrowing/obstruction of peripheral blood vessels leading to functional loss in extremities.

Types

  • Peripheral Arterial Disease (PAD)
  • Peripheral Venous Disease

Peripheral Arterial Disease

  • Arterial flow restriction, causes: atherosclerosis, embolism.
  • Signs/Symptoms: Intermittent claudication, ischemic changes, pallor/rubor with position changes, shiny skin, absent pulses.
  • Treatment: exercise, wound care, medications, surgery.

Aneurysm

  • Weakness in artery wall causing ballooning.
  • Causes: genetic, atherosclerosis, hypertension.
  • Common locations: abdominal, thoracic.
  • Treatment: surgery, antihypertensive drugs.

Venous Disorders

  • Problems with veins affecting blood flow back to heart, e.g., thrombophlebitis, DVT, venous insufficiency, varicose veins.

Deep Vein Thrombosis (DVT)

  • Blood clot from venous stasis; risk of pulmonary embolism.
  • Treatment: anticoagulation, thrombolytics, elastic stockings.

Varicose Veins

  • Enlarged veins distorted by blood accumulation.

Venous Insufficiency

  • Damaged valves causing blood pooling, leading to ulcers and cellulitis.

Nursing Management

  • Regular monitoring, patient education on lifestyle modifications, and proper skin care to prevent complications.

ARTERIAL vs VENOUS

  • Arterial Disorders: Affects arteries, symptoms include tight skin, decreased pulses, requires warm environment.
  • Venous Disorders: Affects veins, symptoms include edema, dark legs, requires leg elevation and compression stockings.

The lecture covered a comprehensive overview of hypertension and peripheral vascular disease, emphasizing the importance of assessment, patient education, and nursing management strategies to improve patient outcomes.