Nursing Assessment for Hypertensive Heart Disease

Hypertensive heart disease is heart disease caused by hypertension. Hypertension that is not controlled for a long time causing the left ventricle hypertrophy (LVH).

The main causes of hypertensive heart disease is chronic hypertension. Hypertension in adults is caused by several things including:
Essential hypertension occurred in 90% of cases of hypertension in adults.
Secondary hypertension 10% of cases of hypertension in adults is caused by abnormalities in the kidneys, endocrine disorders, increased ICT, etc.

In the early stages of hypertension, will appear the signs as a result of chronic sympathetic stimulation. Heart beat faster and stronger. Occurred hyper circulation that may result from increased activity and neurohumoral system accompanied by hipervolumia. At an advanced stage, there will be a compensation mechanism in the form of heart muscle hypertrophy of the left ventricle and increased peripheral vascular resistance. Will appear shortness of breath in patients by the presence of diastolic interference.

The assessment focused on the physical and psychological disorders caused by HHD. The existence of a long history of hypertension and a history of hypertension and heart disease in the family.

Data base assessment:

1. Activity / rest
Symptoms: There is weakness, fatigue, shortness of breath.
Signs: Heart rate increases, changes in heart rhythm, tachypnea.

2. Circulation
Symptoms: A history of hypertension, atherosclerosis, coronary heart disease and cerebrovascular disease.
Symptoms: Increased blood pressure, pulse clear the area of the carotid, jugular and radial. Femoral pulse slowed, while the pulse popliteal, tibial and dorsalis pedis becoming weaker.
Arising tachycardia and dysrhythmias, audible voice S4 atrial gallop.
Skin discoloration occurs in the extremities, cold temperatures, pale skin, cyanosis.

3. Ego integrity
Symptoms: The change of personality, anxiety, depression, anger, multiple stress factors.
Symptoms: Restlessness, narrowing the field of attention, crying, facial muscle tension, increased speech patterns, often sighed.

4. Elimination
Symptoms: The presence of disorders of the kidneys.

5. Food / liquids
Symptoms: The habit of eating foods high in salt, fat and cholesterol. Feelings of nausea and vomiting, weight changes, use of diuretics.
Signs: Normal weight or obese. Arising edema (general or specific).

6. Neuro sensory
Symptoms: The existence of complaints of dizziness, throbbing head, sub-occipital headache, weakness on one side of the body, impairments, and epistaxis may occur.

7. Pain / discomfort
Symptoms: There angina, intermittent pain in the legs as indications of arteriosclerosis, severe occipital headache, abdominal pain.

8. Breathing
Symptoms: dyspnoea associated with the activity, tachypnea, orthopnea, cough with or without sputum, a history of smoking.
Signs: The use of accessory respiratory muscles, the additional breath sounds, cyanosis.

9. Learning
Symptoms: Risk factors family history of hypertension, atherosclerosis, heart disease, diabetes, cerebrovascular disease / kidney. Race factor, the use of drugs / alcohol.