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Chapter 2
•
Cardiovascular Care
The Silent Killer
BRAIN
Stroke
Stroke from blood clots occluding narrowed blood
vessels or from hemorrhage of a weakened vessel wall
(aneurysm) can be disabling or fatal.
Infarct
Hemorrhage
Blood clot
Cotton-wool spot
Flame-shaped
hemorrhage
Swollen optic disk
Hard exudates
R E T I NA
EYE
Hypertensive retinopathy
Effects on the blood vessels within the retina can lead to
hemorrhage, hard exudates, and swelling of the optic disk
that may result in blindness.
KIDNEY
Nephrosclerosis
Arterioles in the kidney harden and
restrict oxygenation of the glomeruli,
causing scarring and kidney failure.
Although patients may feel healthy, untreated or poorly controlled
hypertension can damage their major organs. Organs at greatest
risk are the brain, eyes, and kidneys.
Recommended Screening
•
Adults 40 years or older should
have their blood pressure
measured at least annually.
•
Adults between 18 and 39 years
should also be screened at least
annually if they have risk factors
for hypertension (i.e., obesity) or
if their previously measured blood
pressure was 130 to 139/85 to
89 mm Hg.
•
Adults between 18 and 39 years
whose latest blood pressure was
<
130/80 mm Hg and have no
risk factors for hypertension
should be screened at least every
3 years.
TIP:
Hypertension or high blood
pressure can affect the heart, brain,
kidneys, eyes, and peripheral circu-
lation.
Nursing Considerations
•
When routine blood pressure
screening reveals elevated
pressure, make sure the
sphygmomanometer cuff size is
appropriate for the patient’s upper
arm circumference.
•
Ask the patient if they smoked,
had a beverage containing
caffeine, or was emotionally upset
before the reading.
•
Advise patient to return for blood
pressure testing at frequent
regular intervals.
GLOME RULUS
Scarring
Hardened
arteriole