Subjective data
The patient’s name is Tina who is on her first pregnancy at 35 weeks of gestation. She has got a history of high blood pressure.
Objective data
She has got fluctuating blood pressure levels
BP at first trimester was 90s/65s
BP at second trimester was 110s/70s
BP at third trimester 130s/70s-80s
Current BP level 160s/95
Differential diagnosis
The rising blood pressure levels are an indication of the Tina having a bout of hypertension. An important point to note is that, the risks an individual developing high blood pressure in relation to their ages increase as they continue aging (Carter et al., 2012). The fact that the blood pressure levels exceed 140s/90s means that the levels are within the dangerous levels.
Care goals
Therefore, Tina’s nursing care plan should involve taking diagnostic tests, determining the goals of the care plan, the required interventions, and the discharging goals,
Diagnostic tests
Hematocrit test: to assess the possibilities of anemia or hypercoagulability (Gordon, 2014).
Glucose test: to determine whether possibilities of hyperglycemia (Gordon, 2014).
Serum potassium: to determine if she may be having hypokalemia; a side effect of diuretics therapy (Gordon, 2014).
Uric acid test: increasing levels of Hyperuricemia show that the patient has got increased risks to high blood pressure.
Electrocardiogram test: to show any signs of the heart straining when performing its functions (Gordon, 2014).
The goals of this nursing care plan will include; improving the cardiovascular functioning, prevention of possible compactions, providing support to the patient to ensure that they can effectively address the condition on their own (Gordon, 2014).
Interventions for this condition will include improving the cardiac function of the patient, provision of the required knowledge to the patient, and proposing an effective physical activity regime (World Health Organization, 2015).
Intervention one: Improving Tina’s cardiac functions
Firstly, it will be important to assess conditions that increase stress to the heart with the rationale of determining the straining factor to the heart (Gordon, 2014). Secondly, checking and monitoring the blood pressure by comparing the levels of blood pressure levels brought about by both diastolic and systolic pressure, the cause of fatigue, weight gain and shortness of breath are a possible indication of poor ventricular functions (Gordon, 2014). The medication to be used in this intervention will include loop diuretics, thiazide diuretics, and potassium-sparing diuretics which serve to reduce liquid level on blood thus reducing the straining of the heart (Gordon, 2014).
Intervention two: patient education
Essentially, Tina should be educated on how she will be monitoring her blood pressure levels to reduce the possibilities of the condition affecting her when she is on her own (Ackley & Ladwig, 2013). Education on effective observation is an effective method in following the required medical regimen. Additionally, the nurse providing the care to Tina is tasked with providing the required education concerning how they are supposed to take their medication. Such an effort is targeted at enabling the patient to have an understanding of the correct dosages, and the side effects. She should also be advised against taking alcohol as it affects the functionality of the diuretics (Ackley & Ladwig, 2013). Finally, she needs to be educated on seeking the advice of a medical professional before taking over the counter medication as it may result in dangerous interactions from the mixing of different medications.
Intervention three: effective physical activity regime
Involving in exercises has got the effect of reducing the effects of fatigue to Tina mainly due to her current condition. It is important to assess Tina’s pulse rate with the objective of determining the response of the body to these physical activities. Assessing the probable blockades to exercises for instance stress and depression will be a possible impediment to achieving the objective of addressing hypertension (Ackley & Ladwig, 2013). Therefore, there is the need for Tina to be provided with emotional support o encourage her in times of depression and stress (Ackley & Ladwig, 2013). This will help to keep her blood pressure levels normal.
References
Ackley, B. J., & Ladwig, G. B. (2013). Nursing diagnosis handbook: an evidence-based guide to planning care. Elsevier Health Sciences.
Carter, B. L., Bosworth, H. B., & Green, B. B. (2012). The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. The Journal of Clinical Hypertension, 14(1), 51-65.
Gordon, M. (2014). Manual of nursing diagnosis. Jones & Bartlett Publishers.
World Health Organization (WHO. (2015). A global brief on hypertension: silent killer, global public health crisis. World.
