Question

Mr. Henderson is a 49-year-old patient who is admitted to the medical-surgical floor in a hypertensive crisis. The patient's vital signs are B/P: 200/98, HR: 62; RR: 12; T: 98.4 F, and oxygen saturation: 96% on room air. The patient is complaining of a headache and blurred vision. The patient's past medical history: hyperlipidemia, borderline diabetes, and gout. The patient takes atorvastatin and allopurinol. The patient states, "l control my diabetes with my diet." He is ordered Cardene, 5 mg/hr., via continuous IV infusion. The pharmacy sends Cardene, 25 mg in 250 ml normal saline to the floor.

• Discuss the difference in primary and secondary hypertension. Based on this information, is Mr. Henderson's hypertension primary or secondary and provide a rationale.
• The patient loses the ability to move his right arm and leg. Identify a possible rationale for this loss of movement and two nursing interventions to implement at this time.
• Identify three organ systems that can be damaged by uncontrolled hypertension and discuss how this damage occurs.
• Develop a discharge teaching plan for Mr. Henderson with rationales.

Answer 1

Difference between primary and secondary hypertension.

Primary hypertension	Secondary hypertension
Primary hypertension has no sole cause.	Secondary hypertension has a recognizable cause.
It is associated with different factors like genetic factors, deficient diet, no exercise, and obesity.	It is caused by diseases affecting kidneys, arteries, heart, or pregnancy.
95% of patients are with primary hypertension.	Only 5-7% of patients have secondary hypertension.

Mr. Henderson has secondary hypertension as he is having past medical history of hyperlipidemia, borderline diabetes, and gout.