MEDICAL SURGICAL I | CARREON
Nursing Process in Pulmonary Hypertension 1.2 History of Medication
Nursing Assessment Use of drugs that might contribute to pulmonary
hypertension (e.g., appetite suppressants, certain
1. Nursing History chemotherapy agents)
1.1 Important Symptoms to Assess
Shortness of breath: Dyspnea Current medications and adherence
Fatigue and exercise intolerance
1.3 Lifestyle Factors
Edema
History of Smoking
Chest Pain
Exposure to Environmental Toxins
Physical Activity
2. Physical Exam
2.1 General Inspection
- Signs of Respiratory Distress
Mouth Lips or Fingernails turn bluish
Wheezing sound while breathing
Increased number of breaths per minute
1.2 Review the medical history
CYANOSIS
Heart Failure
Signs of right-sided heart failure, such as
High Blood Pressure
hepatomegaly or ascites
Chronic Obstructive Pulmonary Disease
(COPD)
Pulmonary Embolism
TYPES OF CONNECTIVE TISSUE DISEASE
2.2 Vital signs
Lupus
Rheumatoid Arthritis 2.3 Cardiovascular Exam
Scleroderma
Sjogren’s Syndrome - A loud S2 sound usually means there's increased
Dermatomyositis pressure in the arteries or the heart is working harder
Microscopic Polyangiitis than usual
Churg-Strauss Syndrome
Granulomatosis with Polyangiitis
, 2.4 Respiratory Exam
Auscultate for the presence of crackles or wheezing. 3.4 Test for presence of albumin
- In pulmonary hypertension, crackles or wheezing can Detecting microalbuminuria or macroalbuminuria in
indicate fluid in the lungs or narrowed airways, which can
pulmonary hypertension helps assess kidney damage or
occur due to increased pressure in the pulmonary dysfunction, as these conditions can result from or
arteries. exacerbate the increased pressure and fluid overload
Inspection of respiratory effort and use of accessory associated with pulmonary hypertension.
muscle
Using accessory muscles of respiration
Tracheal Deviation Technique
Asymmetry in chest expansion
Palpation for tracheal deviation or abnormal
chest expansion
2.5 Peripheral Exam
Nursing Diagnosis
Deficient knowledge on treatment regimen and control of
the disease process related to decrease level of
understanding/information about disease process AEB
lack of participation and doubtfulness.
Impaired Gas Exchange related to elevated pulmonary
- In pulmonary hypertension, edema often indicates artery pressure as evidenced by dyspnea and low
that the right side of the heart is struggling to pump oxygen saturation levels
blood effectively, leading to fluid buildup in the
tissues Goal of Care and Outcome Criteria
After 2 hours of nursing instructions client will
- Examination of extremities for
demonstrate an improved level of understanding of
clubbing or cyanosis
pulmonary hypertension, including its management and
treatment secondary to accurate description of condition,
identify necessary lifestyle changes, and answer related
3 Laboratory Exam questions correctly
3.1 Urinalysis Interventions
- Urinalysis to check for signs of kidney dysfunction or Independent Actions
damage, which can occur as a result of the increased
pressure in the pulmonary circulation affecting overall 1. Increase knowledge about disease process and
fluid balance and renal function. management
3.2 Blood Chemistry (Na, K, creatinine, glucose, Provide information about pulmonary HPN, its
cholesterol levels) management, and lifestyle modifications. Educate
on recognizing signs of worsening symptoms and
To assess overall health, monitor kidney function, and when to seek medical help.
evaluate metabolic status, all of which can influence or
be affected by pulmonary hypertension and its treatment.
2. Support Smoking Cessation
Key elements from WHO's recommendations on
3.2 12-lead electrocardiogram (ECG)
supporting smoking cessation:
To detect changes in heart rhythm and structure, identify
right heart strain or enlargement. A. Pharmacotherapy
3.3 Blood Urea Nitrate (BUN) Nicotine Replacement Therapy (NRT): Includes
products like nicotine patches, gum, lozenges, and
To assess kidney function, as elevated BUN levels can inhalers that help reduce withdrawal symptoms
indicate impaired renal function, which can be affected
by or contribute to the condition due to increased Prescription Medications: Such as varenicline
pressure and fluid overload (Champix) and bupropion (Zyban), which can help
reduce cravings and withdrawal symptoms
3.4 Creatinine
B. Behavioral Support.
To evaluate kidney function, as elevated creatinine levels
can signal impaired renal function, which may be a Counseling: Structured counseling sessions, either
consequence of or contribute to the increased pressure in person or via telephone, to provide motivational
Nursing Process in Pulmonary Hypertension 1.2 History of Medication
Nursing Assessment Use of drugs that might contribute to pulmonary
hypertension (e.g., appetite suppressants, certain
1. Nursing History chemotherapy agents)
1.1 Important Symptoms to Assess
Shortness of breath: Dyspnea Current medications and adherence
Fatigue and exercise intolerance
1.3 Lifestyle Factors
Edema
History of Smoking
Chest Pain
Exposure to Environmental Toxins
Physical Activity
2. Physical Exam
2.1 General Inspection
- Signs of Respiratory Distress
Mouth Lips or Fingernails turn bluish
Wheezing sound while breathing
Increased number of breaths per minute
1.2 Review the medical history
CYANOSIS
Heart Failure
Signs of right-sided heart failure, such as
High Blood Pressure
hepatomegaly or ascites
Chronic Obstructive Pulmonary Disease
(COPD)
Pulmonary Embolism
TYPES OF CONNECTIVE TISSUE DISEASE
2.2 Vital signs
Lupus
Rheumatoid Arthritis 2.3 Cardiovascular Exam
Scleroderma
Sjogren’s Syndrome - A loud S2 sound usually means there's increased
Dermatomyositis pressure in the arteries or the heart is working harder
Microscopic Polyangiitis than usual
Churg-Strauss Syndrome
Granulomatosis with Polyangiitis
, 2.4 Respiratory Exam
Auscultate for the presence of crackles or wheezing. 3.4 Test for presence of albumin
- In pulmonary hypertension, crackles or wheezing can Detecting microalbuminuria or macroalbuminuria in
indicate fluid in the lungs or narrowed airways, which can
pulmonary hypertension helps assess kidney damage or
occur due to increased pressure in the pulmonary dysfunction, as these conditions can result from or
arteries. exacerbate the increased pressure and fluid overload
Inspection of respiratory effort and use of accessory associated with pulmonary hypertension.
muscle
Using accessory muscles of respiration
Tracheal Deviation Technique
Asymmetry in chest expansion
Palpation for tracheal deviation or abnormal
chest expansion
2.5 Peripheral Exam
Nursing Diagnosis
Deficient knowledge on treatment regimen and control of
the disease process related to decrease level of
understanding/information about disease process AEB
lack of participation and doubtfulness.
Impaired Gas Exchange related to elevated pulmonary
- In pulmonary hypertension, edema often indicates artery pressure as evidenced by dyspnea and low
that the right side of the heart is struggling to pump oxygen saturation levels
blood effectively, leading to fluid buildup in the
tissues Goal of Care and Outcome Criteria
After 2 hours of nursing instructions client will
- Examination of extremities for
demonstrate an improved level of understanding of
clubbing or cyanosis
pulmonary hypertension, including its management and
treatment secondary to accurate description of condition,
identify necessary lifestyle changes, and answer related
3 Laboratory Exam questions correctly
3.1 Urinalysis Interventions
- Urinalysis to check for signs of kidney dysfunction or Independent Actions
damage, which can occur as a result of the increased
pressure in the pulmonary circulation affecting overall 1. Increase knowledge about disease process and
fluid balance and renal function. management
3.2 Blood Chemistry (Na, K, creatinine, glucose, Provide information about pulmonary HPN, its
cholesterol levels) management, and lifestyle modifications. Educate
on recognizing signs of worsening symptoms and
To assess overall health, monitor kidney function, and when to seek medical help.
evaluate metabolic status, all of which can influence or
be affected by pulmonary hypertension and its treatment.
2. Support Smoking Cessation
Key elements from WHO's recommendations on
3.2 12-lead electrocardiogram (ECG)
supporting smoking cessation:
To detect changes in heart rhythm and structure, identify
right heart strain or enlargement. A. Pharmacotherapy
3.3 Blood Urea Nitrate (BUN) Nicotine Replacement Therapy (NRT): Includes
products like nicotine patches, gum, lozenges, and
To assess kidney function, as elevated BUN levels can inhalers that help reduce withdrawal symptoms
indicate impaired renal function, which can be affected
by or contribute to the condition due to increased Prescription Medications: Such as varenicline
pressure and fluid overload (Champix) and bupropion (Zyban), which can help
reduce cravings and withdrawal symptoms
3.4 Creatinine
B. Behavioral Support.
To evaluate kidney function, as elevated creatinine levels
can signal impaired renal function, which may be a Counseling: Structured counseling sessions, either
consequence of or contribute to the increased pressure in person or via telephone, to provide motivational
