Assessment Nursing Diagnosis Scientific Rationale Objectives Interventions Rationale Evaluation

Subjective: Knowledge deficit Hypertension can cause After 30 minutes of 1. Render physical 1. Ensuring physical After 30 minutes of
 Heavy drinker: related to hypertension stroke through many nursing comfort for the comfort allows the nursing intervention,
1-2 bottles/day: as evidenced by mechanisms. A high intervention, the patient. patient to concentrate the client verbalized
Brandy inaccurate follow- intraluminal pressure willclient will verbalize on what is being understanding of
lead to extensive
 Heavy smoker: through of instruction: understanding of discussed or importance of
alteration in endothelium
66 pack years, 2 Alcohol consumption importance of demonstrated. minimizing
and smooth muscle
packs a day and cigarette smoking. function in intracerebral minimizing 2. Provide an 2. Conveying respect is consumption of alcohol
 Past Hx of arteries. The increased consumption of atmosphere of respect, especially important and smoking.
alcoholic liver stress on the endothelium alcohol and openness, trust, and when providing
disease can increase permeability smoking. collaboration. education to patients After the discharge of
Objective: over the blood-brain with different values the client, the client is
 Increased BP barrier and local or After the discharge and beliefs about amenable to
before multifocal brain oedema. of the client, the 3. Include the patient in health and illness. rehabilitation for
Endothelial damage and client will be creating the teaching 3. Allows the learner to alcohol and smoking
admission
altered blood cell- amenable to plan know what will be withdrawal.
 Non-compliance endothelium interaction
to maintenance rehabilitation for expected during the
can lead to local thrombi
medication alcohol and smoking 4. Explore reactions and session.
formation and ischaemic
 Chest radiology lesions. Fibrinoid necrosis withdrawal. feelings about 4. The nurse can assess
showed an can cause lacunar infarcts changes. how the client might
enlarged heart through focal stenosis and respond to the
with an occlusions. Degenerative teachings and how
atheromatous changes in smooth muscle successful the client
and sclerotic cells and endothelium 5. If the client agrees to might be.
predisposes for smoking cessation, 5. The client would need
aorta.
intracerebral provide knowledge on successful weaning off
haemorrhages. pharmacotherapy for smoking and this
Furthermore,
weaning. could be facilitated
hypertension accelerates
with compliance to
the arteriosclerotic
process, thus increasing pharmacotherapeutic
the likelihood for cerebral 6. Encourage the patient measures.
lesions related to stenosis to enlist in a support 6. A support group could
and embolism originating group show the client insight
from large extracranial regarding the
vessels, the aortic arch progression of the
and from the heart. 3. problems of others
Adaptive structural and can learn from
changes in the resistance them how to manage
vessels, while having the
positive effect of reducing
the vessel wall tension,
have the negative
consequence of increased
peripheral vascular
resistance that may
compromise the collateral
circulation and enhance
the risk for ischaemic
events in connection with
episodes of hypotension
or distal to a stenosis. 4.
Hypertension is clearly a
risk factor for vascular
dementia. All the
mechanisms referred to
above may be important.
Johansson, B. B. (1999),
HYPERTENSION
MECHANISMS CAUSING
STROKE. Clinical and
Experimental Pharmacology
and Physiology, 26: 563-565.
doi:10.1046/j.1440-
1681.1999.03081.x
7. Pace the instruction simple problems.
and keep sessions 7. Learning requires
short. energy, so shorter,
well-paced sessions
reduce fatigue and
8. Include the family in improve focus.
the teachings. 8. The family is the
number one influence
whether the patient
will be successful in
the patients
compliance
9. Avoid stress 9. Stress may make the
client’s alcohol
dependence and
withdrawal worse and
cause other problems
later. Also being that
he already had a
stroke, he would be
predisposed to have
another.
10. Treat the client if ever 10. Withdrawal is full of
withdrawal symptoms discomfort for the
occur while in the patient, so we should
ward perform intervention
that would assure us
of his comfort.