Hypertension and Depression: Pathophysiology, Nursing Interventions, and Medications

HYPERTENSION
AND DEPRESSION

Contents
INTRODUCTION...........................................................................................................................5
MAIN BODY...................................................................................................................................5
Section1Using the CRC and the information presented about Geraldine, identify the abnormal
cues and discuss why these are considered abnormal............................................................5
Section2 using relevant literature discuss the pathophysiology related to depression and
hypertension...........................................................................................................................7
Section3 using the template provided below complete the sections......................................8
Identify the nursing goal for each issue .................................................................................8
List atleast two nursing interventions for each issue.............................................................8
Section 4Using relevant literature, provide a rationale for the listed intervention and discuss
how the interventions will be evaluated.................................................................................9
Section5 identify two medication that were prescribed for the patient pre- operative condition.
Such as Doxepin 25 mg daily and Atorvastatin 40 mg dail, provide the mechanism of action,
side effects and correct dosage and contraindications for each medication.........................10
CONCLUSION..............................................................................................................................12
REFERENCES..............................................................................................................................13

INTRODUCTION
Hypertension is known as blood pressure above the 140/90 and further this could be
considered severe when it is above 180/120.When the force of blood against the artery walls is
too high this condition is known as hypertension. Blood pressure increase the risk of stroke and
heart disease and might leads to the death. Depression this is a persistent feeling loss of interest
and sadness. This is also known as clinical depression and leads to the physical and emotional
problems which include daily behaviour, sleep disorder and self esteem. Lack of dopamine in the
sites of brain this process increases blood pressure and leads to the depression. The ischemic and
crebrovascular changes in the brain further develop high blood pressure and this process may
lead to the hypertension and depression.
MAIN BODY
Case study
Mrs berry she is 72 years old female she got fractured neck of femur and along with this her
head tearing, when she was walking with dog on the uneven pathway. She is living with elderly
husband who had a history of stroke. She lost her two children in a care accident 5 years ago.
Geraldine and her husband they do not have any relatives or children (Eno, and et. al., (2000)).. The
femoral neck connects the femoral head with femoral shaft. The femoral neck fractures are
commonly known as intracapsular hip fracture. The blood supply of the femoral head usually run
along the femoral neck, thus it is an important consideration in the terms of displaced fractures.
The symptoms of hip was inflammation and pain and onset symptoms concerning about severity.
Mrs berry was not able bear the weight, pain was increasing during the rotation of the hip.There
was severe swelling on the side of the hip. Mrs berry was referred to the inpatient care and after
the X-ray and MRI bone scan, diagnosis procedures were held and the treatment of hip fractures
mostly involves combination surgery which includes surgery, medication and rehabilitation,
there was requirement of total hip replacement.The total hip replacement surgery might cause
significant blood losss and in addition might bring adverse patient outcomes. In this type of
surgery upper femur and the socket in the pelvic bone is replaced with specific artificial parts
(prostheses). Therefore Mrs berry was preparing herself emotionally and physically before the
surgical procedure.The surgical procedure were held and Mrs Geraldine was depressed so nurse

was trying to develop relationship with Mrs Geraldine so that they could promote positive
surgery. Mrs Geraldine was in trauma, and facing anxiety stress. Nurse was supporting her
emotionally and mentally and along with this was giving patient education because education
alleviate patients decrease anxiety and patients fears and post surgical pain.. They were
providing medicaments at different intervals. Nursing was monitoring vital air patency and vital
signs and they were managing pain and fluid and electrolyte balance.
Section1Using the CRC and the information presented about Geraldine, identify the abnormal
cues and discuss why these are considered abnormal.
The abnormal cues are hypertension and depression. Clinical research coordinator for abnormal
cues of hypertension and depression , they both shares the common pathway. The patient with
hypertensive they usually prefer antihypertensive diagnosis which commonly excluding central-
acting agents and beta blockers. Geraldine have been facing two abnormal activities they are
hypertension and depression therefore clinical research coordinator performing on these two
abnormal cues. In the terms CRC this is a specialized research in which an individual works
under the specific direction which are instructed by the principal investigator. The principal
investigator probably they are accountable for managing clinical trails and conducting and
designing, CRC plays a vital role in supporting various clinical trials as well as this is an
essential part which conduct the study. Group of older peoples they were prescribed
pharmacotherapy in terms of hypertension and depression from the care practice. Hypertension
is more prevalent compared to depression. Geraldine she got fractured so her blood pressure was
increased then she was frustrated which lead to depression.
Section2 using relevant literature discuss the pathophysiology related to depression and
hypertension.
Pathophysiology of depression
The monoamine-deficiency states that that pathophysiology of depression is the process of
depletion of norepinephrine, neurotransmitter serotonin and dopamine in the central nervous
system. Serotonin is extensively studied in the terms of neurotransmitter in depression(Achor,
Hanson, Gifford, and et. al., (1955)).
Neurotrophic hypothesis