hypertension and surgical patients

  1. I'm doing a care plan paper for my nursing class. I am doing it on a 79 yr old female who was admitted with a parastomal hernia. They closed off the stoma on the left side and made a new one on the right side. Only other medical problem she has at this time is hypertension which she had prior to surgery. They are controlling it with Diovan (valsartan) an angiotension II receptor antagonist.

    My question is....Besides the possible interactions with anesthesia and hypertension medications, possible hypotension, is there any other problems I should address on my paper regarding how hypertension can impact the client at this time.

    Will it slow down healing because of possible circulation problems? and how?

    Thanks for any help you can give me

    Debblynn
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  2. 3 Comments

  3. by   mitchsmom
    I can't comment on healing or anything, but you may want to comment on pain relief drugs postop (if you aren't already) & their potential interactions w/ the pain meds &/or her age - like demerol & some other narcotics aren't usually given to older pts, etc. or at least are given in lower amounts b/c of side effects on vitals.

    edited... oops, duh.. I didn't realize you were looking for nursing diagnoses per se
    Last edit by mitchsmom on Apr 3, '04
  4. by   Mithrah
    Pain, acute
    Nausea rt GI distention and medication or anesthesia effects
    Risk for infection rt surgical incision
    ineffective airway clearance rt ineffective cough and tenacious secretions
    Anxiety
    Constipation rt decreased physical activity and drugs
  5. by   Mithrah
    Body image disturbance
    Knowledge deficit

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