Factors contributing to a nursing protocol on hypertensive patients with essential and secondary hypertension

Abstract The results from the current study are relevant to examining the symptomatology of the factors on long-term effects of hypertensive patients. The dimensions of medical and psychiatric data from the CMI were identified from factor analysis of the item data. In spite of the sophisticated interview tool and well characterized patients, the results from the stepwise discriminant analysis suggest that a discrete pattern of six symptoms separate the essential hypertensives from the secondary ones. One could argue that the analysis allowed the researchers to separate the essential from the secondary hypertensive, but there is no physical reason why these responses would do so. The medically supervised hypertensive group gave evidence of undergoing exhaustion with cardiovascular symptoms and headaches. They felt exhausted and worn out by weak stimuli. They acknowledged that nervousness and worrying ran in the family. It was surmised that exaggerated physical reactions of various kinds such as clearing of throat, having hot or cold spells, sweating in cold weather, and stiffness of muscles and joints were related to irritability. They gave evidence of undergoing irritability; acknowledging nervousness, annoyances and emotional upsets to the point that sudden noises or sudden movements made them scared and jumpy. It was felt that this could be a psychosomatic process whereby hypertension and irritability aggravate each other. Establishing regular rest and exercise patterns on a daily basis was not possible for the majority of patients in this study. These long-term effect symptoms agreed with those of Dollery et al. (1977) and to those of Peart (1977). This study was in agreement with their statement on exertion (Factor I), but the researchers' subjects became exhausted with many other symptoms spelling out an exhaustive complex. In their work they listed depression as a symptom of hypertension, while in this study, Factor VI reveals irritability unspecified. They mentioned cramps in feet and calves, while respondents recognized leg cramps. They listed headaches, which are also a predominant factor (III) in the present work. Chest pains in general were a predominate factor in this study which Dollery et al. (1977) have broken down to a specified pain of angina. The reader is referred to Dollery et al. (1977) for an added array of symptoms not presented here. Along with the findings in this study, there are programs attempting to medically control elevated blood pressure. The article in the Journal of the American Medical Association was paraphrased by an article in the Wall Street Journal . This article placed a strong link between hypertension and obesity. In agreement with this article, better nutritional and exercise habits are recommended. These recommendations coincide with the recommendations of the authors. Yet obesity and the above named problems continue to exist, although they can be controlled by health teaching and self-care. Like standing orders, the protocol must constantly be changed and revised according to discoveries in medical science. The nurse protocol should always represent the intellectual processes of the nurse which are expected to be kept up to date. Without the above considerations the protocol could not be used as a safe and reliable instrument. Protocols can ensure a minimum standard of quality nursing care based on current day standards of nursing practice.