ppt krisis hipertensi

7/26/2019 ppt krisis hipertensi

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CASE REPORTCrisis Hypertension

Preseptor : dr Ihsanil Husna, Sp.PD

Arranged by : Salan Saisar Hidayat !"#$$%#'()


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Patient*s identity

+ae : rs. -

Age : (thyears old

Edu/ation : Senior High s/hool

arital status: arried

O//upation : Seller

Religion : osle

Date o0 adission : April "#$1 R nuber : ##'&%'$%


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Ananesis

Chie0 /oplaint :

Patient /oplained o0 heade/he sin/e &days ago.

Another /oplaint :

Patient 0elt 2ea3ness


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History o0 present illness

Patient /ae 2ith /oplaint o0 her heade/he sin/e & days ago,and also 0elt 2ea3 i0 she 2anted to do the a/ti4ity. She 0elthea4y in the ba/3 o0 ne/3. She denied any heartbeat 0ast. Shedenied o0 de/rease appetite. Patient aditted to ha4ehypertension disease but she had ne4er /ontrolled her disease.

" 2ee3s ago, patient has been hospitali5ed be/ause o0hypertension and diabetes elitus. Her tension 2as "## at thattie and she didn*t 3no2 about the blood sugar Soeties she0elt it/hy and her sight 2as blurry

6e0ore she hospitali5ed, she also /oplains lots o0 urine andshe drin3s too u/h. She denied eat a lot. She 3ne2 about herdiabetes elitus disease but she had ne4er /ontrolled herdisease


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History o0 past illness

History o0 Hypertension

History o0 D

+o history o0 3idney disease +o history o0 astha

+o history o0 allergi/


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History o0 0aily

Her 0ather has sae proble inhypertension

+o history o0 D

+o history o0 allergi/ +o history o0 astha

+o history o0 3idney disease


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History o0 allergy

Patient has no allergy to 0ood, drugs and2eather.


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History o0 treatent

Patient had drin3ed the hypertensiondrugs


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Habits

So3ing habits : Denied

Drin3ing al/ohol : Denied

Doing e7er/ise : Denied


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Physi/al e7aination

8eneral /ondition: ildill

Con/iusness:

/oposentis

8eneralis

status

Blood pressure: 110/70 mmHg

Heart rate: 88x/minute Respiratory rate: 18x/minute Temperature : 36.9 !

9italsigns


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Head : noro/ephal, de0ority !) Eyes : anei/ /on;ungti4a !


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Inspe/tion: loo3ed ?at Aus/ultation: bo2el sounds !=) Palpation: tou/hing pain epigastri3 !) epigastri3

retra/tion !)

Per/ussion: tiphani

Abdoe

n

Superior: Edea ! < ), 2ar a3ral!= < =), RCT @"se/onds != < =)

In0erior: Edea ! < ), 2ar a3ral != < =), RCT @"se/onds != < =)

E7treities


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Resue

rs. -, (thyears old /ae to hospital 2ith

/oplained o0 her heade/he sin/e & days ago. Shealso /oplained the body 2as 0elt 2ea3. She 0elthea4y in the ba/3 o0 ne/3. She aditted to ha4e

hypertension disease and diabetes ellitus diseasebut she didn*t /ontrol her disease. " 2ee3s ago, hertension 2as "## Hg 2hen she /ae to thehospital. She 0elt it/hy and her sight 2as blurry. she

also /oplains lots o0 urine and she drin3s toou/h. She denied eat a lot.

History of past illness: hypertension and DM

History of treatment: she had consumed the

hypertension drugs and DM drugs


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Physical Examination:

TD: 110/70 mmHg


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Proble list

Crisis hypertension

Diabetes elitus


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Assesent

$. Crisis hypertension

S: s. -, (thyears old /ae to hospital 2ith/oplained o0 her heade/he sin/e & days ago.

She also /oplained the body 2as 0elt 2ea3.She 0elt hea4y in the ba/3 o0 ne/3. She adittedto ha4e hypertension disease. She didn*t

/ontroll her desease. " 2ee3s ago, her tension2as "##. History o0 past illness hypertension.History o0 treatent hypertension drugs.

O:TD: $$#


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A: Crisis hypertension

P:Controlled blood pressure

". Diabetes ellitus

S:She 0elt it/hy and her sight 2as blurry. History o0past illness D. She also /oplains lots o0 urineand she drin3s too u/h.

O:

A:diabetes ellitus

P: /he/3 blood glu/ose


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Case analysis


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Denition

Hypertensi4e /rises are dened as le4elso0 systoli/ blood pressure B$# Hgand< or le4els o0 diastoli/ blood pressure

B$"# Hg and are ainly 0ound inpatients 2ith essential arteryhypertension.


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Classi/ation

Hypertensive urgency is a situation2ith a se4ere in/rease in blood pressure2ithout progressi4e dys0un/tion o0 target

organs.

Hypertensive emergencies are li0e

threatening states be/ause theirout/oe is /opli/ated by a/utedaages o0 target organs.


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Epideiology

In an Italian ulti/enter study o0 $,(1 patients2ith hypertensi4e /rises, $& o0 en and '

o0 2oen reported not ta3ing antihypertensi4edrugs.

Hypertensi4e eergen/ies represented "( o0/rises. Appro7iately "( o0 adults 2ith/hroni/ hypertension 2ere una2are o0 theirdisease.

In the S parallels the distribution o0 essentialhypertension 2ith a t2o0old higher in/iden/e in

A0ri/anFAeri/ans than in 2hites.


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Etiology

ndiagnosed or untreated hypertensionis the ost iportant ris3 0a/tor to be/rises hypertension. 8eneti/ 0a/tor,

li0estyle, diet, a/ute physi/al stress,/hroni/ physiologi/al stress /an be the/auses o0 hypertension. So the priarytreatent is to /hange the ris3 0a/tor

that /an a3e hypertension.


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Patophysiology

Pathophysiology o0 hypertensi4e /risesis still un/lear. Gro the aspe/t o0pathophysiology, the disorder o0

systei/ blood o2 auto regulation onthe le4el o0 arterioles is /onsidered tobe a /ause 0or both 0ors o0hypertensi4e /risis.


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Clini/al ani0estation

Hypertensive urgency is a situation 2ith se4erein/rease in blood pressure 2ithout progressi4edys0un/tion o0 4ital organs. The ost /oonsyptos are heada/he, dyspnea, nausea,

4oiting, epista7is, and pronoun/ed an7iety. Hypertensive emergencies in/lude hypertensi4e

en/ephalopathy, hypertensi4e a/ute le0t 4entri/ularrela7ation asso/iated 2ith a/ute yo/ardial

in0ar/tion or unstable angina, aorti/ disse/tion,subarhnoi/ heorrhage, is/hei/ stro3e, andse4ere pree/lapsia or e/lapsia.


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Clini/al ani0estation


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Supporting e7ainations

Re/oended testing in/ludes the 0ollo2ing:

Heatologi/ routine

6lood glu/ose

Total /holesterol seru Seru uri/ a/id

Creatinin seru

-aliu seru rinalisis

Ele/tro/ardiogra


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Treatent


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Re0eren/es

onnet, a4ier, Paul E. ari3. "#$(. hat*s ne2 2ith hypertensi4e/risesJ. Intensi4e Care ed. $:$"%F$

Sal3i/, Sabina, Oli4era 6ati/u;ano4i/, Garid K;u/a, Selira 6r3i/."#$.Clini/al Presentation o0 Hypertensi4e Crises in Eergen/yedi/al Ser4i/es. ater So/ioed. "1!$): $"$1

Sal3i/, Sabina, Selira 6r3i/, Oli4era 6ati/u;ano4i/, Garid K;u/a,Aledina -arabasi/, Seh4eta usta/. "#$(. Eergen/y RooTreatent o0 Hypertensi4e Crises. ed Arh, 1'!()L "

Current edi/al Diagnosis > Treatent. Systei/ Hypertension.Sutters, i/hael.D. "#$1. &(1%

Aeri/an Mournal o0 Eergen/y ed/ine. The Relationship between

vascular infammation and target organ damage in hypertensivecrises. Karaback, Mustaa MD. "#$(L '%(##

Mose Roesa. -risis Hipertensi. Sudoyo, Idrus Al2i editor. 6u3u A;arIlu Penya3it Dala Milid II Edisi 9I. Pusat penerbitan departeenpenya3it dala G-I."#$


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ppt krisis hipertensi

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