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Background: Hypertension is one of the most common diseases afflicting humans worldwide, and one of the leading causes of death and disability in developing countries. The role of nursing in preventing hypertension is to create awareness, hence, its significant reduction. The aim of the study was to detect the effect of nursing guideline for recently diagnosed hypertensive patients on their knowledge,self-care practice and expected clinical outcomes. Subjects and methods: The study was conducted in the outpatient medicine clinics in Elnasr Health Insurance and Zagazig University Hospitals, in Egypt using a controlled quasi-experimental study design with pre-post and follow-up assessments on 85 recently diagnosed hypertensive patients. The data collection tools included Demographic and Medical History Tool, knowledge assessment tool, Stress Assessment Scale, Lifestyle Habits and self-care practice Assessment Tools and the Physical Assessment and Laboratory Investigation Sheet. The researcher developed nursing guideline aimed at effecting lifestyle changes in hypertensive patients to help control their blood pressure and prevent complications. The study was achieved through four phases namely assessment, planning, implementation and evaluation. Each patient was evaluated at the assessment phase, six months after program implementation, and six months after the second evaluation. Results: Fifteen patients dropped out. The implementation of the intervention was associated with significant improvements in all aspects of patients' knowledge at the post and follow-up tests (p < .001). The total mean stress score declined from a mean 1.2±0.3 at the pretest, to 1.1±0.4 at posttest and 0.9±0.3 at follow-up (p < .001). There were significant improvements in blood pressure and lab findings of the patients throughout study phases (p < .001). Multivariate analysis showed that the implementation of the nursing guideline was the most important independent predictor of the control of hypertension, in addition to the scores of practice of exercise, compliance and personal self care practice. Conclusion and recommendations: Individualized custom-tailored nursing guideline can be effective in the management of recently diagnosed hypertensive patients through improving their related knowledge, self-care practices and Excepected clinical outcomes. It is recommended to apply this program as a routine in the study setting and similar ones.

Spinal anesthesia is a frequently performed procedure in medical emergencies and anesthesia. Tension headache after lumbar puncture is a common occurrence (32%) and carries a considerable morbidity, with symptoms lasting for several days, at times severe enough to immobilize. The aim of this study is to assess the effect of pre and post nursing intervention on the occurrence of tension headache among surgical patients undergoing spinal anesthesia. This quasi-experimental study was conducted in El-Naser Health Insurance Hospital; in Helwan city in Egypt, 60 adult patients admitted for lower abdominal surgery using spinal anesthesia were recruited. The only exclusion criterion was pregnancy in female patients. Participants were alternatively assigned to either the intervention or control groups, ending with 30 patients in each group. The data collection tools consisted of two tools. Tool 1 was concerned with characterization of the pain and patient's personal data. The second tool was a visual analog scale (VAS). The researchers designed a structured pre-spinal anesthetic nursing intervention to be applied to the study group. Control group received the routine nursing intervention only. The results revealed that the incidence of tensions headache became significantly lower in the study group, reaching its lowest rate (3.3%) by the end of the third day, compared to 76.7% in the control group (p<0.001) the mean duration of tension headache was shorter in the study (22.1 ± 34.0 hours) than in the control (111.2 ± 55.9 hours) group, p<0.001 as well patients in the study and control groups also demonstrated statistically significant differences in the experience of symptoms associated with tension headache (p < 0.001). In conclusion, the structured nursing measures before and after the procedure was successful in decreasing the incidence and duration of this tension headache and its associated symptoms. Therefore, it is recommended to generalize these structured nursing measures in hospitals to be included in the routine pre-operative and post-operative nursing care for patients undergoing lower abdominal surgery with spinal anesthesia.

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