Presenting Sx/Sx That R/T
Admitting Diagnoses
Silent killer (mild/mod)
Severe= fatigue, dizziness,
palpitations, angina, dyspnea
PMH that Relates to Admitting Diagnoses
(include supporting rationale)
Race (Hispanics do not get treatment as
much)
Men more common before middle age
Increased age
Congenital heart defects
Modifiable = alc/smoking, diabetes, excess
sodium, obesity, inactivity, socioeconomic
status, stress
Relevant Medications That Effect or
Treat the Dx(s)
Alpha blockers -> lower BP
ACEIs & ARBs -> lower BP
Beta Blockers -> lowers HR & BP
CCBs -> Lowers HR & BP
Digoxin -> lowers HR
Dilators -> dilate vessels
Diuretics -> promotes Na, H20 loss
Black people = CCBS
inc risk of angioedema with ACE
Admitting
Diagnosis
Hypertension
Relevant Labs/Xrays
that Confirm the Dx(s)
(include supporting rationale)
Hypertensive crisis is 180 SBP or 120 DBP
First line = BP measurement
Hx and phys assess, with ophthalmic exam
Fasting BG
Routine U/A
BMP with eGFR
CBC
Serum lipids, uric acid, Ca, Mg
12-lead ECG
Optional: 24 hr uro clearance, echocardio, lft, tsh
Medical/Surgical Treatments this
Hospitalization
Stenting, cath, pacemaker,
angiograms
Diagnostic Cues
R/T 1° Nursing Dx (Data)
1° Nursing Dx
Goal 1
Treatment of Hypertensive
Crisis
Focus of Care
Provide oxygen at 2-4 L
Bedrest
Admin nitrates as ordered
Risks: bleeding, infection,
clots
3 Outcome Goals (Planning)
Goal 2
Prevention
Focus of Care (Interventions)
Pt teaching:
Manage BP
control Cholesterol
Reduce BS
Active lifestyle
Better diet
Lose weight
Stop smoking
ACE= cough, angioedema,
low sodium high potassium
Evaluation
Evaluation
Monthly follow up visits
before goal BP, then 3-6 mo
check ups
Nutrition therapy (low Na,
cholesterol, good K and Ca
intake)
Regular activity
Stress management
techniques
Goal 3
Complications
Focus of Care
CVA
MI
CKD
Atherosclerosis
Blindness
Hypertensive
encephalopathy
Evaluation