Nursing care plans for Hypertension

Nursing Care Plans for Hypertension

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Hypertension is a complaint affecting most children in the United States. It can cause serious health problems if left untreated.

This site post will outline hypertension interventions and nursing care plans and highlight critical themes to raise realization about this topic.

As you study, remember that our exceptional nursing writers are here to assist you with your nursing assignment if you remain or cannot finish it due to other factors, such as a hectic schedule. You only need to place an order with us!

Table of Contents

What Exactly is Hypertension?

High blood pressure is referred to as Hypertension. Hypertension is defined as persistently increased blood pressure above 140 mmHg.

It is restricted as primary or essential (accounting for over 90% of all instances) or secondary due to an identified, possibly correctable clinical condition, such as renal illness or primary Aldosteronism.

Hypertension is classified into different levels:

  • Normal Blood Pressure: Lower than 120/ 80
  • Prehypertension: 120-139/80-89
  • Stage 1 Hypertension: 140-159/90-99
  • Stage 2 Hypertension: 160+/100+

Hypertension is risky because it causes the heart to work hard to pump blood to the body, increasing the chance of heart failure, stroke, and artery hardening.

What Are the Causes of Hypertension?

The precise cause of Hypertension is commonly known. Primary (or essential) Hypertension occurs when there is no single cause of Hypertension or when there is a preliminary indication to relate it to a specific cause.

Original Hypertension accounts for over 90% of all hypertension cases. Secondary Hypertension is defined as high blood pressure that does not have a known cause.

Primary and Indirect Causes of Hypertension Include:

Being overweight or obese:

It is defined as a body mass higher than 25.

Smoking:

This process is called mainstream smoke when a person inhales and then exhales through the lungs. Smoking is a nasty habit.

Symptoms:

  • Skin problem
  • Lungs problem
  • Kidney problem
  • Emphysema.

Genetics/family history of Hypertension: 

The study of genes and their role in inheritance is called genetics. Inheritance means the transmission of characters from one generation to another.

A diet high in salt: 

Taking more salt in our daily routine may cause heart disease and high blood pressure. Most people take 1.5 teaspoons of salt in their daily life.

Consuming more than 1-2 alcoholic drinks a day:

Drinking alcohol more than 1-2 drinks a day doesn’t affect the disease, but it may cause severe lung disease after some time.

Example:

Vine is made up of grapes.

Stress:  

Any change in our body is known as stress.

Symptoms:

Chest pain

High blood pressure

Sleep problem

Old age:

The later part of life is known as old age. Although 70 is an old age.

Symptoms:

Hearing loss

Tooth decay

Back and neck pain

Lack of exercise: 

Exercise makes us strong and active. It also makes me fresh.

Sleep apnea:

Sleep apnea is a severe sleep problem in which breathing repeatedly stops and starts.

Kidney disease:

Large crystals are present, can’t pass through urine, and are hard to deposit, called kidney stones. This disease can be treated by lithotripsy.

Symptoms:

Severe pain

Vomiting

Thyroid disorders: 

In humans, it is the largest endocrine gland. It is present in the neck region, under the larynx, and produces a hormone called thyroxin.

Disorders:

Hyperthyroidism

Hyperthyroidism

What Are the Symptoms and Signs of Hypertension?

Hypertension has been linked to a variety of organ system dysfunctions. The following are some typical indications and symptoms:

Frequent headaches or migraines:

It is defined as headaches that may last at least 15 days a month, with at least 8 days of migraine.

Chest pain:

Chest pain may be due to a heart problem, but other causes are lung infection, a rib injury, or a panic attack.

Crying spells:

Crying spells, crying about anything, and crying about small things may be signs of depression.

Feeling nervous or anxious: 

The feeling of unease or fear. Every person feels anxious during their life.

Example:

Being anxious before your exam makes you alert to improve your performance.

Vaginal bleeding: 

Bleeding from the vagina is not part of a menstrual period.

Irregular menstrual cycle:

Fatigue: 

The feeling of weakness and tiredness is known as Fatigue.

Lightheadedness and dizzy spells: 

Various factors, including inner ear disturbance, motion sickness, and drug side effects, can cause dizziness. An underlying health issue, such as poor circulation, infection, or injury, can sometimes cause it.

Unexplained weight loss:

Weight can be lost by:

  • Having problem
  • Job loss
  • Someone you love most would die

Blurred vision:

  • Using a mobile phone or laptop
  • Study during dim light
  • Use of lenses
  • It may cause blurred vision.

Difficulty concentrating: 

  • Difficulty in Concentration may be caused by the following:
  • Psychological issues
  • Sleeping disorders
  • Due to alcohol or drugs
  • Sadness
  • Anxiety

Constipation: 

If you’re constipated, the following quick fixes can help you have a bowel movement in a few hours.

  • Consume a fiber supplement.
  • Consume constipation-relieving foods.
  • Take a sip of water.
  • Take a stimulant laxative.

Frequent urination: 

Infection, sickness, injury, or bladder irritation are all possible causes of frequent urination. Conditions can cause an increase in urine output. Changes in muscles, nerves, or other tissues impact bladder function.

Nose bleeding: 

Nose bleeding may be due to high blood pressure. On the other hand, it may suggest more severe health issues or blood clotting disorders.

Unusual tiredness: 

Unusual tiredness indicates such as thyroid disease, heart disease, or diabetes. Alcohol or narcotics is a lack of regular exercise.

Tightness of the chest:

The main reason for the tightness of the chest is that of having a heart attack.

  • It may be caused by to following:
  • Infection
  • Injury
  • Anxiety
  • Cardiovascular disorders

Night sweats: 

They are frequently the result of an underlying ailment or illness. You may occasionally wake up after sweating significantly, especially if you sleep with too many blankets or your bedroom is too warm.

Changes in mood or personality: 

Throughout your life, your personality can evolve. Mood swings are typical from time to time.

On the other hand, unusual personality changes may indicate a medical or mental condition. A personality shift can manifest itself in a variety of ways.

Nausea and vomiting:

Nausea and vomiting are indications of various disorders, including infection (“stomach flu”), food poisoning, motion sickness, overeating, a blocked bowel, illness, concussion or brain injury, appendicitis, and migraines.

Fatigue and weakness: 

Weakness is characterized by a lack of muscle strength and a limited ability to move your body, regardless of how hard you try. Fatigue is characterized by significant exhaustion or a severe lack of energy.

Irregular pulse rapid heartbeat: 

When the electrical signals that coordinate the heart’s beats fail to function correctly, heart rhythm abnormalities (heart arrhythmias) arise.

Because of the incorrect signals, the heart beats too quickly (tachycardia), too slowly (bradycardia), or irregularly.

Headache: 

A headache is a head or face discomfort commonly described as throbbing, continuous, acute, or dull.

Visual blurring: 

Blurred vision may be due to various eye diseases, such as our vision, as with near-sightedness or far-sightedness.

Dyspnea: 

Medically referred to as dyspnea, shortness of breath is frequently described as a severe tightening of the chest, a need for air, difficulty breathing, breathlessness, or a sense of suffocation.

Chest pain: 

Chest pain may be due to broken ribs or due heart problem.

Dizzy: 

  • A phase of a variety of feelings is called dizziness.
  • Including faintness
  • Wooziness
  • Weakness

Anxiety: 

Anxiety disorders fall within the category of mental health issues. It’s challenging to get through the day when you’re anxious.

Factors Predisposing to Hypertension:

There are various risk factors for Hypertension, including:

Age:

Hypertension is present in childhood and adolescence, although it may also be present in individuals aged 50 and older.

Gender:

Hypertension is most common in men.

Coronary heart disease:

A family history of high blood pressure or a first-degree relative who suffered from a stroke or coronary heart disease is a risk factor.

Obesity: 

Obese people have higher blood pressure values.

Salt:

Excessive salt intake

Smoking:

Smoking Liver issues

Medication use:

Certain medications, including steroids, birth control pills, and some antidepressants, can cause Hypertension.

How Can Hypertension Be Prevented?

Quit smoking:

If we stop smoking, we can quickly reduce our blood pressure by up to 10 points.

Regular exercise helps keep the heart and arteries, improves blood flow, and reduces stress.

An exercise regimen involving cardio (such as walking) and strength training (such as free weights or weight machines) is recommended for physical activity.

Eat healthily:

Fruits and vegetables can help to improve some of the symptoms of Hypertension.

 Maintain a healthy weight:

You can maintain weight by exercising daily and eating a healthier diet. You can lose weight by;

Reduce stress:

Learn how to control your feelings and talents to deal with stress.

Protocols for Nursing Care

The objectives of nursing care management for Hypertension include:

  • Decreasing or regulating blood pressure.
  • Ensuring compliance with the prescribed course of treatment.
  • Making lifestyle changes.
  • Preventing further problems.

Six nursing diagnoses and care strategies for Hypertension include:

  1. Decreased Cardiac Output Risk

Peripheral resistance combined with cardiac output results in blood pressure. Increased peripheral resistance, high cardiac output (heart rate times stroke volume), or both can lead to Hypertension.

Nursing Diagnosis:

  • Risk for Reduced Cardiac Output

Other possible nursing diagnoses comprise:

  • Risk for Reduced Cardiovascular Performance
  • Reduction in Cardiac Output
  • Reduced Cardiac tissue perfusion risk

Risk Factors may comprise

The common contributing factors for the nursing diagnosis of reduced cardiac output secondary to Hypertension are as follows:

  • Increase in vascular resistance and Vasoconstriction
  • Myocardial ischemia
  • Myocardial loss
  • Hypertrophy/rigidity of ventricles

Objectives and Desired Results:

As a result of Hypertension, the following are typically expected effects for decreased cardiac output:

Low blood pressure

The patient will engage in exercises that reduce blood pressure and cardiac burden.

  • The patient will keep their blood pressure at a healthy level.
  • The patient will show a stable rate and rhythm within the normal range.
  • The patient will engage in stress-reduction exercises (including stress management, balanced exercise, and a rest plan).

Nursing Assessment and Interventions

These nursing evaluations are for diagnosing reduced cardiac output due to Hypertension. Here we will explain different nursing assessments:

General test:

A nurse will test the following things:

  • Heart-related problems
  • Hypertension causing factors

Result:

By applying the test, the nurse will get answers such as;

Test: Review the risk factors

Be able to review patients who are at risk, as mentioned in the related factors, and people who have heart-related conditions. People with acute or chronic problems may have compromised circulation and an overburdened heart.

Test: Check Laboratory Reports

Review the laboratory results (cardiac markers, complete blood cell count, electrolytes, ABGs, urea nitrogen and creatinine, cardiac enzymes, and blood culture).

Result: Help in determining the contributing factors of Hypertension.

Test: Record of Blood Pressure

Record and keep track of your blood pressure. For the initial evaluation, measure the patient’s thighs and both arms three times, three to five minutes apart, first in sitting and then standing position. Apply precise technique and the right cuff size.

Result: Adults with a diastolic pressure elevation of 110 mmHg are considered to have severe Hypertension; as the diastolic pressure increases and when readings exceed 120 mmHg, it is first deemed accelerated and then considered malignant (very severe).

When there is an increase in diastolic pressure, systolic Hypertension is a recognized risk factor for ischemic heart disease and cerebrovascular disease. Refer to the most recent guidelines for classifications of Hypertension above.

Test: Check Pulses

Note whether both central and peripheral pulses are detectable and their quality.

Result: Bounding carotid, jugular, radial, and femoral pulses can be detected and palpated. Pulses in the feet and thighs may become weaker, indicating the consequences of venous congestion and vasoconstriction (enhanced systemic vascular resistance [SVR]).

Test: Check breath, and heart sounds

Listen for breath sounds and heart tones.

Result: Due to atrial hypertrophy, S4 heart sounds are frequently heard in people with severe Hypertension (increased atrial volume and pressure).

Development of S3 heart sound is a sign of ventricular dysfunction and hypertrophy. When crackles and wheezes are present, it may indicate pulmonary congestion caused by chronic or progressing heart failure.

Test: Check symptoms of Vasoconstriction

Notice the capillary refill time, temperature, moisture, and skin color.

Result: Pallor, cool, damp skin, and a delayed capillary refill time may be symptoms of peripheral vascular constriction or indicate that the heart is working less efficiently.

Test: Check Edema

Take notice of general and dependent edema.

Result: This may indicate renal, vascular, or cardiac failure.

Test: Check Heart Performance

Assess client reports or evidence of acute tiredness, intolerance to Exertion, abrupt or gradual weight gain, extremity edema, and growing shortness of breath.

Result: To look for indicators of weak ventricular performance or probable heart failure.

Nursing Interventions and Possible Justifications

Here are several therapeutic nursing actions for diagnosing reduced cardiac output due to Hypertension.

Test: Providing a Good environment

Create a peaceful and quiet atmosphere, and reduce surrounding movement and noise. Keep both number of visitors and stay time to a minimum.

Result: It assists in reducing emotional interaction and encourages relaxation.

Test: Less Interruption

Keep the patient’s activity limits in place (such as bed rest or chair rest); plan uninterrupted rest hours; and, as necessary, help the patient with self-care tasks.

Result: It reduces physical stress and tension, which impact blood pressure and the development of Hypertension.

Test: Reduce Discomfort

Offer consolation options (back/neck massage and head elevation).

Result: Lessens discomfort and possibly decreases autonomic excitation.

Test: Teach Distraction Techniques

Teach distraction strategies, guided imagery, and relaxation techniques.

Result: Can lessen stressful sensations; and provide a soothing effect, thus causing lower blood pressure.

Test: Check Medicine Performance

Keep track of how blood pressure-lowering medications are working.

Result: The effectiveness of drug therapy, which typically entails a combination of beta and calcium channel blockers, diuretics, ACE inhibitors, vascular smooth muscle relaxants, and other medications, depends on the patient and the interactions between the drugs.

The least number and lightest dose of drugs should be used due to side effects, drug interactions, and the patient’s motivation for taking blood pressure medication.

Administer medications as indicated:

  • Thiazide diuretics: 
  • chlorothiazide (Diuril); 
  • hydrochlorothiazide (Esidrix/HydroDIURIL); bendroflumethiazide (Naturetin); 
  • indapamide (Lozol); metolazone (Diulo); quinethazone (Hydromox).

Diuretics are used as the first-line treatment for uncomplicated stage I or stage II hypertension in individuals with generally normal renal function.

These can be used with other medications (such as beta-blockers) to lower blood pressure. By preventing fluid retention, these diuretics can enhance the effectiveness of other antihypertensive medications and may lower the risk of heart failure and stroke.

  • Loop diuretics: 
    • Furosemide (Lasix)
    • Ethacrynic acid (Edecrin)
    • Bumetanide (Bumex)
    • Torsemide (Demadex)

 These medications are efficient antihypertensives, especially in individuals resistant to thiazides or with renal impairment. They produce a noticeable diuresis by preventing the absorption of salt and chloride.

  • Potassium-sparing diuretics: 
  • Spironolactone (Aldactone)
  • Triamterene (Dyrenium
  •      Amiloride (Midamor).

It can be administered along with a thiazide diuretic to reduce potassium excretion.

Alpha, beta, or centrally acting adrenergic antagonists: 

  • doxazosin (Cardura); 
  • propranolol (Inderal); 
  • acebutolol (Sectral); 
  • metoprolol (Lopressor), labetalol (Normodyne); 
  • atenolol (Tenormin); 
  • nadolol (Corgard), carvedilol (Coreg); 
  • methyldopa (Aldomet); 
  • clonidine (Catapres); 
  • prazosin (Minipress); 
  • terazosin (Hytrin); 
  • pindolol (Visken).

For patients with ischemic heart disease, obese people with cardiogenic Hypertension, and patients with recurrent supraventricular arrhythmias, angina, or hypertensive cardiomyopathy, beta-blockers may be prescribed instead of diuretics.

These medications have various specific effects, but they all work to lower blood pressure by reducing cardiac output, sympathetic activity, total peripheral resistance, and renin release.

Note: Due to their ability to prolong and suppress the hypoglycemia effects of insulin, Corgard and Visken should be used with caution by diabetic patients.

Due to the possibility of bradycardia and hypotension, older people may need a lesser dosage. African-American individuals typically respond less well to beta-blockers in general. They could need to take more or use another medication (monotherapy with a diuretic).

Calcium channel antagonists: 

  •      Nifedipine (Procardia)
  •      Verapamil(Calan)
  •      Diltiazem (Cardizem)
  •      Amlodipine (Norvasc)
  •      Isradipine (DynaCirc)
  •      Nicardipine (Cardene).

 When a diuretic plus a sympathetic inhibitor do not regulate blood pressure effectively, this medication may be required to treat severe Hypertension.

Secondary advantages of vasodilator therapy include vasodilation of healthy cardiac vasculature and enhanced coronary blood flow.

Adrenergic neuron blockers: 

  • Guanadrel (Hylorel)
  • Guanethidine (Ismelin)

Eserpine (Serpalan)

  •  Reduce the activity of arterial and venous constriction at terminal points of the sympathetic nerve.

Direct-acting oral vasodilators:

  • Hydralazine (Apresoline)

Minoxidil (Loniten).

  •  By relaxing the vascular smooth muscle, vascular resistance is decreased.

Direct-acting parenteral vasodilators:

  • Diazoxide (Hyperstat)
  • Nitroprusside (Nitropress)

Labetalol (Normodyne).

  •  These are administered intravenously to treat hypertensive emergencies.

Angiotensin-converting enzyme (ACE) inhibitors: 

  •      Captopril (Capoten)
  •      Enalapril (Vasotec)
  •      Lisinopril (Zestril)
  •      Fosinopril (Monopril)
  •      Ramipril (Altace). 
  •      Angiotensin II blockers: valsartan (Diovan), guanethidine (Ismelin).

When other methods have failed to control blood pressure, or when congestive heart failure (CHF) or diabetes is present, an additional sympathetic inhibitor may be necessary for its combined impact.

Test: Diet Changes

Apply the recommended dietary sodium, fat, and cholesterol limitations.

Result: These limitations can lessen myocardial workload by controlling fluid retention and the resulting hypertensive response.

Test: Surgical Intervention

Get ready for surgery when necessary.

Result: When a pheochromocytoma is the cause of Hypertension, the condition can be resolved by removing the tumor.

  1. Decreased Activity Tolerance

Definition

Decreased Activity Tolerance is another nursing diagnosis for Hypertension. It is commonly caused by changes in cardiac output and adverse effects from antihypertensive drugs.

The nursing evaluation

Decreased Activity Tolerance [According to current recommendations, Decreased Activity Tolerance is now the diagnostic term for Activity Intolerance]

Associated Factors

The standard associated factors for the nursing diagnosis of activity intolerance are as follows:

  • General weakness
  • Sedentary lifestyle
  • Oxygen supply and demand imbalance

Determining Features

The typical evaluation cues may be used as defining traits or as a component of your diagnostic statement’s “as proven by” clause.

  • Verbal report of weakness or tiredness
  • Excessive heartbeat or blood pressure response to exercise
  • Uneasiness or dyspnea during Exertion
  • Changes in the electrocardiogram (ECG) indicating ischemia and dysrhythmias

Desired Results

Typical targets and outcomes for activity intolerance:

  • The patient will take part in activities that are essential or encouraged.
  • The patient will increase activity tolerance using the methods specified.
  • The patient will note a noticeable improvement in activity tolerance.
  • The patient will demonstrate a reduction in physiological indicators of intolerance.

Nursing Interventions and Rationales

The nursing evaluations listed below are designed to address activity intolerance linked to generalized weakness.

Test: Check factors for Fatigue

Take note of the factors that lead to tiredness (age, frail, acute or chronic illness, heart failure, hypothyroidism, cancer, and cancer therapies).

Result: The client’s capacity to participate in actual and perceived activities is affected by Fatigue.

Test: Patient Education 

Assess the client’s actual and perceived restrictions or degree of the deficit with their specific position.

Result: It gives a comparative foundation and explains the education and treatments necessary to improve life quality.

Test: Activity Response

  1. Evaluate how the patient responds to the activity.

Noticing a pulse rate that is 20 or more beats per minute higher than the resting rate; a significant rise in blood pressure before and after exercise (systolic pressure 40 mm Hg or diastolic pressure 20 mm Hg); dyspnea or chest pain; severe tiredness and weakness; diaphoresis; syncope.

Result: The listed parameters aid in evaluating physiological reactions to activity-induced stress and, if existent, are signs of overexertion.

Test: Emotional Response 

  1. Evaluate how emotional and psychological variables are impacting the situation.

Result: Stress or depression may aggravate the symptoms of a condition, or depression may be brought on by being forced to become inactive. The stated parameters help assess physiological responses to the stress of activity and, if present, are indicators of overexertion.

Nursing Interventions and Rationales

In this section are therapeutic nursing interventions to address activity intolerance nursing diagnosis.

Test: Energy-Saving Methods

Teach the patient energy-saving methods (using a chair when showering, brushing teeth, or combing hair while sitting and performing activities at a reasonable pace).

Result: Energy-saving methods lower energy consumption, which helps to balance the supply and demand of oxygen.

Test: Promote Gradual Activity 

When tolerated, promote gradual activity and self-care. Assist when required.

Result: A gradual increase in activity level prevents a rapid rise in heart workload. Giving help only when necessary promotes confidence in carrying out activities.

  1. Severe Pain

Elevated resting blood pressure indicates a steady decrease in acute pain sensitivity, which may cause a tendency to raise alertness levels in the presence of painful stimuli.

Nursing Diagnosis

  • Severe Pain

Related Factors

There are frequent contributing factors to the nurse’s diagnosis of acute pain:

  • Increase in cerebral vascular pressure

Defining Characteristics

The standard evaluation cues may be used as defining traits or as a component of your diagnostic statement’s “as evidenced by” clause.

  • Verbal complaints of throbbing pain in the suboccipital region that appears on waking and disappears suddenly after getting up and moving.
  • A stiff neck, head rubbing, intolerance to loud noises and bright lights, a furrowed brow, and clenched fists.
  • Variations in appetite.
  • Neck stiffness, faintness, blurring of vision, nausea, and vomiting have all been reported.

Desired Outcomes

Objectives and anticipated results for the nursing diagnosis of acute pain:

  • The patient will report feeling better or less pain.
  • The patient will speak about comforting techniques.
  • The patient will stick to the medication schedule.
  • The patient will exhibit relaxation techniques and diversionary activities appropriate for the situation.

Nursing Assessment and Rationales

The nurse assessments below address acute pain for this hypertensive nursing care plan.

Test: Patient Viewpoint

  1. Take note of the patient’s viewpoint on pain, use of painkillers, and any history of substance abuse.

Result: It is helpful to evaluate the etiology or contributing causes.

Test: Specific Details of the Pain

Identify the specific details of the pain, including its characteristics, site, severity (0–10), start, and duration. Watch for nonverbal indicators.

Result: Aids in problem diagnosis and the start of the proper therapy. Essential in determining the success of therapy.

Nursing Interventions and Rationales

Here are the therapeutic nursing interventions for this hypertension nursing diagnosis to address acute pain.

Test: Bed Rest

During the acute period, encourage bed rest and keep it up.

Result: Promotes relaxation and reduces excitement.

Test: Non-Pharmacological Treatments

Offer or suggest non-pharmacological headache relief treatments, such as applying a cool towel to the forehead, massaging the back and neck, resting in a relatively dark, quiet space, and engaging in distracting activities.

Result: Reducing cerebral vascular pressure and slowing or blocking the sympathetic nervous system cures headaches and their complications.

Test: Stop Vasoconstricting Activities

Reduce or stop vasoconstricting activities that could worsen headaches (prolonged coughing, straining at stool, and bending over).

Result: In the presence of increased cerebral vascular pressure, activities that induce Vasoconstriction intensify the headache.

Test: Ambulation

If necessary, help the patient ambulate.

Result: Vascular headaches typically come with dizziness and blurred vision. Additionally, the patient may go through postural hypotension periods, making them unstable when moving around.

Test: Light Diet

If nosebleeds occur or nasal packing has been used to halt bleeding, give drinks, soft meals, and frequent mouth care.

Result: Encourages overall comfort. Nasal packing may make it difficult to swallow or force mouth breathing, which causes oral secretions to stagnate and mucous membranes to dry out.

Test: Use of Medicines

Dispense medicines as directed:

  • Analgesics; Antianxiety agents: 
  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Diazepam (Valium).

Result: Minimize or manage pain by reducing sympathetic nervous system activity. It helps alleviate tension and discomfort brought on by stress.

  1. Inefficient Coping

Patient’s failure to cope is typically caused by their general health (“I don’t feel ill”), the complexity of their treatment plan, the need for lifestyle modifications, and the side effects of their drugs.

Nursing Diagnosis

  • Inefficient Coping

Related Factors

Common associated factors for inefficient nursing diagnosis:

  • Multiple changes in one’s life; a situational or maturational problem.
  • Insufficient calmness; minimal or no exercise; excessive workload.
  • Insufficient support practices.
  • Inadequate diet.
  • Unattainable opinions and unfulfilled expectations.
  • Ineffective coping mechanisms.
  • Differences in coping mechanisms between men and women.

Defining Characteristics

The standard evaluation cues may be used as defining traits or as a component of your diagnostic statement’s “as proven by” clause.

  • I am expressing an inability to cope or requesting assistance verbally.
  • Inability to solve problems or fulfill basic requirements or role expectations.
  • Self-destructive behavior, excessive eating, lack of appetite, excessive drinking and smoking, and the tendency for alcohol addiction.
  • Long-standing fatigue/sleeplessness; muscular tension; frequent pain in head/neck;
  • chronic concern, irritability, anxiety, emotional strain, depression

Desired Outcomes

Shared objectives and anticipated effects for the nursing diagnosis of ineffective coping:

  • The patient will recognize inadequate coping mechanisms and their effects.
  • The patient will express awareness of their coping skills and resources.
  • The patient will detect potentially stressful conditions and take action to prevent or change them.
  • The patient will demonstrate the application of successful coping methods.

Nursing Assessment and Rationales

The following nursing evaluations discuss ineffective coping for this hypertension nursing care plan.

Test: Stress Elements

  1. Identify personal stressors (family, friends, the workplace, life changes, or healthcare management).

Result: To gauge the severity of the damage.

Test: Event assessment 

  1. Examine your ability to interpret events and honestly assess the scenario.

To gauge the severity of the impairment.

Test: Check Behaviors

  1. By keeping a close watch on behaviors, determine the effectiveness of coping mechanisms (ability to express thoughts and worries in words, readiness to engage in the recommended course of action).

Result: Flexible strategies are required to modify a person’s lifestyle, manage chronic Hypertension, and incorporate recommended medicines through daily activities.

Test: Difficulties in Coping

  1. Watch for reports of sleep difficulties, increased tiredness, poor concentration, restlessness, decreased headache tolerance, and difficulty coping or solving problems.

Result: Maladaptive coping methods can be markers of suppressed anger and essential predictors of diastolic blood pressure.

Nursing Interventions and Rationales

This section includes specific nursing interventions and inefficient coping nursing diagnosis methods for this hypertension nursing care plan.

Test: Identify Stressors 

  1. Help the patient identify particular stressors and potential coping mechanisms.

Result: The first step towards changing one’s response to a stressor is recognizing it.

Test: Patient Participation 

  1. Involve the patient in the care planning process and urge full participation in the treatment plan.

Result: Participation gives the patient a constant sense of control, enhances coping mechanisms, and can increase cooperation with the treatment plan.

Test: Priorities of patient 

  1. Support the patient to consider their priorities and aspirations in life. Ask oneself, “Are you obtaining what you want with what you’re doing?”

Result: Focuses the patient’s attention on the reality of the current situation compared to the patient’s desired outcome. Strong work ethics, a desire for “control,” and an outward-looking mindset can cause one to neglect their own needs.

Test: Plan Lifestyle Modifications

  1. Aid the patient in determining the necessary lifestyle modifications and start planning. Instead of giving up on your personal and family goals, help them adjust.

Result: Realistically prioritizing necessary adjustments will help patients avoid feeling overwhelmed and helpless.

Test: Psychological Help

  1. Assist the client in replacing negative thoughts with optimistic ones, such as “I can achieve this; I am in control of myself.”

Result: To fulfill psychological demands 

  1. Over-Weight

Being overweight or obese increases the chance of developing Hypertension. According to studies, gaining weight may pathophysiologically lead to increased blood pressure.

Nursing Diagnosis

  • Overweight

 Other nursing diagnoses include:

  • Risk due to Overweight
  • Obesity

Associated Factors

The following are the most common associated factors with the nursing diagnosis of Being Overweight:

  • Excessive eating compared to metabolic requirements
  • Low amount of activity.
  • Cultural tendencies

Defining Characteristics

The standard evaluation cues may be used as defining traits or as a component of your diagnostic statement’s “as proven by” clause.

  • BMI greater than 25kg/m2 in adults.
  • Maximum triceps skinfold according to gender that is more than 15 mm in men and 25 mm in women
  • Reported or noticed abnormal eating habits
  • A sedentary way of life

Desired Outcomes

Common objectives and anticipated results for the nursing diagnosis of Overweight:

  • The patient will notice the relationship between obesity and Hypertension.
  • The patient will change eating habits (e.g., food selections, amount) to achieve the ideal body weight while maintaining good health.
  • The patient will begin and follow an activity regimen that is right for him.

Nursing Evaluations and Rationales

The nurse evaluations for this nursing diagnosis are listed below.

Test: Check obesity-related factors

  1. Determine the likelihood that obesity-related conditions are present.

Result: Because of the imbalance between fixed aortic capacity and increased cardiac output brought on by increasing body mass, obesity is a risk factor for high blood pressure. Numerous studies have demonstrated that a decrease in blood pressure is commonly linked to weight loss.

Test: Food Consumption

  1. Evaluate the patient’s relationship to food and its relevance in their lives.

Result: The patient’s eating habits implicitly influence their decision between good and bad foods.

Test: Obesity and Hypertension

  1. Evaluate the patient’s awareness of the connection between obesity and Hypertension.

Result: Disorganized eating patterns increase the risk of atherosclerosis, obesity, and Hypertension, raising the risk of consequences like heart failure, kidney disease, and stroke.

Test: Intention to Reduce Weight

  1. Discover whether the patient intends to reduce weight.

Result: A key component of behavior change therapy is assessing a patient’s readiness and motivation to make changes for weight loss. For the program to succeed, the person must be prepared to reduce weight.

Test: Maintain Food Diary

  1. Utilize a food diary to evaluate the patient’s nutritional status.

Result: Examining the patient’s eating habits and typical foods is beneficial. Apps for self-monitoring are convenient and helpful.

Test: Food Preference

  1. Examine food preferences and typical daily caloric consumption.

Result: Identifies the existing strong and weak points in nutritional programs, which helps determine which individuals need modification and coaching.

Nursing Interventions and Rationales

In this section are therapeutic nursing interventions for this nursing diagnosis.

Test: Weight Loss Strategy

  1. Develop a reasonable weight-loss strategy, like 1 lb weekly with the patient.

Result: Theoretically, cutting 500 calories from your diet daily will result in a 1 lb loss per week. So a steady weight loss implies fat loss while protecting muscle and typically shows a change in eating habits.

Test: Food Journal

  1. Encourage the patient to keep a food journal that details when and where they eat and the circumstances and emotions present at the time.

Result: Comes up with a database that includes information on the emotional aspects of eating and the number of nutrients consumed. It aids in focused Concentration on aspects that the patient can influence or change.

Test: Less Calorie Intake 

  1. Talk about consuming fewer calories and only the recommended amounts of salt, sugar, and fat.

Consuming too much salt can harm the kidneys and increase intravascular fluid volume, worsening Hypertension. Limiting salt intake and cutting back on saturated fats and cholesterol aid in weight loss.

Test: Healthy Food Choices

  1. Provide guidance and support in making healthy food choices, such as the DASH diet (Dietary Approaches to Stop Hypertension), which emphasizes a diet plan comprising fruits, vegetables, and low-fat dairy products while avoiding foods high in saturated fat (butter, cheese, eggs, meat, ice cream, etc.) and cholesterol (fatty meat, egg yolks, whole dairy products, shrimp, organ meats).

Result: It’s crucial to avoid foods high in cholesterol and saturated fat to stop atherogenesis from progressing. Instead of completely withdrawing from some foods, moderation and using low-fat products may reduce a sensation of deprivation and improve compliance with the dietary plan. When combined with exercise, weight loss, and salt limitations, the DASH diet may reduce or even eliminate the need for medication therapy.

Test: Breakfast Routine

  1. Advise the patient to eat a wholesome, balanced breakfast each morning.

Result: The patient will probably overeat in the evening if he skips breakfast.

Test: Dietician Support

  1. When necessary, consult a dietician.

Result: Can offer extra advice and help with dietary needs-specifics.

  1. Knowledge Deficiency

Controlling Hypertension depends on the patient’s Knowledge of the disease process, treatment plan, and lifestyle modifications. The nurse must highlight the idea of regulating Hypertension rather than treating it while making a nursing diagnosis of Deficient Knowledge.

Nursing Diagnosis

  • Knowledge Deficiency

Related Factors

The following are the common related factors for knowledge deficiency:

  • Lack of information or recollection;
  • Information misunderstanding;
  • Intellectual disability;
  • Refusal to accept a diagnosis

Defining Characteristics

The common evaluation cues may be used as defining features or as a section of your diagnostic statement’s “as proven by” clause.

  • Expression of the problem verbally.
  • Request information.
  • A statement of misunderstanding.
  • Poor execution of techniques and incorrect following of directions.
  • Improper or excessive actions include aggression, irritation, or apathy.

Desired Outcomes

Common objectives and anticipated results for the nursing diagnosis of Knowledge Deficiency:

  • The patient will verbally express their understanding of the disease and the recommended action.
  • The patient will be able to recognize potential complications and medication side effects that call for medical attention.
  • The patient will keep their blood pressure within their acceptable ranges.
  • The patient will explain the rationale for the therapeutic measures and treatment plan.

Nursing Assessment and Rationales

The nurse evaluation for this nursing diagnosis is listed below:

Test: Learning Barrier

  1. Determine learning barriers and readiness. Include a significant other (SO).

Misunderstandings and refusal of the diagnosis due to long-standing thoughts of well-being may limit the patient’s and SO’s desire to learn about the disease, its course, and its prognosis. Lifestyle and behavioral modifications will not be undertaken or sustained if the patient does not embrace the reality of a life-threatening condition requiring ongoing treatment.

Nursing Interventions and Rationales

The nurse interventions in this section address the lack of Knowledge (nursing diagnosis) for this antihypertensive care plan.

Test: BP Limits

  1. Specify and indicate the desired BP limits. Describe the effects of bp on the kidneys, brain, blood vessels, heart, and body.

Result: Provides a foundation for understanding BP spikes and defines commonly used medical terms. The key to helping the patient continue medication even while feeling well is understanding that high blood pressure can exist without symptoms.

Test: Difference between “normal” and “well-controlled BP”

  1. While describing a patient’s blood pressure within acceptable ranges, avoid using the term “normal” instead of “well-controlled.”

Result: Because Hypertension requires lifelong therapy, explaining the concept of “control” aids the patient in understanding the necessity of ongoing care and medication.

Test: Changeable Risk Factors

  1. Help the patient discover risk factors that can be changed (Overweight; diet with high sodium, saturated fats, and cholesterol; sedentary lifestyle; smoking; alcohol intake of more than 2 oz per day regularly; stressful lifestyle).

Result: These risk factors have been proven to impact Hypertension, cardiovascular, and renal disease.

Test: Lifestyle Adjustments 

  1. Work out a solution with the patient to determine how proper lifestyle adjustments can lower the risk factors.

Result: Modifying “comfortable or habitual” behavioral patterns can be challenging. The patient’s success in changing these behaviors can be improved with support, direction, and empathy.

Test: Strategy to Quit Smoking

  1. Stress the significance of quitting smoking and help the patient create a strategy.

Result: Nicotine raises catecholamine release, which elevates heart rate, and blood pressure, causes Vasoconstriction, increases myocardial workload, and lowers tissue oxygenation.

Test: Importance of Treatment plan and Follow-up

  1. Stress the value of following treatment plans and maintaining follow-up consultations.

Result: Antihypertensive therapy frequently fails due to patient noncompliance. Therefore, it is essential for successful therapy that the patient’s compliance is continually evaluated. Compliance typically increases when the patient is aware of the root causes and effects of insufficient intervention and care.

Test: Self-monitoring of BP

  1. Explain and practice the BP self-monitoring approach. Assess the patient’s coordination, manual dexterity, hearing, and vision.

Result: Patients find monitoring their blood pressure at home reassuring because it gives visual and positive reinforcement for adhering to the medication regimen.

Test: Medicine Schedule

  1. Assist patients in creating an easy-to-follow medication schedule.

Result: It may be easier for patients to comply with the long-term regimen if medication schedules are tailored to their routines and requirements.

Test: Information about BP Medicines 

  1. Describe the purpose, dosage, anticipated side effects, uniqueness, and side effects of any given medication.

Result: Adequate information and an understanding that side effects (mood swings, weight gain, dryness of mouth) are typical and often resolved with time might improve compliance with a treatment plan.

Test: Morning-time drugs 

  1. Take daily dosages of diuretics in the morning.

Result: Scheduling reduces the need to urinate at night.

Test: Record Body Weight

  1. Weighing yourself regularly and keeping track.

Result: It is the best way to gauge how well a diuretic works.

Test: Avoid Alcohol

  1. Avoid or reduce alcohol consumption.

Result: The risk of orthostatic hypotension is significantly increased by the interaction between alcohol’s vasodilator effects and a diuretic’s volume-depleting effects.

Test: Inability to Eat/drink

  1. If you can’t take food or liquids, inform your doctor immediately.

Result: If your intake is insufficient and you’re on a diuretic, dehydration can happen quickly.

Test: Follow the Treatment Plan

  1. When using antihypertensives, follow the directions carefully and never skip, adjust, or make up a dose. You should also never quit taking them without informing your doctor. Study possible side effects and drug interactions.

Result: It’s crucial to understand how drugs function and their adverse effects because patients frequently cannot notice the difference drugs make in their blood pressure.

For instance, stopping treatment suddenly can result in rebound hypertension and other serious complications. In some cases, medication dosage can also be changed to lessen side effects.

Test: Avoid Hypotension

  1. Sit for a few minutes before rinsing carefully from lying to standing. Head slightly lifted when you sleep.

Result: When vasodilators and diuretics are used, precautions are taken to lessen the severity of orthostatic hypotension.

Test: Change in Posture 

  1. Encourage regular posture changes and leg workouts while lying down.

Result: Reduces peripheral venous pooling, which can be aggravated by vasodilators and extended sitting or standing.

Test: Alcohol and Vasodilatation 

  1. Advise staying away from hot baths, steam rooms, and saunas, especially when drinking alcohol simultaneously.

Result: Prevents vasodilatation, which could have the dangerous adverse effects of hypotension and syncope.

Test: OTC Drugs Usage

  1. Tell the patient to talk to a doctor before taking additional prescription or over-the-counter (OTC) drugs.

Result: To avoid potentially harmful drug interactions, care must be taken. Any medication with a sympathetic nervous system stimulant may raise blood pressure or work against antihypertensive effects.

Test: Potassium Intake 

  1. Tell the patient to consume more potassium-rich foods and liquids (foods and beverages high in calcium, such as low-fat milk, yogurt, oranges, bananas, figs, dates, tomatoes, potatoes, raisins, apricots, Gatorade, and calcium supplements, when appropriate).

Result: Potassium levels may drop after taking diuretics. Dietary replacement is more appealing than pharmaceutical supplements, and it may be all that is required to restore the shortfall. Specific research shows that 400 mg of calcium can reduce systolic and diastolic blood pressure. The BP may also be improved by addressing mineral deficits.

Test: Timely Information to the Doctor 

  1. Review the warning signs and symptoms that should be reported to your doctor, such as a headache that does not go away after waking up, a sudden and persistent rise in blood pressure, chest pain, shortness of breath, an irregular or rapid heartbeat, considerable weight gain (2 pounds per day or 5 pounds per week), peripheral and abdominal swelling, visual problems, frequent, uncontrollable nosebleeds, depression or emotional instability, extreme dizziness or fainting spells, and muscle weakness.

Result: Timely intervention is made possible by early recognition of developing problems, reduced performance of a treatment regimen, or adverse drug reactions.

Test: Justified Diet Plan

  1. Describe the justification for the suggested eating plan (usually a diet low in saturated fat, sodium, and cholesterol).

Result: Nutritional concerns for Hypertension include excessive saturated fats, cholesterol, sodium, alcohol, and calories. In both normotensive and hypertensive individuals, a diet low in fat and high in polyunsaturated fat lowers blood pressure, presumably through prostaglandin equilibrium.

Test: Salt Sources

  1. Assist the patient in identifying sources of salt intake (table salt, salty snacks, processed meats and cheeses, sauerkraut, sauces, canned soups and vegetables, baking soda, baking powder, and monosodium glutamate). Make clear the significance of reading OTC medicine and food ingredient labels.

Result: It may be possible to treat mild Hypertension or minimize the medicine needed with two years of moderate low-salt dieting.

Test: Personalized Fitness

  1. Motivate the patient to create a personalized fitness plan that includes aerobic exercise (walking, swimming) within the patient’s range of motion. Insist on how crucial it is to stay away from isometric exercise.

Result: Aerobic exercise lowers blood pressure and tones the cardiovascular system. Purely isometric exercise can raise blood pressure by raising serum catecholamine levels.

Test: Nosebleed Remedy

  1. Show the patient how to apply pressure and an ice pack to the back of the neck and the distal portion of the nose, and advise them to bend their heads forward if they experience nosebleeds.

Result: Excessive vascular pressure can cause nasal capillaries to rupture. Capillaries constrict under pressure and cold to reduce or stop bleeding. The volume of blood swallowed is decreased by bending forward.

Test: Community Resources

  1. Inform the patient about available resources in the community and encourage them to adopt new healthy routines. Start referrals as needed.

Result: The American Heart Association, “coronary clubs,” stop smoking clinics, alcohol (drug) rehabilitation, weight loss programs, stress management courses, and counseling services are a few examples of local resources that may be useful to patients in their efforts to start and maintain lifestyle changes.

Related Nursing Diagnoses

You can use related nursing diagnoses to create your nursing care plan for patients with Hypertension.

  1. Poor management of the treatment protocol. It is due to the complicated nature of the treatment plan, required lifestyle modifications, drug side effects, and frequent feelings of overall well-being.
  2. Sexual behaviors that are ineffective. Exercise intolerance and drug side effects can both interfere with sexual function.
  3. Aptitude for Good Family Coping. Family members can support the patient while lowering their risk factors and raising the quality of life for the entire family.
  4. Possibility of Cardiovascular Function Impairment. An overweight, little exercise, and an unhealthy diet.

Nursing care plan for Pulmonary Arterial Hypertension

Pulmonary arterial Hypertension is a severe condition in which the systolic artery pressure exceeds 30 mm Hg or the mean pulmonary artery pressure surpasses 25 mm Hg.

Right-sided cardiac catheterization is used to measure pulmonary arterial Hypertension.

Determining the causes is crucial while creating a nursing plan for pulmonary arterial Hypertension.

The causes may include:

  • Alteration to immunological systems and processes.
  • Raynaud’s phenomenon
  • Collagen diseases
  • Oral contraceptive misuse
  • Sickle cell disease
  • Silent pulmonary emboli.
  • A few more secondary reasons, such as COPD and other lung conditions, may also exist.
  • Other potential causes of these issues include primary heart diseases.
  • Many people may also develop PAH, known as pulmonary arterial Hypertension, due to acquired diseases.

The symptoms and manifestations are also assessed when creating the best nursing care plan for PAH.

There are numerous indicators that PAH may be present, and we have compiled a list of the most significant ones.

  • Dyspnea related to Exertion
  • Substernal Chest pain
  • Hemoptysis and occasional weakness
  • Syncope
  • Ascites
  • Peripheral edema
  • Enlargement of Liver
  • Engorged Veins in the neck
  • Heart murmur
  • Crackles

How is diagnosis carried out?

A variety of well-planned and documented approaches are used to make the diagnosis.

These consist of the following:

  • Taking the history of the patient
  • Assessing the patient physically.
  • Pulmonary function tests and X-ray.
  • ECG
  • Echocardiogram
  • Cardiac catheterization
  • Biopsy of Lung tissue
  • Ventilation

The next step is medical management, which involves determining the underlying reason and treating the patients accordingly.

The underlying factors may include cardiac conditions, COPD, and valve abnormalities.

How do you create a nursing care plan for high blood pressure?

Writing a nursing care plan is a complicated procedure overall. It can’t be done fast or overnight.

The decision must be made after carefully weighing all the relevant factors and accounting for several significant inputs, readings, findings, pathological test reports, scan reports, ECG data, and other similar items.

It also considers additional external factors that could affect blood pressure, such as stress, underlying illnesses, and other factors.

For instance, a patient may have high blood pressure or Hypertension due to the inability to handle particular circumstances.

This could result in higher stress levels, which may then cause high blood pressure.

Conclusion

Hypertension is the term for high blood pressure (repeatedly exceeding 140 over 90 mmHg). Multiple factors cause it. Hypertension impacts multiple organ systems causing different signs and symptoms.

There are multiple risk factors for developing Hypertension, and it can be prevented by controlling the risk factors. The objectives of nursing care management for Hypertension include decreasing or regulating blood pressure, ensuring compliance with the prescribed course of treatment, making lifestyle changes, and preventing further problems.

Nursing diagnosis and care strategies for Hypertension enlist decreased cardiac output risk, Decreased Activity Tolerance, Severe Pain, Inefficient Coping, Overweight, and Knowledge Deficiency.

After going through the nursing diagnosis mentioned above and applying nursing care strategies, the patient would get immediate results in controlling Hypertension.

FAQS :

What is the nursing care strategy for high blood pressure?

The objectives of nursing care planning for Hypertension include decreasing or regulating blood pressure, maintaining adherence to the prescribed course of treatment, making lifestyle changes, and avoiding complications.

What is a reliable nursing diagnosis for high blood pressure?

Here are six nursing diagnoses for nursing care for Hypertension:

  • Risk for Decreased Cardiac Output.
  • Decreased Activity Tolerance.
  • Acute Pain.
  • Ineffective Coping.
  • Overweight.
  • Knowledge deficiency.
  • Other possible nursing care plans.

What common nursing interventions are used to treat Hypertension?

Interventions for excessive water intake.

  • Inform the patient about salt and fluid limitations. Hypertensive patients need to be mindful of their sodium and fluid consumption.
  • Give out diuretics….
  • Elevate the extremities.
  • Educate people about low-sodium food options.

Which five nursing care plans are there?

A nursing care plan comprises five essential parts: assessment, diagnosis, anticipated results, actions, and justification/evaluation.

How is Hypertension diagnosed?

Suppose the blood pressure value equals or exceeds 130/80 mm Hg. In that case, high blood pressure (Hypertension) is considered present. Typically, a diagnosis of high blood pressure is made by averaging two or more readings collected at various times.

What is the effective way to treat Hypertension?

The first step in managing Hypertension should be adjusting to one’s lifestyle. These changes should include reducing salt, quitting smoking, losing weight, increasing potassium intake, avoiding alcohol, exercising regularly, and managing stress.

How should a patient with high blood pressure be treated?

Stress the value of living a healthy life.

Changing one’s lifestyle is essential to disease therapy for people with Hypertension. They not only can lower blood pressure but also improve the effectiveness of antihypertensive medications and lessen the risk of cardiovascular disease in general.

What are the top five symptoms of Hypertension?

High blood pressure symptoms:

  • Double vision or blurry vision.
  • Lightheadedness/Fainting.
  • Fatigue.
  • Headache.
  • Palpitations
  • Nosebleeds.
  • Breathing difficulty.
  • Nausea with or without Vomiting

Read More: Are Nurses, First Responders?