Nursing care plan for hypertension are essential for nurses in the management of patients that are diagnosed with hypertension. Its goals are to reduce and maintain the blood pressure, reduce excess body fluid and promote physical activity of patients as well as to avoid further complications such as diabetes, renal failure and heart failure.
Hypertension is a medical term used to describe high blood pressure. It is characterized by a blood pressure reading of 140 over 90 mmhg and above.
In this article we will discuss the NANDA Nursing diagnosis for hypertension, nursing assessment, nursing intervention, rationale behind it and patient education and counseling.
Nursing care plan for hypertension
- The achievable outcomes of a Nursing care plan for hypertension are
- To lower and keep the blood pressure stable, Maintain a healthy lifestyle
- Prevent further complications.
Nursing diagnosis and management of hypertension.
Risk for decreased cardiac output related to Myocardial damage, Myocardial ischemia, Increased vascular restriction
Nursing goals and outcomes;
- Patient will engage in activities that help to reduce blood pressure and regulate cardiac output
- Patient will partake in stress-management activities
- Patient blood pressure will be at a normal stable range
Nursing assessment ;.
- Access electrolyte values, cardiac markers and blood cell count
- Observe patient capillary refill time
- Monitor vital signs and record bp and short intervals
- Palpate pulse at several pulse points to note their presence and quality of the pressure felt
- Auscultate heart sounds and lung sounds to detect abnormalities
- Obtain patient history of exercise and sudden or progressive weight gain , edema on the extremities and shortness of breath.
- Provide calm and conducive environment for the patient- it’s easier to establish a relationship with the patient in a calm environment
- Assist patient with self care activity to reduce stress on the patient – stress aids in increasing blood pressure , so to avoid that limit the physical activity of the patient until the bp is under control
- Provide comfort means for the patient – put on a show on the tv , warm blankets and soft pillows all in an attempt to promote relaxation of the patient
- Administer prescribed medication – Diuretics are administered . they help in removing extra body fluids and reduce swelling of the hands and legs
- Monitor patient response to medication- all medications react differently in people, so monitor for non-expected responses of the patient to the medication
- Educate patient to opt for low sodium foods in diet- sodium increases body fluid and blood pressure , so reducing sodium intake would help in maintaining normal bp
Excess fluid volume related to excessive fluid and sodium intake
As Evidenced by:
- weight gain,
- Edema in upper and lower extremities,
- Jugular vein distention,
- High blood pressure,
goals and outcomes;
- Patient will maintain stable fluid volume with a balanced fluid chart
- Patient will maintain reduced sodium intake lifestyle
- Access patients for edema by palpating extremities and a weight patient frequently to determine weight gain.
- Assess nutritional intake , to determine if patient has high sodium intake
- Access electrolyte values and monitor creatine and blood urea nitrogen values, cardiac markers blood cell count etc
- Educate patient on sodium and fluid restriction– well you’re not gonna tell the patient to not drink water or add sal in their food entirely but opting for substitutes of salts and taking water in very little quantity helps
- Elevate extremities – this is where physics meets nursing , using gravity to push the down back into proper circulation , this done by elevating the legs and hands. Explain this to the patient first because some might find this procedure uncomfortable and stressful
- Administer diuretics– diuretics reduces excess body fluids and reduces blood pressure. Follow the physician’s prescription.
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Sedentary lifestyle related to inability to participate in physical activity due to health limitations, lack of knowledge of the benefit of exercise In maintaining blood pressure
As Evidenced by:
- activity intolerance ,
- being overweight,
- Abnormal heart rate response to activity
Nursing goals and outcomes
- Patient will engage in physical activity with good tolerance
- Patient will report absence of shortness of breath after exercise
- Patient will report stable blood pressure from 1 month of religiously exercising
- Assess patient history of exercise
- Assess patient level of interest in physical activities
- Assess for fatigue and shortness of breath before engaging patient in physical activities
- Help patient establish a plan for physical exercise – physical activity could be mentally discouraging for people , having a plan on what to do help in motivating the patient to stick with the process
- Keep tabs on patients – instruct patient to log in the time and hours spent in engaging in exercise daily to track the patients improvement
- Educate patients on the benefits of exercising– when a patient understands why they need to perform a task it helps them stick to the plan and complete it.
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Hypertension is a clinical case that is easily managed with adequate planning and care. Nurses should apply the care plans in this article to manage patients and restore them back to good health.