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Sample Hypertension Nursing Care Plan

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Sample Hypertension Nursing Care Plan

Nursing Care Plan for Hypertension – Case Scenario:

In this nursing care plan for hypertension, we encounter a male patient, aged 72, of Caucasian descent. He presented to the hospital after receiving a blood pressure reading of 195/125 mmHg during a visit to his primary care physician. The patient has a medical history includes hypertension, a prior myocardial infarction with coronary artery bypass grafting (CABG) in 2012, type 2 diabetes mellitus (T2DM), and hyperlipidemia. He expressed concerns about his risk of experiencing another cardiovascular event. Presently, the patient reports no chest pain at rest but mentions a mild headache. He has been taking metformin 1000mg orally twice daily, glipizide 2.5 mg orally daily, rosuvastatin 20mg orally daily, lisinopril 10 mg orally daily, warfarin 2mg orally daily, and low-dose 81mg chewable aspirin. The patient mentioned running out of his antihypertensive medication two weeks ago while on vacation. His current vital signs are BP 205/125 mmHg, HR 55 BPM, O2 saturation at 94%, temperature 98.7°F, and a respiratory rate of 13. His INR is 1.3, and his lipid levels are within normal limits.

Diagnosis: The patient presents with a hypertensive emergency, characterized by systolic and diastolic blood pressure readings exceeding 180 mmHg and 120 mmHg, respectively. The presence of secondary bradycardia is linked to this hypertensive episode. Other symptoms include a mild headache, which may be attributed to hypertension.

Subjective: The patient seeks medical attention due to a troubling blood pressure reading at his primary care physician’s office. He is particularly concerned because of a previous myocardial infarction. He mentions missing several doses of lisinopril over the past few weeks while on vacation, as he forgot to bring extra medication. The patient reports no vision disturbances but does complain of a mild headache. He does not routinely monitor his blood pressure at home, believing it to be “under control.” Contributing factors to this hypertensive episode include T2DM, a history of myocardial infarction, and missed doses of antihypertensive medications.

Objective: The patient is at an increased risk of a cardiovascular event due to his previous myocardial infarction, hyperlipidemia, and hypertension. His hypertensive emergency is evidenced by a blood pressure reading of 205/125 mmHg with secondary bradycardia at 55 BPM. The patient is currently taking metformin 1000mg orally twice daily, glipizide 2.5 mg orally daily, rosuvastatin 20mg orally daily, lisinopril 10 mg orally daily, warfarin 2mg orally daily, and low-dose 81mg chewable aspirin orally daily.

Goals of Therapy: The primary objectives of therapy are to acutely reduce blood pressure to levels below 140/90 mmHg and eventually below 130/80 mmHg, following the 2017 ACC guidelines for clients with diabetes. Additionally, the patient’s headache should be resolved within a day of treatment.

Interventions: Patients presenting with complications described in this nursing care plan for hypertension may necessitate specific interventions during your practice. It is important to be familiar with these key interventions:

  1. Initiate treatment with a vasodilatory medication, such as nitrates (e.g., nitroglycerin, nitroprusside), non-dihydropyridine calcium channel blockers (e.g., nicardipine, amlodipine), or hydralazine. Avoid beta-blockers and dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) due to the risk of severe bradycardia. Adjust vasodilators according to the physician’s instructions to reduce blood pressure to the specified parameters (e.g., <140/90).
  2. Educate the patient on the importance of consistent medication adherence to reduce the risk of cardiovascular events.
  3. Provide patient education on lifestyle modifications to minimize the risk of cardiovascular events, including increased aerobic exercise, limiting daily salt intake to <2 grams, and taking antihypertensive medications daily.
  4. A home blood pressure cuff is recommended to monitor and prevent future hypertension episodes.

Frequently Asked Questions About “Hypertension Nursing Care Plans”

What is a Hypertension Nursing Care Plan?

A Hypertension Nursing Care Plan is a structured document that outlines the nursing interventions and strategies for managing a patient with hypertension to control blood pressure and reduce the risk of related complications.

Why is it important to have a care plan for hypertension?

Having a care plan for hypertension is crucial to ensure systematic and effective care delivery, promote patient education, and monitor progress in managing high blood pressure, a significant risk factor for various health issues.

Who is involved in creating a Hypertension Nursing Care Plan?

A Hypertension Nursing Care Plan is typically created by registered nurses, nurse practitioners, and other healthcare professionals involved in the patient’s care in collaboration with the patient and, in some cases, their family.

How does a patient’s medical history impact the care plan for hypertension?

A patient’s medical history, including conditions like diabetes or heart disease, can significantly impact the care plan, as it influences medication choices, lifestyle recommendations, and the overall management approach.

What are the key components of a Hypertension Nursing Care Plan?

Key components include patient assessment, nursing diagnoses, goals and outcomes, interventions (such as medication management and lifestyle changes), evaluation criteria, and documentation guidelines.

How often should a Hypertension Nursing Care Plan be reviewed and updated?

Hypertension care plans should be regularly reviewed and updated to reflect changes in the patient’s condition or treatment, typically every 3 to 6 months or as needed.

What are the primary goals of therapy in a hypertension care plan?

The primary goals of therapy include reducing and maintaining blood pressure within a target range, preventing complications, and improving the patient’s overall cardiovascular health.

What interventions are typically included in the care plan for hypertension?

Interventions may involve medication management, dietary recommendations, exercise programs, stress management, and patient education on self-monitoring and lifestyle modifications.

How can patient education be integrated into the care plan for hypertension?

Patient education is essential and should cover topics like blood pressure monitoring, medication adherence, dietary choices, and lifestyle changes. It empowers the patient to participate in their care actively.

Are there different care plans for primary and secondary hypertension?

While the fundamental principles of hypertension care are similar, care plans can vary depending on the underlying cause. Secondary hypertension may require additional diagnostics and treatment tailored to the specific etiology, whereas primary (essential) hypertension focuses on managing blood pressure as a primary condition.

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