Nursing Care Plan for Hypertension

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nursing care plan for hypertension

Hypertension is common. However, despite being common, a lot of people aren’t fully aware of what it is, what damages it can cause, and why it happens.

Affecting about 75 million Americans and killing about 41,000 Americans in 2014, it’s important to draft the right nursing care plan for hypertension. This will help ensure that patients’ individual needs are met and proper care is delivered.

What Is Hypertension?

blood pressure

Hypertension is more commonly known as high blood pressure. It happens when the pressure of your blood that gets pumped through your arteries goes beyond the norm and what the body can handle.

Because there are usually no signs and symptoms, hypertension is popularly called as the “silent killer”. As patients don’t feel any dramatic change in how they feel, the constant pressure in the arteries usually ends up causing serious damage and health problems.

The list includes:

  • Heart attack
  • Metabolic syndrome
  • Heart failure
  • Aneurysm
  • Narrowing and weakening of the blood vessels in the kidneys
  • Narrowing and weakening of the blood vessels in the eyes
  • Issues with memory

Hypertension can happen in one of three adults worldwide. Middle aged men who are around 45 years of age frequently develop the condition. And it’s not just the adults who can have high blood pressure.

Children who are inactive, living an unhealthy lifestyle and those who are obese can be hypertensive, too.

Other risk factors for hypertension include:

Race

It’s been established that people with dark skin are more predisposed to getting high blood pressure than those who have pale skin.

Age

As you age, the walls of the arteries become less and less flexible. This prevents the walls of the arteries from opening effectively as they should. This greatly increases peripheral resistance.

Genetics

Having people in the family with hypertension increases your likelihood of developing it, too.

Diet

Having too much salt as well as having too little potassium in your daily diet can cause your blood pressure to be constantly elevated. Drinking too much alcohol counts, too.

See Also: 10 Tasty and Healthy Salt Substitutes

Obesity

Weighing more means needing more oxygen to supply nutrients and oxygen to your tissues. This increase in demand also increases the pressure on the artery walls.

Types of Hypertension

There are two major types of hypertension.

Essential hypertension

Essential hypertension is when you have a high blood pressure reading in three or more visit to the doctor. This is after all possible causes of hypertension have been ruled out.

It’s typical for patients with essential hypertension to not experience any symptoms. However, there are patients who experience frequent headaches, dizziness and tiredness.

Secondary hypertension

Secondary hypertension refers to high blood pressure caused by other medical conditions, like diseases that affect the kidneys, endocrine system and heart. In some cases, one can also develop it during pregnancy.

Categories of Hypertension

Doctors usually categorize blood pressure into the following:

Normal blood pressure-120/80 mmHg and lower
Prehypertension- 120-139 / 80-89 mmHg
Stage 1 hypertension- 140-159 / 90-99 mmHg
Stage 2 hypertension- 160 / 100 mmHg or higher

See Also: Severely Elevated Blood Pressure: When Is It an Emergency?

Hypertension Nursing Care Plans

hypertension patient

If you are caring for a hypertensive patient, you need to be thorough in planning your care. To help you get started, here are some of the essential nursing care plans for hypertension you need to prepare.

1Activity intolerance

May be related to
-Imbalance between oxygen supply and demand
-Generalized weakness
-Sedentary lifestyle

Possibly evidenced by
-Exertional discomfort
-Abnormal blood pressure in response to activity
-Verbal report of fatigue

Desired outcomes
-Demonstrate a decrease in physiological signs of intolerance
-Participate in desired activity
-Use identified techniques to enhance activity tolerance
-Report an increase in physical activity

Nursing Interventions Rationale
Evaluate current limitations/degree of deficit in light of usual
status.
Provides a baseline information on interventions needed to improve the quality of life.
Assess cardiopulmonary response to physical activity, including
vital signs before, during, and after activity.
Indicates patient’s physiological response to the stress of the activity.
Assess emotional/psychological factors affecting the current
situation.
Depression about changes in health can affect motivation to participate in activities.
Adjust activities to prevent overexertion (performing activities slowly, sitting down when brushing teeth and combing hair). Reduces energy expenditures, aiding in balancing out oxygen supply and demand.
Increase exercise/activity levels gradually and plan rest periods between activities (resting for 3 minutes in a 10-minute walk). Prevents sudden increase in cardiac workload; reduces fatigue.
Promote comfort measures and provide for relief of pain, if there’s any. Enhances patient’s ability to participate in activities.

2Knowledge, deficient regarding condition, treatment plan and lifestyle changes

May be related to
-Information misinterpretation
-Unfamiliarity with information resources
-Lack of knowledge
-Denial of diagnosis

Possibly evidenced by
-Verbalization of the problem
-Statements reflecting misconceptions
-Request for information

Desired outcomes
-Verbalize understanding of condition/disease process and treatment
-Initiate necessary lifestyle changes and participate in treatment regimen
-Exhibit increased interest/assume responsibility for own health
-Maintain blood pressure within normal range

Nursing Interventions Rationale
Assess level of knowledge and be alert to signs of avoidance. Patient must be ready to receive information for intervention to be effective.
Define and specify the desired blood pressure limits. Enables patient to have a clear understanding of the normal values.
Describe what hypertension is and how it affects the heart, kidneys, brain and blood vessels. Enables patient to understand that high blood pressure can happen without any symptoms.
Assist patient in identifying modifiable risk factors and how to take control of them (drinking alcohol, smoking and having a sedentary lifestyle). Gives the patient a clearer understanding of what caused the condition.
Emphasize the importance of adhering treatment plan. Failure to comply is one of the most common reasons why treatment plans for hypertension fail.
Teach patient or his relative on how to take proper blood pressure measurement. Monitoring blood pressure at home can help determine if the existing treatment plan is working or not.
Make patient aware of the signs and symptoms that would require an urgent visit to the physician (a persistent headache, a sudden spike in blood pressure, dizziness, chest pain and fainting).  The earlier complications are detected and reported, the earlier proper interventions can be applied.

3Imbalanced nutrition: more than body requirements

May be related to
-Excessive intake in relationship to metabolic need
-Sedentary lifestyle

As evidenced by
-Weight 20% over ideal for height and frame
-Triceps skin fold greater than 15 mm in men and 25 mm in
Women
-Weight 10% over ideal for height and frame
-Reports of dysfunctional eating patterns

Desired outcomes
-Demonstrate appropriate changes in lifestyle and behaviors,
including eating patterns, food quantity/quality, and exercise
Program
-Attain desirable body weight

Nursing Interventions Rationale
Record height, weight, body build, gender, and age. Serves as baseline data.
Determine patient’s desire to lose weight.
Reassess dietary choices.
The motivation to lose weight is internal; patient must be ready and willing to lose weight before the process begins.
Discuss the need to have a lower intake of calories, salt, fats, and sugar. Provides a baseline for creating a dietary program.
Set realistic goals for weekly weight loss. Excessive intake of salt causes an increase in intravascular fluid volume which can damage the kidneys and aggravate the condition. Too much sugar in the diet can lead to diabetes which can complicate hypertension.
Encourage patient to keep a log of food intake. Drastic weight loss can put a strain on the heart; helps determine emotional conditions that can affect eating.
Aid in the selection of appropriate food and DASH (Dietary Approaches to Stop Hypertension), like increasing intake of whole grains, low-fat dairy, fruits, and vegetables. DASH provides the patient with key nutrients that can aid in lowering blood pressure.
Refer to a dietitian as needed.  Provides assistance and additional counseling.

Resources:

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2010). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. Philadelphia: F.A. Davis.

https://www.cdc.gov

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