Best Nursing Care Plan for Hypertension

If you are caring for a hypertensive patient, you need to be thorough in planning your care, here is a nursing care plan for hypertension. It will be helpful in your job in a systematic way with continuous monitoring and evaluation.

nursing care plan for hypertension

Table of Contents

What is Hypertension and what are the Types of Hypertension

According to WHO, Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body. Hypertension is when blood pressure is too high

Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days are ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg

Type of HypertensionDescription
Primary HypertensionThe most common form of high blood pressure occurs without any identifiable underlying cause. It develops gradually over time and is often associated with factors such as age, family history, obesity, lack of physical activity, and poor dietary choices.
Secondary HypertensionHigh blood pressure is caused by an underlying medical condition, such as kidney disease, hormonal disorders, obstructive sleep apnea, or the use of certain medications. Secondary hypertension is less common than primary hypertension, but it tends to be more severe and can develop suddenly.

What are the risk factors of Hypertension?

The contributing factors or risk factors of hypertension are mainly divided into two; modifiable risk factors and non-modifiable risk factors

Unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, a poor intake of fruits and vegetables), physical inactivity, cigarette and alcohol use, and being overweight or obese are all modifiable risk factors.

A family history of hypertension, age over 65, and co-existing disorders such as diabetes or kidney disease are non-modifiable risk factors.

What are the main signs and symptoms of Hypertension

Symptoms Description
Headaches Headaches are one of the most common symptoms of hypertension. The headaches are typically felt in the back of the head and may be accompanied by dizziness or lightheadedness.
Shortness of breath Shortness of breath is another common symptom of hypertension. It may be a sign that the heart is working too hard to pump blood through the body.
Chest pain Chest pain may occur if hypertension has caused the heart to work too hard, leading to a buildup of plaque in the arteries that supply blood to the heart.
Nosebleeds Nosebleeds can occur if hypertension has caused the blood vessels in the nose to become weakened and more susceptible to rupture.
Visual changes Visual changes, such as blurred vision or seeing spots, may occur if hypertension has caused damage to the blood vessels in the eyes.
Chest pain Chest pain may occur if hypertension has caused the heart to work too hard, leading to a buildup of plaque in the arteries that supply blood to the heart.

Nursing Diagnosis for Hypertension

1) Activity intolerance related to an imbalance between oxygen supply and demand, generalized weaknesses, sedentary lifestyle

2) Knowledge deficient regarding condition, treatment plan, and lifestyle changes related to information misinterpretation, unfamiliarity with information resources, lack of knowledge, and denial of the diagnosis

3) Imbalanced nutrition more than requirements related to excessive intake in relation to metabolic need, sedentary lifestyle

4) Risk for Decreased Cardiac Output related to hypertension

5) Risk for Impaired Cardiovascular Function related to hypertension

6) Risk for Ineffective Peripheral Tissue Perfusion related to hypertension

7) Risk for Imbalanced Fluid Volume related to hypertension

8) Risk for Disturbed Maternal-Fetal Dyad related to pregnancy-induced hypertension

1) Activity intolerance related to imbalance between oxygen supply and demand, generalized weaknesses, sedentary lifestyle

Evidenced by
Exertional discomfort, abnormal blood pressure in response to activity, verbal fatigue report.

Desired outcomes

  • Demonstrate a decrease in physiological signs of intolerance.
  • Participate in the desired activity.
  • Use identified techniques to enhance activity tolerance.
  • Report an increase in physical activity.

Activity Intolerance – Nursing interventions & Rationales

1) Evaluate current limitations or assess the degree of deficit in light of the usual status

Rationale: Provide baseline information on interventions needed to improve the quality of life.


2) Asses cardiopulmonary response to physical activity, including vital signs before, doing, and after the activity

Rationale: Indicates the patient’s physiological response to the stress of the activity.


3) Asses emotional or physiological factors affecting the current situation

Rationale: Depression about changes in health can affect motivation to participate in activities.


4) Adjust activities to prevent overexertion ( performing activities slowly, sitting down when brushing teeth and combing hair)

Rationale: Reduce energy spend, aiding in balancing oxygen supply and demand.


5) Increase exercises or activity levels gradually and plan rest periods between activities (resting for 3 minutes in a 10-minute walk)

Rationale: Prevents a sudden increase in cardiac workload, and reduces fatigue.


6) Promote comfort measures and provide for the relief of pain, if there is any

Rationale: Enhances the patient’s ability to participate in activities.

2) Knowledge deficient regarding condition, treatment plan, and lifestyle changes related to information misinterpretation, unfamiliarity with information resources, lack of knowledge, and denial of the diagnosis

  • Evidenced by
  • Verbalization of the problem
  • Statements reflecting misconceptions
  • Request for information

Outcomes

  • Verbalize understanding of conditions or disease processes and treatment.
  • Initiate necessary lifestyle changes and participate in the treatment regimen.
  • Exhibit increased interest or assume responsibility for own health.
  • Maintain blood pressure within normal range.

Knowledge Deficit – Nursing Interventions & Rationales


1) Asses the level of knowledge and be alert to signs of avoidance

Rationale: The patient must be ready to receive information for intervention to be effective


2) Define and specify the desired blood pressure levels

Rationale: Enables patients to have a clear understanding of the expected values.


3) Describe hypertension and how it affects the heart, kidney, brain, and blood vessels.

Rationale: Enable the patient to understand that high BP can happen without any symptoms.


4) Assist the patient in identifying modifiable risk factors and how to control them (drinking alcohol, smoking, and having a sedentary lifestyle)

Rationale: Give the patient a clearer understanding of what caused the condition.


5) Emphasize the importance of adhering treatment plan

Rationale: Failure to comply is one of the most common reasons why treatment plans for hypertension fail.


6) Teach the patient or his relatives how to take proper blood pressure measurement

Rationale: Monitoring BP at home can help determine if the existing treatment plan is working or not


7) Make the patient aware of the signs and symptoms that would require an urgent visit to a physician (a persistent headache, sudden spike in BP, dizziness, chest pain, and fainting )

Rationale: The earlier complications are detected and reported, the earlier proper interventions can be applied.

3) Imbalanced nutrition more than requirements related to excessive intake in relation to metabolic need, sedentary lifestyle

Evidenced by


1) Weight 20% over ideal for height and frame
2) Report dysfunctional eating patterns
3) Triceps skinfold greater than 15 mm in men and 25mm in women

Outcome

Demonstrate appropriate changes in lifestyle and behavior including eating patterns food quantity and exercise programs, and attain desirable body weight.

Imbalanced Nutrition, More than Body Requirements – Nursing Interventions

1) Record height, weight, body build, gender, and age

Rationale: Serves as baseline data.


2) Determine the patient’s desire to lose weight. reassess dietary choices

Rationale: The motivation to lose weight is internal, the patient must be ready and willing to lose weight before the process begins


3) Discuss the need to have a lower intake of calories, salt, fats, and sugar

Rationale: Provides a baseline for creating a dietary program


4) Set realistic goals for weekly weight loss

Rationale: Excessive intake of salt causes an increase in intravascular fluid volume which can damage the kidneys and aggravate the conditions. Too much sugar in the diet can lead to diabetes which can complicate hypertension


5) Encourage the patient to keep a log of food intake.

Rationale: Drastic weight loss can put a strain on the heart, and help determine emotional conditions that can affect eating.


6) Refer to a dietician as needed.

Rationale: Provide assistance and additional counseling.

4. Risk for Decreased Cardiac Output related to hypertension

Outcome:

Maintain adequate cardiac output.

Prevent complications related to decreased cardiac output.

Risk for Decreased Cardiac Output – Nursing Interventions and Rationales

  1. Monitor vital signs including blood pressure, heart rate, and rhythm.

Rationale: Monitoring vital signs and cardiac function can help identify early signs of decreased cardiac output and guide appropriate interventions.

2. Monitor cardiac function through electrocardiogram (ECG) and other diagnostic tests.

Rationale: Monitoring cardiac function through electrocardiograms and other diagnostic tests is crucial in the care of patients with hypertension, as it allows for early detection of cardiac abnormalities or changes and facilitates timely and appropriate interventions to improve outcomes.

3. Administer antihypertensive medications as ordered.

Rationale: Antihypertensive medications can help control blood pressure and prevent complications related to decreased cardiac output.

4. Monitor for signs and symptoms of decreased cardiac output such as dyspnea, fatigue, decreased urine output, and peripheral edema.

Rationale: It will help to detect early signs of cardiac dysfunction, and guide timely interventions to improve cardiac function and prevent further complications.

5. Encourage a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques.

Rationale: Lifestyle modifications can help control hypertension and promote overall cardiovascular health.

6. Provide patient education about the importance of compliance with medication and lifestyle modifications.

Rationale: It will help to empower patients to take an active role in their care and facilitate adherence to prescribed treatments, which can improve hypertension control, prevent complications, and promote overall health and well-being.

Evaluation:

The patient maintained adequate cardiac output as evidenced by stable vital signs and the absence of complications related to decreased cardiac output.

5. Risk for Impaired Cardiovascular Function related to hypertension

Objectives:

  • Maintain optimal cardiovascular function.
  • Prevent complications related to impaired cardiovascular function.

Risk for Impaired Cardiovascular Function – Nursing Interventions and Rationales

  1. Monitor vital signs including blood pressure, heart rate, and rhythm.

Rationale: Monitoring vital signs and cardiovascular function can help identify early signs of impaired cardiovascular function and guide appropriate interventions.

2. Monitor cardiovascular function through electrocardiogram (ECG) and other diagnostic tests.

Rationale: monitoring cardiac function through electrocardiograms and other diagnostic tests is crucial in the care of patients with hypertension, as it allows for early detection of cardiac abnormalities or changes and facilitates timely and appropriate interventions to improve outcomes.

3. Administer antihypertensive medications as ordered.

Rationale: Antihypertensive medications can help control blood pressure and prevent complications related to impaired cardiovascular function.

4. Monitor for signs and symptoms of impaired cardiovascular function such as chest pain, dyspnea, palpitations, and peripheral edema.

Rationale: It will help to detect early signs of cardiovascular complications and guide timely interventions to improve cardiac function and prevent further complications.

5. Encourage a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques.

Rationale: Lifestyle modifications can help control hypertension and promote overall cardiovascular health

6. Provide patient education about the importance of compliance with medication and lifestyle modifications.

Rationale: It will help to empower patients to take an active role in their care and facilitate adherence to prescribed treatments, which can improve hypertension control, prevent complications, and promote overall health and well-being.

Evaluation:

The patient maintained optimal cardiovascular function as evidenced by stable vital signs and the absence of complications related to impaired cardiovascular function.

6. Risk for Ineffective Peripheral Tissue Perfusion related to hypertension

Objective:

Maintain adequate peripheral tissue perfusion.

Prevent complications related to ineffective peripheral tissue perfusion.

Risk for Ineffective Peripheral Tissue Perfusion – Nursing Interventions and Rationales

1) Monitor peripheral pulses, capillary refill, and skin color and temperature:

The rationale for monitoring peripheral pulses, capillary refill, and skin color and temperature is to assess peripheral tissue perfusion and detect any signs of impaired perfusion, which can guide appropriate interventions and prevent tissue damage or loss.
2) Elevate legs when appropriate to promote venous return:

The rationale for elevating legs when appropriate is to promote venous return and reduce edema, which can improve cardiovascular function and prevent complications such as deep vein thrombosis (DVT) or venous insufficiency.
3) Administer antihypertensive medications as ordered:

The rationale for administering antihypertensive medications as ordered is to lower blood pressure and prevent complications associated with hypertension, such as stroke, heart failure, or renal damage.
4) Encourage a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques:

The rationale for encouraging a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques is to improve overall health and well-being, reduce hypertension risk factors, and promote hypertension control.
5) Provide patient education about the importance of compliance with medication and lifestyle modifications:

The rationale for providing patient education about the importance of compliance with medication and lifestyle modifications is to empower patients to take an active role in their care and facilitate adherence to prescribed treatments, which can improve hypertension control, prevent complications, and promote overall health and well-being.

Evaluation:

The patient maintained adequate peripheral tissue perfusion as evidenced by normal peripheral pulses, capillary refill, and skin color and temperature.

7. Risk for Ineffective Renal Perfusion related to hypertension

Objective:

Maintain adequate renal perfusion. Prevent complications related to ineffective renal perfusion

Risk for Ineffective Renal Perfusion – Nursing Interventions and Rationales

  1. Monitor urine output, serum creatinine, and blood urea nitrogen (BUN):

The reason for monitoring urine output, serum creatinine, and blood urea nitrogen (BUN) is to assess kidney function, detect early signs of renal impairment, and guide appropriate interventions to prevent further damage or loss of function.
2. Administer antihypertensive medications as ordered:

The reason for administering antihypertensive medications as ordered is to lower blood pressure and prevent complications associated with hypertension, such as stroke, heart failure, or renal damage.
3. Encourage a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques:

The reason for encouraging a healthy lifestyle including a low-sodium diet, regular exercise, and stress reduction techniques is to improve overall health and well-being, reduce hypertension risk factors, and promote hypertension control.
4. Provide patient education about the importance of compliance with medication and lifestyle modifications:

The reason for providing patient education about the importance of compliance with medication and lifestyle modifications is to empower patients to take an active role in their care and facilitate adherence

Evaluation:

The patient maintained adequate renal perfusion as evidenced by normal urine output, serum creatinine, and blood urea nitrogen (BUN).

(In case of Pregnancy Induced Hypertension or Hypertension in Pregnancy)

8. Risk for Disturbed Maternal-Fetal Dyad related to pregnancy-induced hypertension

Objective:

Maintain adequate maternal and fetal perfusion.

Prevent complications related to a disturbed maternal-fetal dyad.

Risk for Disturbed Maternal-Fetal Dyad – Nursing Interventions and Rationales

  1. Monitoring maternal vital signs including blood pressure, heart rate, and rhythm:

This intervention is important because changes in vital signs can be early signs of complications such as hypertension or cardiac arrhythmias, which can be harmful to both the mother and baby. Early detection allows for prompt intervention and treatment.

2. Monitoring fetal heart rate and uterine contractions:

This intervention is important to assess fetal well-being and to identify potential fetal distress or hypoxia during labor. Early detection and intervention can prevent fetal compromise and reduce the risk of adverse outcomes.

3. Administering antihypertensive medications as ordered:

This intervention is important in managing hypertension during pregnancy and reducing the risk of complications such as eclampsia, stroke, or placental abruption. Prompt administration of antihypertensive medications can help prevent or manage these complications.

4. Monitoring for signs and symptoms of preeclampsia such as proteinuria, edema, and visual disturbances:

This intervention is important in identifying early signs of preeclampsia, a serious complication of pregnancy characterized by hypertension, proteinuria, and organ dysfunction. Early detection allows for prompt management and treatment to prevent severe complications such as seizures or HELLP syndrome.

Evaluation:

Maternal and fetal perfusion remained adequate as evidenced by stable maternal vital signs and fetal heart rate and the absence of complications related to a disturbed maternal-fetal dyad.

9. Risk for Imbalanced Fluid Volume related to hypertension

Goals:

Maintain optimal fluid balance.

Prevent complications related to imbalanced fluid volume.

Nursing Interventions:

Monitor fluid intake and output.

Administer diuretic medications as ordered.

Encourage a healthy lifestyle including a low-sodium diet and regular exercise.

Monitor for signs and symptoms of fluid overload or dehydration.

Provide patient education about the importance of compliance with medication and lifestyle modifications.

Rationales:

Monitoring fluid intake and output can help identify early signs of imbalanced fluid volume and guide appropriate interventions.

Diuretic medications can help promote optimal fluid balance and prevent complications related to imbalanced fluid volume.

Lifestyle modifications can help control hypertension and promote overall fluid balance.

Evaluation:

The patient maintained optimal fluid balance as evidenced by stable fluid intake and output, the absence of signs and symptoms of fluid overload or dehydration, and the absence of complications related to imbalanced fluid volume.

You May Also Like

Nursing Care Plan for Postpartum Hemorrhage

Nursing Care Plan for Myasthenia Gravis

Evidence-Based Nursing Practice