Hypertension is the term used to describe high blood pressure.

Blood pressure is a measurement of the force against the walls of your arteries as the heart pumps
blood through the body.
The top number is called the systolic blood pressure, and the bottom number is called the diastolic
blood pressure.
Normal blood pressure is when blood pressure is lower than 120/80 mmHg most of the time.
High blood pressure (hypertension) is when blood pressure is 140/90 mmHg or above most of
the time.

If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called prehypertension.

Many factors can affect blood pressure, including:

How much water and salt you have in your body

The condition of your kidneys, nervous system, or blood vessels

The levels of different body hormones

Most of the time, there are no symptoms. Symptoms that may occur include:

Confusion
Ear noise or buzzing
Fatigue
Headache
Irregular heartbeat
Nosebleed
Vision changes

Nursing Care Plan for Hypertension

Nursing Diagnosis I :
Decreased Cardiac Output
NANDA Definition: Inadequate blood pumped by the heart to meet metabolic demands of the body
NOC:

Demonstrate stable cardiac rhythm and rate within patients normal range.

Maintain blood pressure within individually acceptable range.

Participate in activities that reduce blood pressure /cardiac workload.

Interventions :
1. Monitor blood pressure, measure in both arms/thighs three times, use correct cuff size and
accurate technique.
Rationale : Comparison of pressures provides a more complete picture of vascular
involvement/scope of problem. Systolic hypertension also is an established risk factor for
cerebrovascular disease and ischemic heart disease, when diastolic pressure is elevated.
2. Note dependent/general edema.
Rationale : May indicate heart failure, renal or vascular impairment.
3. Note presence, quality of central and peripheral pulses.
Rationale : Pulses in the legs/feet may be diminished, reflecting effects of vasoconstriction
(increased systemic vascular resistance [SVR]) and venous congestion.
4. Observe skin color, moisture, temperature, and capillary refill time.
Rationale : Presence of pallor; cool, moist skin; and delayed capillary refill time may be due to
peripheral vasoconstriction or reflect cardiac decompensation/decreased output.
Nursing Diagnosis II :
Acute Pain

NANDA Definition: Pain is whatever the experiencing person says it is, existing whenever the person
says it does (McCaffery, 1968); an unpleasant sensory and emotional experience arising from actual
or potential tissue damage or described in terms of such damage (International Association for the
Study of Pain) sudden or slow onset of any intensity from mild to severe with an anticipated or
predictable end and a duration of
NOC :

Verbalize methods that provide relief.

Report pain/discomfort is relieved/controlled.

Follow prescribed pharmacological regimen.

Interventions :
1. Assess pain scale. Determine specifics of pain, e.g., location, characteristics.
Rationale : Helpful in evaluating effectiveness of therapy.
2. Encourage bedrest during acute phase.
Rationale : Minimizes stimulation/promotes relaxation.
3. Assist patient with ambulation as needed.
Rationale : Patient may also experience episodes of postural hypotension, causing weakness when
ambulating.
4. Minimize vasoconstricting activities that may aggravate headache.
Rationale : Activities that increase vasoconstriction accentuate the headache in the presence of
increased cerebral vascular pressure.
Nursing Diagnosis III :
Activity Intolerance
NANDA Definition: Insufficient physiological or psychological energy to endure or complete required
or desired daily activities
NOC :

Demonstrate a decrease in physiological signs of intolerance.

Participate in necessary/desired activities.

Report a measurable increase in activity tolerance.

Interventions :
1. Encourage progressive activity/self-care when tolerated. Provide assistance as needed.
Rationale : Gradual activity progression prevents a sudden increase in cardiac workload. Providing
assistance only as needed encourages independence in performing activities.
2. Instruct patient in energy-conserving techniques, e.g., using chair when showering, sitting
to brush teeth or comb hair, carrying out activities at a slower pace.
Rationale : Energy-saving techniques reduce the energy expenditure, thereby assisting in
equalization of oxygen supply and demand.
Nursing Diagnosis IV :
Imbalanced Nutrition : more than body requirements
NANDA Definition: Intake of nutrients that exceeds metabolic needs
NOC :
Initiate/maintain individually appropriate exercise program.
Nutritional Status: Nutrient Intake (NOC) Demonstrate change in eating patterns (e.g., food
choices, quantity) to attain desirable body weight with optimal maintenance of health.

Identify correlation between hypertension and obesity.

Interventions :

1. Discuss necessity for decreased caloric intake and limited intake of fats, salt, and sugar as
indicated.
Rationale : Excessive salt intake expands the intravascular fluid volume and may damage kidneys,
which can further aggravate hypertension.
2. Determine patients desire to lose weight.
Rationale : Motivation for weight reduction is internal. The individual must want to lose weight.
3. Review usual daily caloric intake and dietary choices.
Rationale : Identifies current strengths/weaknesses in dietary program.
4. Instruct and assist in appropriate food selections, such as a diet rich in fruits, vegetables, and
low-fat dairy foods.
Rationale : Avoiding foods high in saturated fat and cholesterol is important in preventing
progressing atherogenesis.
Nursing Diagnosis V :
Deficient Knowledge
NANDA Definition: Absence or deficiency of cognitive information related to a specific topic
NOC :
Identify drug side effects and possible complications that necessitate medical attention.
Verbalize understanding of disease process and treatment regimen.
Maintain blood pressure within individually acceptable parameters.
Interventions :
1. Define and specify the desired blood pressure limits. Describe hypertension and its effect on the
heart, blood vessels, kidneys, and brain.
Rationale : Provides a basis for understanding blood pressure elevation, and describes commonly
used medical terms. Understanding that high blood pressure can occur without symptoms is the
center allows patients to continue treatment, even when it feels good.
2. Assist patients in identifying the risk factors that can be modified, for example, obesity, a diet high
in sodium, saturated fat, and cholesterol, sedentary lifestyle, smoking, alcohol consumption, stress
lifestyle.
Rationale : Risk factors that have been shown to contribute to hypertension and cardiovascular and
renal disease.