Hypertensive

crisis
prepared by: lili
 What is Hypertensive crisis?

Severe BP Stroke

-Systolic pressure of 180 mmHg or

-Diastolic pressure of 120 mmHg or

Hypertensive crisis is divided into two categories.

Urgent

Emergency
 URGENCY VS EMERGENCY

Urgent hypertensive Emergency hypertensive

crisis crisis
BP extremely and has
BP extremely caused damage to organs.
but no suspect Can associated with
of damage organ. life-threatening complications.
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 SIGNS & SYMPTOMS
Of
Urgent and Emergency
hypertensive crisis
include:

Headacheor blurredvision
Increasing confusion
Seizure
Increasing chest pain
Increasing shortness of breath
Swelling or edema (fluid
buildup in the tissues)
Severe anxiety
Unresponsiveness
Certain tests will be performed to monitor
blood pressure and assess organ damage,
including:

Regular monitoring of
blood pressure
Eye examto look for
swelling and bleeding
Blood and urine testing
Nursing Diagnosis:
- Decrease cardiac output r/t altered stroke
volume secondary to hypertensive emergency.
Possibly evidenced by:
Increase in blood pressure
Dysrhythmias
Prolonged capillary refill
Cold clammy skin
Dyspnea
Variations in BP
Restlessness
 Nursing Rationale
Interventions
- Establish rapport -to gain pt. trust
- Monitor V/S -to obtain baseline data
- History taking -focus on the presence of end
organ dysfunction

- Carefully assess pt. -chest pain may indicate

complaint of symptoms myocardial ischemia or
infarction back pain may denote
aortic dissection, and dyspnea
may suggest pulmonary edema
or congestive heart failure.
The presence of neurologic
symptoms may include seizures.
Medication/Treatment:
Sodium nitroprusside
-is a commonly used medication.
-it is a short-acting agent, and the BP
response can be titrated from minute
to minute.

Labetalol
-is particularly preferred to pt. with acute dissection
and the pt. with end stage renal disease.

Fenoldopam
-a peripheral dopamine-1 receptor agonist is given
as initial IV dose of 0.1 ug/kg/min titrated every 15min.
Other possible Nursing Care Plans:

Risk for Noncompliance

Acute Pain
Altered (Cardiopulmonary)
Tissue Perfusion
Thank
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For
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