Your nursing care planning guide that includes 6 nursing diagnosis for hypertension (HTN). Get to know the common nursing diagnosis for hypertension, nursing assessment, nursing interventions and rationale, including teaching and goals.
What is Hypertension?
Hypertension is the term used to describe high blood pressure. Hypertension is repeatedly elevated blood pressure exceeding 140 over 90 mmHg. It is categorized as primary or essential (approximately 90% of all cases) or secondary, which occurs as a result of an identifiable, sometimes correctable pathological condition, such as renal disease or primary aldosteronism.
Classifications of Hypertension
The American College of Cardiology and American Heart Association published new guidelines (as of 2018) and ways to categorize blood pressure.
- Normal: Less than 120/80 mmHg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1: Systolic between 130-139 and diastolic 80-89
- Stage 2: Systolic 140 or higher and diastolic at 90 or higher.
- Hypertensive Crisis: Higher than 180 for systolic and diastolic higher than 120.
Nursing care planning goals for hypertension includes focus on lowering or controlling blood pressure, adherence to the therapeutic regimen, lifestyle modifications, and prevention of complications.
Here are six (6) nursing diagnosis for hypertension nursing care plans:
- Risk for Decreased Cardiac Output
- Activity Intolerance
- Acute Pain
- Ineffective Coping
- Imbalanced Nutrition: More Than Body Requirements
- Deficient Knowledge
- Other Nursing Care Plans
The general well-being (“I’m not feeling sick”), complexity of therapeutic regimen, required lifestyle changes, and side effects of medications result usually in inability of the patients to cope.
Common related factors for ineffective nursing diagnosis:
- Situational/maturational crisis; multiple life changes
- Inadequate relaxation; little or no exercise, work overload
- Inadequate support systems
- Poor nutrition
- Unmet expectations; unrealistic perceptions
- Inadequate coping methods
- Gender differences in coping strategies
The common assessment cues that could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement.
- Verbalization of inability to cope or ask for help
- Inability to meet role expectations/basic needs or problem-solve
- Destructive behavior toward self; overeating, lack of appetite; excessive smoking/drinking, proneness to alcohol abuse
- Chronic fatigue/insomnia; muscular tension; frequent head/neck aches;
- chronic worry, irritability, anxiety, emotional tension, depression
Common goals and expected outcomes for Ineffective coping nursing diagnosis:
- Patient will identify ineffective coping behaviors and consequences.
- Patient will verbalize awareness of own coping abilities/strengths.
- Patient will identify potential stressful situations and steps to avoid/modify them.
- Patient will demonstrate the use of effective coping skills/methods.
Nursing Interventions and Rationale
Here are the nursing interventions for this hypertension nursing care plans.
|Determine individual stressors (family, social, work environment, life changes, or healthcare management).||To evaluate degree of impairment.|
|Evaluate ability to understand events, provide realistic appraisal of situation.||To evaluate degree of impairment.|
|Assess effectiveness of coping strategies by observing behaviors (ability to verbalize feelings and concerns, willingness to participate in the treatment plan).||Adaptive mechanisms are necessary to appropriately alter one’s lifestyle, deal with the chronicity of hypertension, and integrate prescribed therapies into daily living.|
|Note reports of sleep disturbances, increasing fatigue, impaired concentration, irritability, decreased tolerance of headache, inability to cope or problem-solve.||Manifestations of maladaptive coping mechanisms may be indicators of repressed anger and have been found to be major determinants of diastolic BP.|
|Assist patient to identify specific stressors and possible strategies for coping with them.||Recognition of stressors is the first step in altering one’s response to the stressor.|
|Include patient in planning of care, and encourage maximum participation in treatment plan.||Involvement provides patient with an ongoing sense of control, improves coping skills, and can enhance cooperation with therapeutic regimen.|
|Encourage patient to evaluate life priorities and goals. Ask questions such as “Is what you are doing getting you what you want?”||Focuses patient’s attention on reality of present situation relative to patient’s view of what is wanted. Strong work ethic, need for “control,” and outward focus may have led to lack of attention to personal needs.|
|Assist patient to identify and begin planning for necessary lifestyle changes. Assist to adjust, rather than abandon, personal/family goals.||Necessary changes should be realistically prioritized so patient can avoid being overwhelmed and feeling powerless.|
|Help client to substitute positive thoughts for negative ones such as ” I can do this; I am in charge of myself.”||To provide meeting psychological needs|
References and Sources
Recommended references and sources for this hypertension nursing care plan guide:
- Arbour, R. (2004). Intracranial hypertension monitoring and nursing assessment. Critical Care Nurse, 24(5), 19-32. [Link]
- Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
- Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
- Hamilton, G. A. (2003). Measuring adherence in a hypertension clinical trial. European Journal of Cardiovascular Nursing, 2(3), 219-228. [Link]
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Cardiac Care Plans
Nursing care plans about the different diseases of the cardiovascular system:
- Angina Pectoris (Coronary Artery Disease) | 4 Care Plans
- Cardiac Arrhythmia (Digitalis Toxicity) | 3 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cardiogenic Shock | 5 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Heart Failure | 16+ Care Plans
- Hypertension | 6 Care Plans
- Hypovolemic Shock | 4 Care Plans
- Myocardial Infarction | 7 Care Plans
- Pacemaker Therapy | 7 Care Plans