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
Imbalanced Nutrition: More Than Body Requirements
Obesity, endocrine disorders, and hyperlipidemia are risk factors for hypertension and blood pressure control. Imbalanced Nutrition:More Than Body Requirements is a common nursing diagnosis for hypertension.
The following are the common related factors for Imbalanced Nutrition: More Than Body Requirements:
- Excessive intake in relation to metabolic need
- Sedentary activity level
- Cultural preferences
The common assessment cues that could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement.
- Weight 10%–20% more than ideal for height and frame
- Triceps skinfold more than 15 mm in men and 25 mm in women (maximum for age and sex)
- Reported or observed dysfunctional eating patterns
Common goals and expected outcomes for Imbalanced Nutrition: More Than Body Requirements:
- Patient will identify correlation between hypertension and obesity.
- Patient will demonstrate change in eating patterns (e.g., food choices, quantity) to attain desirable body weight with optimal maintenance of health.
- Patient will initiate/maintain individually appropriate exercise program.
Nursing Interventions and Rationale
Here are the nursing interventions for this nursing diagnosis for hypertension.
|Assess risk or presence of conditions associated with obesity||Obesity is an added risk with high blood pressure because of the disproportion between fixed aortic capacity and increased cardiac output associated with increased body mass.|
|Assess patient understanding of direct relationship between hypertension and obesity.||Reduction in weight may obviate the need for drug therapy or decrease the amount of medication needed for control of BP.Faulty eating habits contribute to atherosclerosis and obesity, which predispose to hypertension and subsequent complications (stroke, kidney disease, heart failure).|
|Discuss necessity for decreased caloric intake and limited intake of fats, salt, and sugar as indicated.||Excessive salt intake expands the intravascular fluid volume and may damage kidneys, which can further aggravate hypertension.
|Determine patient’s desire to lose weight.||Motivation for weight reduction is internal. The individual must want to lose weight, or the program most likely will not succeed.|
|Review usual daily caloric intake and dietary choices.||Identifies current strengths and weaknesses in dietary program. Aids in determining individual need for adjustment and teaching.|
|Establish a realistic weight reduction plan with the patient such as 1 lb weight loss per wk.||Reducing caloric intake by 500 calories daily theoretically yields a weight loss of 1 lb per wk. Slow reduction in weight is therefore indicative of fat loss with muscle sparing and generally reflects a change in eating habits.|
|Encourage patient to maintain a diary of food intake, including when and where eating takes place and the circumstances and feelings around which the food was eaten.||Provides a database for both the adequacy of nutrients eaten and the emotional conditions of eating. Helps focus attention on factors that patient has control over or can change.|
|Instruct and assist in appropriate food selections, such as a diet rich in fruits, vegetables, and low-fat dairy foods referred to as the DASH Dietary Approaches to Stop Hypertension) diet and avoiding foods high in saturated fat (butter, cheese, eggs, ice cream, meat) and cholesterol (fatty meat, egg yolks, whole dairy products, shrimp, organ meats).||Avoiding foods high in saturated fat and cholesterol is important in preventing progressing atherogenesis. Moderation and use of low-fat products in place of total abstinence from certain food items may prevent sense of deprivation and enhance cooperation with dietary regimen. The DASH diet, in conjunction with exercise, weight loss, and limits on salt intake, may reduce or even eliminate the need for drug therapy.|
|Refer to dietitian as indicated.||Can provide additional counseling and assistance with meeting individual dietary 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