6 Hypertension Nursing Care Plans

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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 due to 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 Plans

Nursing care planning goals for hypertension include lowering or controlling blood pressure, adherence to the therapeutic regimen, lifestyle modifications, and prevention of complications.

Here are six nursing diagnoses for hypertension nursing care plans

  1. Risk for Decreased Cardiac Output
  2. Decreased Activity Tolerance
  3. Acute Pain
  4. Ineffective Coping
  5. Overweight
  6. Deficient Knowledge
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Overweight

Excess weight or being overweight is an added risk in causing hypertension. Studies suggest that weight gain may pathophysiologically contribute to blood pressure elevation.

Nursing Diagnosis

  • Overweight
  • Other possible nursing diagnoses:
    • Risk for Overweight
    • Obesity

Related Factors

The following are the common related factors for the nursing diagnosis of Overweight:

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  • Excessive intake in relation to metabolic need
  • Sedentary activity level
  • Cultural preferences

Defining Characteristics

The common assessment cues could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement.

  • Adult BMI greater than 25kg/m2
  • Triceps skinfold more than 15 mm in men and 25 mm in women (maximum for age and sex)
  • Reported or observed dysfunctional eating patterns
  • Sedentary lifestyle

Desired Outcomes

Common goals and expected outcomes for Overweight nursing diagnosis:

  • 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 Assessment and Rationales

Here are the nursing assessments for this nursing diagnosis.

1. 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. Many studies have shown that weight loss is frequently associated with a decrease in blood pressure.

2. Assess the meaning and significance of food in the patient’s life.
The patient’s attitude towards food implicitly determines their choices between healthy and unhealthy foods.

3. Assess patient understanding of the direct relationship between hypertension and obesity.
Weight reduction may obviate the need for drug therapy or decrease the medication needed to control BP. Dysfunctional eating habits contribute to atherosclerosis and obesity, which predispose to hypertension – ultimately complications such as stroke, kidney disease, and heart failure.

3. Determine the patient’s desire to lose weight.
Readiness and motivation to change for weight reduction is an important part of treatment for behavior change. The individual should be ready to lose weight, or the program will most likely not succeed.

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4. Assess the patient’s current nutritional status by using a food diary.
Insightful to examine the usual foods eaten and the patient’s pattern of eating. Self-monitoring apps are also useful and convenient.

5. Review usual daily caloric intake and dietary choices.
Identifies current strengths and weaknesses in the dietary program—aids in determining the individual need for adjustment and teaching.

Nursing Interventions and Rationales

In this section are therapeutic nursing interventions for this nursing diagnosis.

1. 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. Therefore, a slow weight reduction indicates fat loss with muscle-sparing and generally reflects a change in eating habits.

2. Encourage the 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. It helps focus attention on factors that the patient has control over or can change.

3. Discuss the necessity for decreased caloric intake and limited fats, salt, and sugar as indicated.
Excessive salt intake expands the intravascular fluid volume and may damage kidneys, which can further aggravate hypertension. Restriction on salt intake and lowering intake of saturated fats and cholesterol helps in reducing body weight.

4. 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 a sense of deprivation and enhance cooperation with the dietary regimen. In conjunction with exercise, weight loss, and limits on salt intake, the DASH diet may reduce or even eliminate the need for drug therapy.

5. Recommend patient to eat a well-balanced, healthy breakfast every morning.
Skipping breakfast will likely cause the patient to overeat during the evening.

6. Refer to a dietitian as indicated.
Can provide additional counseling and assistance with meeting individual dietary needs.

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Cardiac Care Plans

Nursing care plans about the different diseases of the cardiovascular system:

 

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

12 thoughts on “6 Hypertension Nursing Care Plans”

  1. Real i like the website as i’m a nursing student third year, i wish if could get an app from play store for Android, “Nurseslabs.com” with this materials care plans for different medical conditions to guide on caring patients according to standard and finally saving life of many patients through competence and experience.👊🙏

    Reply
  2. Hi! Its really helpful but couldn’t find any nursing interventions as assessments are not considered as an intervention!! Just a request if you could add some nursing interventions for hypertension, it’ll be great. Thank you.

    Reply
  3. I love your website and info provided. Please make an App for my phone/tablet as I am a PACE RN CM and could really use it for in the field.

    Reply
  4. I always run to you. Thank you so much.
    I’m kindly requesting you to help us with more of the nursing interventions for the different nursing diagnoses of this condition plus those of other conditions in the different care plans. May God bless you exceedingly and abundantly.

    Reply

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