Interventions and Evaluation: Hypertension
After solutions are selected, the nurse implements and evaluates care. Take action and evaluation are addressed for hypertension.
Hypothesis and Expected Outcomes
Actions/Interventions
Evaluation
Hypothesis
Altered Blood Pressure
Hypertension (as indicated in the image, BP 182/111 with pulse 88)
Outcome
Patient’s blood pressure will return to expected ranges 72 hours after treatment (timeline may vary depending upon severity of BP).
Monitor and record BP.
Provide calm, restful surroundings; minimize environmental activity and noise.
Administer prescribed antihypertensive medications.
Encourage the Dietary Approaches to Stop Hypertension (DASH) eating plan (reduce fat intake; increase fruit and vegetable intake).
Encourage a lower intake of sodium (1.5–2.3 g/day).
Arrange for nutritional support, if overweight.
Support aerobic physical activity for at least 30 minutes/day.
Arrange smoking cessation support, if smokes.
Encourage stress management.
Limit alcohol consumptions to two drinks/day for males and one drink/day for females.
Improving
BP returning to expected ranges for age.
Decreasing signs and symptoms, such as headaches and nose bleeds decreasing.
Exercising and eating more fruits and vegetables.
Declining
BP rising (notify health care provider; sustained blood pressure can lead to stroke and heart disease; increase frequency of vital sign monitoring).
Gaining body weight (obtain dietary consult).
Unchanged
If remaining unchanged will move into declining (use therapeutic techniques to obtain patient information about possibilities of not following regimen, notify health care provider).
Interventions and Evaluation: Hypotension and Orthostatic Hypotension
Key Points
Interventions for BP alterations focus on returning the BP to expected ranges.
Actions for hypertension involve lowering the blood pressure, whereas actions for hypotension and orthostatic hypotension involve raising the blood pressure.
Extremely elevated hypertension and hypotension require immediate intervention to prevent further deterioration.
Evaluations indicate the BP is remaining the same, increasing, or decreasing.
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