Hypertensive crisis - The Nursing management

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Some patients may be admitted for the treatment of hypertensive crisis, control of complication or for the preparation of a treatment regimen. When on admission, here are some of the immediate cares that the nursing team could give to the outpatient to aid his quick recovery:

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1. Observation: Vital signs should be checked 2 hourly with emphasis on Blood pressure and pulse rate. Monitor patient's weight daily and keep allowable record. This is to help detect oedema or weight loss. Check for side effects of drugs e.g. Orthostatic hypotension.

2. Rest: outpatient should be advised to avoid stress and tension. He should therefore have corporeal and mental rest in order to conserve energy. Encourage moderate rehearsal e.g. Walking if there is no dyspnoea. Mild tranquilizers may be given to enable outpatient sleep. Should there be dizziness outpatient should be protected from falls and injury.

3. Diet: Restrict sodium intake to about 4grams daily. Give light, authentically digestible diet. Fatty food and excessive carbohydrate that can increase weight and cholesterol should be avoided. Coffee, tea, kola nuts, alcohol should be avoided or minimized.

4. corporeal care: support outpatient with corporeal care if outpatient is very weak. Where there is blurred foresight outpatient may want the use of medicated eye glasses. If there is bleeding from the nose (epistaxis) apply ice pack to the bridge of the nose and back of the neck. When the ice pack cannot control bleeding the nose may be packed. The pack should however be removed within few days. Make sure outpatient does not lie on one side of his body for several days in bed. If he is to be admitted for days, his position should be changed every 2-4 hours to prevent pressure sore from developing.

5. Elimination: Constipation should be avoided because it makes the outpatient strain at defecation thereby further elevating the blood pressure. Food rich in fibre should be given to prevent constipation. Enough fluid should be given but Enough care has to be taken in order not to overload the outpatient with fluid. Overloading with fluid could pose its own problems to the patient.

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