Hypertension Nursing Care Plan: 2 Sample Plans and Interventions

Hypertension is blood pressure that stays high over time, which strains the heart, brain, kidneys, and eyes. Most clients feel fine, so it is called a silent killer. Your priorities are lowering BP safely, spotting a hypertensive crisis, and teaching lifestyle changes and medication habits.

A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation

Each care plan below follows the nursing process (ADPIE).

CARE PLAN 1 · NURSING DIAGNOSIS

Risk for Decreased Cardiac Output

Risk factors

Increased afterload from high BP
Vasoconstriction
Thickening of the heart muscle over time

PLANNING · EXPECTED OUTCOMES

Short-term goals

BP moves toward the ordered goal within the ordered time
Client reports no chest pain, severe headache, or vision changes

Long-term goals

Client maintains BP within the target range at home

ASSESSMENT

BP in both arms with the right cuff size
Heart rate and rhythm
Headache, vision changes, chest pain, or confusion
Kidney labs and urine output

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Give antihypertensives as ordered and check BP before and after	This shows whether the drug is working and prevents BP from dropping too low.
Report BP of 180/120 or higher with symptoms right away	This can signal a hypertensive emergency with organ damage.
Lower BP gradually as ordered in a crisis	Dropping BP too fast can reduce blood flow to the brain and heart.
Provide a calm, quiet environment	Stress and pain can raise BP.

EVALUATION

BP is trending toward the goal
Client denies chest pain or headache
Kidney labs stay stable

CARE PLAN 2 · NURSING DIAGNOSIS

Deficient Knowledge

Related to

New diagnosis
No symptoms, so the condition seems unimportant
Unfamiliar medication plan

As evidenced by

Client asks questions about the diagnosis
Client skips doses when feeling well
Client continues high-sodium diet

PLANNING · EXPECTED OUTCOMES

Short-term goals

Client states 3 lifestyle changes that lower BP before discharge

Long-term goals

Client takes medications daily and keeps a home BP log

ASSESSMENT

Current diet, activity, smoking, and alcohol use
Understanding of medications and side effects
Readiness to learn

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Teach a low-sodium, heart-healthy diet such as DASH	Less sodium and more fruits and vegetables help lower BP.
Teach the client to take medications even when feeling well	High BP usually has no symptoms, but damage still happens.
Teach to rise slowly and report dizziness	Many BP drugs can cause orthostatic hypotension.
Teach home BP checks and how to log them	A log helps the provider adjust treatment.

EVALUATION

Client lists lifestyle changes
Client demonstrates home BP check
Client states why daily medication matters

Practice this in Pharmacy

Give BP medications safely and know when to hold them.

Play Pharmacy

Quick answers

What is a priority teaching point for a client starting an ACE inhibitor?

Rise slowly, report a dry cough or facial swelling, and avoid potassium supplements unless ordered, since ACE inhibitors can raise potassium.

Why is BP lowered slowly in a hypertensive emergency?

A rapid drop can cause stroke or heart attack because organs are used to the higher pressure.

For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.