Nursing Care Plan: Hypertension

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: 

 Risk for Decreased Cardiac Output
 Risk for Impaired Cardiovascular Function
 Decreased Cardiac Output
 Risk for Decreased Cardiac Tissue Perfusion
NANDA Definition: Inadequate blood pumped by the heart to meet metabolic demands of the body.
Blood pressure is the product of cardiac output multiplied by peripheral resistance. Hypertension can result from an
increase in cardiac output (heart rate multiplied by stroke volume), an increase in peripheral resistance, or both.
 Decreased Activity Tolerance
NANDA Definition: Insufficient physiological or psychological energy to endure or complete required or desired daily
activities.
Another nursing diagnosis for hypertension is Decreased Activity Tolerance, which frequently occurs due to alterations in
cardiac output and side effects of antihypertensive medications. 
 Acute Pain
NANDA Definition: Pain is whatever the experiencing person says it is, existing whenever the person says it does; an
unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of
such damage sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a
duration of.
Elevation in resting blood pressure means a progressive reduction in sensitivity to acute pain, which could result in a
tendency to restore arousal levels in the presence of painful stimuli.
 Ineffective Coping
NANDA Definition: Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or
inability to use available resources.
The general well-being (“I’m not feeling sick”), the complexity of the therapeutic regimen, required lifestyle changes, and
side effects of medications usually result in the inability of the patients to cope. 
 Overweight
NANDA Definition: Intake of nutrients that exceeds metabolic needs.
Excess weight or being overweight is an added risk in causing hypertension. Studies suggest that weight gain may
pathophysiologically contribute to blood pressure elevation.
 Deficient Knowledge
NANDA Definition: Absence or deficiency of cognitive information related to a specific topic.
The patient’s understanding of the disease process, therapeutic regimen, and lifestyle changes are key in controlling
hypertension. In nursing diagnosis Deficient Knowledge the nurse must emphasize the concept of controlling
hypertension rather than curing it. 
 NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Decreased Activity After 8 hrs. of nsg. Independent:
“Lagi po akong Tolerance related to interventions, the pt.  Assess and record vs  Baseline data for assessment After 8 hrs. of nsg.
nahihilon, imbalanced will:  Note each of the factors  Fatigue affects both the client’s actual and interventions, the pt.
between oxygen that contribute to fatigue  perceived ability to participate in activities.
nanghihina at  Participate in Able to met the goal.
supply and demand  Evaluate the patient’s  Provides comparative baseline and provides
mabilis pong desired activities Blood pressure
as evidenced by degree of activity information about needed education
mapagod. Mataas  Use identified decreased from 140/110
verbal report of intolerance and when it and interventions regarding the quality of life.
din po ang BP ko” fatigue and techniques to to 120/80. The pt. was
enhance activity occurs.
as verbalized by the weaknesses, and  Monitor how the patient  Noting pulse rate more than 20 beats per min able to participate in
abnormal blood tolerance
patient. responds to activity faster than resting rate; marked increase in BP activities that reduce
pressure response  Report a
measurable (pulse, heart rate, chest during and after activity (systolic pressure BP/cardiac workload
to activity. pain, dizziness, excessive increase of 40 mm Hg or diastolic pressure
Objective: increase in and; Risk for decreased
T- 35 °C activity tolerance. fatigue, etc.). increase of 20 mm Hg); dyspnea or chest pain; cardiac output is lessen.
excessive fatigue and weakness; diaphoresis;
BP- 140/110
dizziness or syncope. The stated parameters
mmHg help assess physiological responses to the
PR- 64 bpm stress of activity and, if present, are indicators
RR- 21bpm of overexertion.
O2Sat- 97%  Instruct the patient in  It helps reduce energy expenditure, thereby
energy-saving techniques assisting the equalization of oxygen supply and
demand.
 Encourage progressive  Gradual activity progression prevents a sudden
activity and self-care increase in cardiac workload. Providing
when tolerated. assistance only as needed encourages
independence in performing activities.
 NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Risk for Decreased After 8 hrs. of nsg. Independent:
“Lagi po akong Cardiac Output interventions, the pt.  Assess and record vs  Baseline data for assessment After 8 hrs. of nsg.
nahihilo at secondary to will:  Elevate HOB  Gravity decrease blood return to the heart thus interventions, the pt.
hypertension decreasing volume and pressure.
tumataas po ang  Decrease blood Able to met the goal.
BP ko” as pressure from  Auscultate heart tones  S4 heart sound is common in severely Blood pressure
140/110 to and breath sounds. hypertensive patients because of atrial
verbalized by the decreased from 140/110
120/80 hypertrophy (increased atrial volume and
patient. pressure). Development of S3 indicates to 120/80. The pt. was
 Participate in
ventricular hypertrophy and impaired able to participate in
activities that
Objective: reduce functioning. The presence of crackles, wheezes activities that reduce
T- 35 °C BP/cardiac may indicate pulmonary congestion secondary BP/cardiac workload
BP- 140/110 workload. to developing or chronic heart failure. and; Risk for decreased
mmHg  Risk for  Observe skin color,  The presence of pallor; cool, moist skin; and cardiac output is lessen.
decreased moisture, temperature and delayed capillary refill time may be due to
PR- 64 bpm
cardiac output capillary refill time. peripheral vasoconstriction or reflect cardiac
RR- 21bpm decompensation and decreased output.
O2Sat- 97% will be lessen.
 Provide calm and restful  To provide comfort and rest.
environment and
encourage rest
 Maintain activity  To lessens physical stress and tension that
restrictions affect blood pressure and course of
 Emphasize importance of hypertension
low salt, low fat diet  Restriction can help manage fluid retention that
is associated with hypertensive response.
Dependent:
 Administer Losartan  Administer as ordered to help reduce blood
50mg 1tab as ordered. pressure.

Collaborative:
 Referred to dietician for  For co-management and formulation of proper
low salt, low fat diet. diet plan.