Hypertensive urgency - The Nursing administration

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Some patients may be admitted for the treatment of hypertensive crisis, operate 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 fast 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 proper 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 physical and thinking 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, no ifs ands or buts digestible diet. Fatty food and immoderate carbohydrate that can growth weight and cholesterol should be avoided. Coffee, tea, kola nuts, alcohol should be avoided or minimized.

4. physical care: help outpatient with physical 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 operate 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 some days in bed. If he is to be admitted for days, his position should be changed every 2-4 hours to preclude pressure sore from developing.

5. Elimination: Constipation should be avoided because it makes the outpatient strain at defecation thereby added elevating the blood pressure. Food rich in fibre should be given to preclude constipation. Sufficient fluid should be given but Sufficient 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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