Hypertensive crisis - The Nursing supervision

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Some patients may be admitted for the treatment of hypertensive crisis, control of complication or for the making ready of a treatment regimen. When on admission, here are some of the immediate cares that the nursing team could give to the inpatient to aid his speedy 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: inpatient should be advised to avoid stress and tension. He should therefore have bodily and mental rest in order to conserve energy. Encourage moderate exercise e.g. Walking if there is no dyspnoea. Mild tranquilizers may be given to enable inpatient sleep. Should there be dizziness inpatient should be protected from falls and injury.

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

4. bodily care: assist inpatient with bodily care if inpatient is very weak. Where there is blurred vision inpatient may wish 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 any way be removed within few days. Make sure inpatient does not lie on one side of his body for any 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 inpatient strain at defecation thereby added 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 inpatient with fluid. Overloading with fluid could pose its own problems to the patient.

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