HIGH Blood Pressure

Aneroo, LPN · Nov 1, 2005

Not really sure what you mean. Do you mean what medical problems do the patient present with along with the HTN?

I usually see pain, headache, CVA symptoms, nausea and anxiety (not all at the same time). Some can be the cause or the effect of the HTN.

We try and start and IV, get some beta blockers or something on board ASAP to bring their BP down. Sometimes a nitro drip (which I try to avoid b/c it totally narrows which floor the patient can go to). Ativan for anxiety will usually bring BP down when the pt relaxes. If pt is + nausea with their HTN, some zofran or phenergan will usually take care of that, and in effect, also bring down their BP.

JMBM · Nov 2, 2005

Yes. you might want to separate the issue of chronic hypertension, which you might see most anywhere, from an emergent hypertensive crisis, such as we might see in the ER. If someone comes into the ER due to hypertension, we are usually seeing headache, light-headedness and neuro symptoms. As the prior respondent said, the treatment isn't real complicated. Get an IV line, beta blockers and ativan. A nitro drip would be a second resort. In the ER, the goal is to get that pressure down to reduce the possibility of stroke. AFter that, its up to the admitting doc or the primary care provider.

Aneroo, LPN · Nov 2, 2005

And how could I forget patient teaching...

These folks are in and out of the hospital all the time! Poor compliance a lot of times. Sometimes you have to give them the "You're going to have a stroke. You're killing your kidneys between this and your blood sugar in the high 100's constantly". I live in the stroke and dialysis belt- we see so many dang patients with HTN, DM and ESRD/CRF. GRRR!