Hypertension & Nursing Diagnosis

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My patient has chronic hypertension and is two days post-op. My professor pretty much told me to pick ineffective tissue perfusion as my nursing diagnosis but when none of the careplan books that I have relate hypertension to ineffective tissue perfusion. (My patient had no edema, good peripheral pulses, but abnormal H&H).

Any thoughts would be greatly appreciated!

Thank you. I will do my best in this care plan

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Specializes in med/surg, telemetry, IV therapy, mgmt.
shinneh said:
The fetus is 39 wks AOG, mother's first baby. Baby is normal. The mother is 80 kg, 5 ft. I just checked her chart and see that it is eclampsia. They already administer MgSO4. She has an apresoline IV, and that helps normalize her BP. her BP (if w/o meds) is 190/120

A care plan is like taking a snapshot and addressing all the problems going on in the picture at that time the photo was taken. Are you care planning for her labor and delivery or now, after she has delivered. You need to be clear on that. The history of what has happened to her is important, but don't get so hung up on it that you fail to deal with what is going on now.

Some of the things to consider now: What is her blood pressure now? What are her electrolyte values because fluid excesses or deficits are a problem to consider. Did she sustain any injuries as a result of the seizures as these are problems to care plan for. Are more seizures likely (Risk for Injury)? Assess the lungs for function (Risk for Ineffective Breathing Pattern or Risk for Ineffective Airway Clearance). Assess the C-section wound because this is a nursing problem (Impaired Tissue Integrity). Is she moving around since delivery (Impaired Physical Mobility or Activity Intolerance)? What does she know about the treatment of her HTN (Deficient Knowledge, hypertension)?

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Specializes in OB, GYN, PEDS, Urgent Care.

I know this post is from a few years ago, but I have a question re: NANDA for HTN. if I used Ineffective Tissue Perfusion: Cardiopulomary R/T PVD AEB weak pedal pulse, is the PVD counted as a medical Dx? Is this even a good NANDA, please help!

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Specializes in IMCU.
Chanel63 said:
I know this post is from a few years ago, but I have a question re: NANDA for HTN. if I used Ineffective Tissue Perfusion: Cardiopulomary R/T PVD AEB weak pedal pulse, is the PVD counted as a medical Dx? Is this even a good NANDA, please help!

Mate, you need a nursing diagnosis handbook like Ackley. Try Ineffective tissue perfusion: peripheral r/t impaired transport of oxygen AEB absent pedal pulse (right/left/both) -- if their is other evidence such as altered sensation, color etc.

Go look at your peripheral vascular assessments results to make sure you get all of your evidence. Is there is no pedal pulse (even with doppler?) I presume then it is PAD? Then you could have weak pedal pulse rather than absent. Also, f their pedal pulse was absent how far up did you have to go to find a pulse?

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Specializes in OB, GYN, PEDS, Urgent Care.
DolceVita said:
Mate, you need a nursing diagnosis handbook like Ackley. Try Ineffective tissue perfusion: peripheral r/t impaired transport of oxygen AEB absent pedal pulse (right/left/both) -- if their is other evidence such as altered sensation, color etc.

Go look at your peripheral vascular assessments results to make sure you get all of your evidence. Is there is no pedal pulse (even with doppler?) I presume then it is PAD? Then you could have weak pedal pulse rather than absent. Also, f their pedal pulse was absent how far up did you have to go to find a pulse?

Thank you for your help and response. The pt has a pedal pulse, however it is weak. The pulse is present bilaterally, and pt has a Hx of PAF, which she has a pacemaker for. She was dx with PVD by her Dr.

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Aloha everyone, I am from Honolulu, Hhawaii and I am student nurse here. Please help me how to manage three patients? My instructor will assigment me with three patients next week and I am very concern not be able to manage my time effeciently. Is there a cheat sheet or form that I can use? Thank you very much.

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Specializes in IMCU.
mawarputih said:
Aloha everyone, I am from Honolulu, Hhawaii and I am student nurse here. Please help me how to manage three patients? My instructor will assigment me with three patients next week and I am very concern not be able to manage my time effeciently. Is there a cheat sheet or form that I can use? Thank you very much.

I would start a new thread.

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I'm in a similar situation:

My patient has a history of hypertension, however his admitting diagnosis was intracerebral hemorrhage due to a personal fall prior to admission. He is taking medication for htn. He occasionally forgets bits of information; i.e., what he had for breakfast the same day. On our third week together, he had pains that traveled from his right side to the groin area. When asked to describe the as, "sharp, aching, or throbbing?" patient replied, "all the above." onset was said to have started more than 48 hours prior to assessment. "pains come and go. They last from less than an hour to more than an hour."

Correct me if I'm wrong: my two nursing diagnoses are

Risk for falls r/t personal history of falls aeb unsteady gait

Impaired memory r/t neurological disturbances aeb periods of forgetfulness

I'm having trouble coming up with a nursing diagnosis for his acute pain.

He also has trouble hearing sentences the first time. I've had to repeat myself a couple of times for him to respond. What nursing diagnosis could there be for that?

What about hypertension? His blood pressure has shown signs of prehypertension:

(oct 6) am: 122/62

(oct 7) am: 122/65

(oct 13) pm: 124/74

(oct 14) am: 119/72

(oct 20) 7:15am - 122/68. Then 10:03am - 119/63 - patient was discharged same day.

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RE: pain..... first thing I'd look into is last BM. Also have the doc check for inguinal hernia... It would be (and I'm not up on the most current wording- I did care planning for years in LTC, and they went to "normal speech" years ago- LOL) alteration in comfort r/t c/o R groin pain...

The falls dx - I'd have : risk for falls r/t personal history of falls AND unsteady gait ; the unsteady gait doesn't "show" history of falls, but it does increase the risk for falls- does that make sense? Since it's a "risk", it hasn't happened yet, so you don't have any AEB...

the memory one will work.

The blood pressure readings are fine....but with a history of HTN and ICH, I'd have a "potential for" recurrence of HTN r/t hx of HTN ; goal- BP within ___/___ to ___/___. Again, since it's a risk for, it hasn't happened while you've had him. So no AEB.

Does this make sense? I jump around on forums, but if you want, you can always PM me- I'll get that for sure ?

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