Nursing diagnosis on hypertension/tissue perfusion

Brieb90 · Dec 4, 2015

Im having a bit of trouble finding "the perfect" nursing diagnosis for my scenario

A 65 year old African American man goes to weekly hypertension clinic for blood pressure checks. He has a 20 year old history of smoking 2 packs of cigarettes a day. His father died from heart disease and his brother has hypertension and diabetes. His current blood pressure reading is 144/108, -he is complaining of headache and dizziness, slurred speech and numbness on left arm . This client is admitted to the unit. The physician is ruling out the possibility of a stroke

Initially i was going with a hypertension diagnosis but in my care plan books it only has at risk for decreased cardiac output. I also thought the pt may be exhibiting TIA but thats not for me to decide i assume. With all of that being said here are the two diagnosis i came up with.

1. Decreased cardiac output r/t vasoconstriction aeb Blood pressure of 144/108, dizziness, altered mental status (Slurred speech)

Thoughts:

I feel like decreased cardiac output and vasoconstriction are oxymorons. i get that initially the heart may overcompensate but shouldn't the ultimate effects of cardiac output be vasodilation/ low bp because its not pumping effectively?

2. ineffective cerebral tissue perfusion related to decreased cardiac output as evidenced by dizziness, slurred speech and numbness in left arm

Thoughts:

Can i even use this because the docs ruled out stroke? Can i form my nursing diagnosis like this? Basically having one NANA domain being because of another NANDA domain.