Nursing diagnosis HYPOTENSION

[melly_25]

My patient was admitted with hypotension. The past med hx consists of fibromyalgia, COPD, CHF, CAD, and she is paced. She is prescribed a beta blocker and I know that will cause hypotension but it was held while she was at the hospital. It was noted though she had taken it before she was admitted. She is not allowed to be given any pain meds because her BP is too low and the doctors are working on trying to raise it. I am just confused on what I should use for the priority nursing dx. would risk for fall be the best because she came in fainting, or maybe acute pain?? or would it be something with her tissue perfusion? PLEASE HELP. Thanks in advance :)

[opensesame]

Yes. Altered tissue perfusion R/T hypotension, possibly hx of CHF.

Generally the priority nursing dx should be based on the medical dx and patient's medical plan of care. That isn't what your instructors are going to tell you, but if the doc is concerned primarily with low B/Ps and that is why the patient is admitted, that is what your nursing plan of care (and dx) should be based on.

[catherine_cardella]

I agree with the Altered Tissue Perfusion diagnosis. If the patient's BP continues to remain critically low, she would eventually be transferred to the ICU and possibly started on a dopamine drip (hypothetically speaking).

If you're looking for a second-best diagnosis, Risk for Injury would be ideal because patient safety is huge right now.