post op hypertension care plan

[jitterbugg]

I am trying to write a care plan on post op hypertention, when the pt didn't loose much blood. She has a history of mild hypertension, but after surgery it remained in the 180/60's.

I don't understand why it would remain high 2 days post op, and the pt is not bleeding.

Any sugestions would be great.5t4tr

Thanks

[Daytonite, BSN, RN]

Why is this important for your care plan? A care plan is about the patient's nursing problems, not their medical problems. The doctor treats their medical problems and we assist in that. We treat the nursing problems. Focus on what this patient's nursing problems are.

[jitterbugg]

I have to have a care plan, and the only problem my pt has is hypertension. Surgery went well, recovering well, but I have to have a cp. My teacher agrees that the issue is hypertension and I need to create a care plan about it. I thought about knowledge deficit or ineffective theraputic regimine, but the pt is very aware of her hypertension, taking meds, chainged diet, exercises, and still has hypertension. No abormal assessments....so I am a bit lost.

[Daytonite, BSN, RN]

then, you need to look up the pathophysiology of hypertension. you will find it on this thread: https://allnurses.com/general-nursing-student/help-pathophys-hypertension-295077.html - help with pathophys of hypertension. the nursing diagnosis to use is decreased cardiac output.

however, if this is a post-op patient there is plenty to care plan for. post-op patients have to be monitored for and possibly treated for complications of general anesthesia and there are nursing diagnoses for some of these:

• breathing problems (atelectasis, hypoxia, pneumonia, pulmonary embolism)
  
• hypotension (shock, hemorrhage)
  
• thrombophlebitis in the lower extremity
  
• elevated or depressed temperature
  
• any number of problems with the incision/wound (dehiscence, evisceration, infection)
  
• fluid and electrolyte imbalances
  
• urinary retention
  
• constipation
  
• surgical pain
  
• nausea/vomiting (paralytic ileus)
  

think about the things that are being done for this patient and why. they are not being kept in the hospital just to take up a bed. they are being monitored for these complications as well as any complications of the surgical procedure that they had. most of the common performed surgical procedures can be found (as well as their complications) on these two websites:

• medline plus (use the search box) http://www.medlineplus.gov/
  
• encyclopedia of surgery http://www.surgeryencyclopedia.com/index.html
  

you need to look up the surgical procedure that was performed and look at specific complications that need to be monitored for or specific care that needs to be done. if there is a surgical incision or dressing that needs to be monitored and become part of the care plan.