Hypertensive Urgency

DRUG NAME Generic Name: Losartan + Amlodipine Brand Name: Cozaar XQ Dosage: 50mg/5mg Classification: Angiotensin II Antagonist Anti-Hypertensive MECHANISM OF ACTION Angiotensin's attachment to the receptors causes the muscle cells to contract and the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure INDICATION >hypertension >stroke risk >left ventricular hypertrophy >DM II >diabetic neuropathy CONTRAINDICATION >hypotension >hypersensitivity ADVERSE REACTION >diarrhea >nasal congestion >muscle cramps >insomnia >lightheadedness >dizziness >Impotence >hyperkalemia >Angioedema NURSING RESPONSIBILITIES >Check BP prior to drug administration >WOF adverse reactions >monitor efficacy of the medication >provide safe and comfortable environment >keep side rails secured >attend to patients needs > monitor intake and output >monitor potassium level of the patient

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
DRUG NAME Generic Name: Nicardipine Brand Name: Cardene Dosage: 10mg in 90cc D5W Classification: Calcium Channel Blocker MECHANISM OF ACTION These medications block the movement of calcium into the smooth muscle cells surrounding the arteries of the body. Since calcium promotes contraction of muscle, blocking calcium entry into the muscle cells relaxes the arterial muscles and causes the arteries to become larger. INDICATION >hypertension >coronary artery disease >angina CONTRAINDICATION >hypotension >hypersensitivity >breastfeeding mother ADVERSE REACTION >edema >dizziness >fainting >headache >flashing >palpitation >fainting >rashes >hypotension NURSING RESPONSIBILITIES >Check BP prior to drug administration >WOF adverse reactions especially hypotension >monitor efficacy of the medication >provide safe and comfortable environment >keep side rails secured >attend to patients needs > monitor intake and output >monitor potassium level of the patient

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
DRUG NAME Generic Name: Carvedilol Brand Name: Coreg Dosage: 25mg Classification: BetaAdrenergic Blocker MECHANISM INDICATION OF ACTION It reduces the >hypertension heart's rate and >heart failure force of contraction and thereby reduces the work of the heart. Carvedilol also blocks adrenergic receptors on arteries and causes the arteries to relax and the blood pressure to fall. CONTRAINDICATION >insulin therapy >pregnancy ADVERSE REACTION >edema >dizziness >bradycardia >headache >fainting >lightheadedness >postural hypotension NURSING RESPONSIBILITIES >Check BP prior to drug administration >WOF adverse reactions especially hypotension >monitor efficacy of the medication >provide safe and comfortable environment >keep side rails secured >attend to patients needs > monitor intake and output >monitor potassium level of the patient

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
DRUG NAME Generic Name: Olmesartan Brand Name: Alzor Hct Dosage: 40/12.5mg Classification: Angiotensin II receptor Antagonist MECHANISM INDICATION OF ACTION It blocks the >hypertension receptors that angiotensin II acts on, and so prevents its actions. The main result of this is that the peripheral blood vessels are allowed to widen, which means that there is more space and less resistance in these blood vessels. This is the main mechanism by which the pressure in the blood vessels is lowered. CONTRAINDICATION >liver impairment >renal impairment >severe heart failure ADVERSE REACTION >fatigue >dizziness >fainting >headache >cough >hematuria >hyperkalemia >rashes >hypotension >chest pain NURSING RESPONSIBILITIES >Check BP prior to drug administration >WOF adverse reactions especially hypotension >monitor efficacy of the medication >provide safe and comfortable environment >keep side rails secured >attend to patients needs > monitor intake and output >monitor potassium level of the patient

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
ACTUAL PROBLEM ASSESMENT OBJECTIVE >with good appetite >(-) cephalgia >(-) Chest pain >(-) dizziness >afebrile > on LSLF diet >due meds given >Initial BP = 150/100 >kept patient safe and comfortable >to help lower the BP of the patient >to promote optimum quality of health care >to monitor fluid intake and output for possible complication of fluids >to promote ANALYSIS Altered tissue perfusion related to vasoconstriction as evidenced by BP of 150/100 PLANNING At the end of 8 hours nursing interventions, the patients BP will decrease to 130/90 IMPLEMENTATION RATIONALE >established rapport >to promote trust between patient and the student nurse >IVF monitored and regulated at prescribed rate > VS monitored and documented >to prevent fluid complications EVALUATION Goal Met. The patients blood pressure decreased to 130/90.

>to monitor occurrence of alterations in vital signs

>I&O monitored and recorded

>reinforced prescribed

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
diet wellness, prevent fluid retention and high level of cholesterol >to prevent hypertension due to increased blood flow secondary to pull of gravity

>maintained at semifowlers to high fowlers position

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
POTENTIAL PROBLEM ASSESMENT OBJECTIVE: >(+) Vomiting upon admission >(+) dizziness >RR: 24 cpm >BP: 200/120 mmHg >decreased sodium level: 134 mmol/L >due meds given >increased HDL level: 1.7 mmol/L >kept patient safe and comfortable ANALYSIS Risk for Injury related to sensory, biochemical and blood profile changes PLANNING At the end of 8 hours of nursing interventions, the patient will be able to prevent injuries. IMPLEMENTATION RATIONALE >established rapport >to promote trust between patient and the student nurse >IVF monitored and regulated at prescribed rate > VS monitored and documented >to prevent fluid complications EVALUATION >Goal met. There was no injury noted during the whole shift.

>to monitor occurrence of alterations in vital signs >to help lower the BP of the patient >to promote optimum quality of health care >to prevent orthostatic hypotension, dizziness and fainting >to be able to attend to

>instructed patient to dangle feet first before taking off from the bed

>instructed patient to report dizziness and

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City

Hypertensive Urgency
nausea patients needs and to provide assistance >to prevent further increase of blood pressure >to prevent worsening of the condition

>placed patient to semi-fowlers to high fowlers position

>reinforced prescribed diet

University of Perpetual Help System DALTA Las Pias

Alabang Zapote Rd, Pamplona, Las Pias City