Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Hypertension can occur in pregnant women or women in the postpartum period. Acute severe hypertension in the second half of gestation may occur in preeclampsia, gestational hypertension or HELLP syndrome.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The withdrawal of certain medications can be associated with a hypertensive crisis. Rapid withdrawal of clonidine has been associated with a hyperadrenergic state characterized by hypertension, diaphoresis, headache and anxiety.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The preferred agents for the treatment of hypertension resulting from pheochromocytoma are nitroprusside and phentolamine, a potent alpha-adrenergic antagonist. If necessary, phentolamine can be combined with a beta-blocker.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Pheochromocytoma results in the production of circulating catecholamines, which causes hypertension, diaphoresis, tachycardia and paresthesias of the hands and feet. The classic triad includes headaches, palpitations and diaphoresis.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Scleroderma renal crisis is characterized by acute renal failure associated with the abrupt onset of moderate to severe hypertension, elevated plasma renin activity and a normal to minimally abnormal urine sediment.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The kidney is both a source of mediators that promote hypertension (angiotensin II) and a target of high systemic arterial pressure. Chronic hypertension is second to diabetes mellitus as a primary cause of renal insufficiency.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Heart rate and blood pressure in aortic dissection should be promptly reduced. Titratable combined modality therapy to promote vasodilation (nitroprusside) and control cardiac contractility (esmolol) is advocated for this disorder.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Aortic dissection results from an intimal tear in the aortic wall. The extent is determined by factors that increase the rate of change of aortic pressure (dp/dt), including elevation in blood pressure, heart rate and myocardial stroke volume.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Patients presenting with acute myocardial ischemia or infarction frequently suffer from an elevated MAP. Decreasing the heart rate and blood pressure in these patients will favorably reduce the myocardial oxygen demand and infarct sized.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Consensus guidelines recommend that blood pressure not be treated acutely in the patient with ischemic stroke unless the hypertension is extreme (SBP >220 mm Hg or DBP >120 mm Hg) or the patient has active end-organ dysfunction.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
During an acute stroke, cerebral autoregulation may be compromised in ischemic tissue, and lowering of blood pressure may further compromise cerebral blood flow and extend ischemic injury.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The diagnosis of hypertensive encephalopathy is confirmed by the absence of other conditions and the prompt resolution of symptoms and neuroimaging abnormalities with effective blood pressure control.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Acute elevations in systemic arterial blood pressure can lead to hypertensive encephalopathy. The clinical manifestations include headache or a depressed level of consciousness; nausea and vomiting; visual disturbances; or seizures.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Hypertensive emergency may develop as secondary hypertension in association with such diverse etiologies as renal vascular disease, sleep apnea, hyperaldosteronism, pheochromocytoma and pregnancy (preeclampsia).

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
A patient with hypertensive urgency evaluation must include a medication history with attention to medications associated with blood pressure elevation (nonsteroidal antiinflammatory drugs [NSAIDs], calcineurin inhibitors, sympathomimetics).