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[Nursing management in hypertensive crises]
1Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, 14080 México, D.F.
Insights
Arterial hypertension, or high blood pressure, is defined as elevated systemic arterial pressure. Hypertensive crisis, a severe form, requires immediate medical intervention to prevent target organ damage.
Area of Science:
- Cardiology
- Nephrology
- Neurology
Context:
- Arterial hypertension is a condition characterized by elevated systemic arterial pressure.
- Hypertensive crisis is defined as diastolic arterial pressure exceeding 120-130 mmHg.
- Accurate blood pressure measurement is crucial for diagnosis and management.
Purpose:
- To differentiate between hypertensive emergency and urgency.
- To outline therapeutic management strategies for hypertensive crisis.
- To emphasize the importance of nursing care and surveillance.
Summary:
- Hypertensive crisis is classified into hypertensive emergency (with target organ damage) and hypertensive urgency (without acute damage).
- Hypertensive emergency necessitates immediate reduction of blood pressure using intravenous medications.
- Hypertensive urgency involves gradual blood pressure reduction within 24 hours via oral or sublingual routes.
Impact:
- Distinguishing between hypertensive emergency and urgency guides appropriate and timely treatment.
- Prompt management of hypertensive crisis prevents severe complications like stroke, myocardial infarction, and kidney failure.
- Standardized nursing care protocols ensure accurate assessment and effective patient monitoring.
Abstract:
Arterial hypertension is the increase in systemic arterial pressure above the values considered normal according to the age of the subject, referenced either to the systolic or diastolic pressure or to both. A diastolic arterial pressure above 120-130 mmHg is called hypertensive crisis, and is classified for its therapeutic management in: Hypertensive emergency that causes damage to target organs, i.e., brain, heart, and kidney, which require an immediate decrease in arterial pressure through the use of i.v. applied medication, although not necessarily down to normal values, and Hypertensive urgency, in which no acute damage is evidenced and treatment is focused on diminishing pressure values within the first 24 hours using oral or sublingual medication. Both conditions require strict surveillance and nursing care starting with the correct procedure to determine blood pressure.