1. Pathophysiology: Blood pressurethat is above normal for a sustained period; SBP >140, DBP >90, which causes increased peripheral resistance. Primary /Essential cause is unknown. Secondary has a known pathology which involves dysfunction of the neurohormonal system, overactivation or both angiotensin and aldosterone results in increased BP.
2. TREATMENT: Lifestyle ( diet, weight loss, limit alcohol) & Pharmacologic ( Diuretics; beta blockers, ARB, ACE inhibitors, Ca Channel blockers
3. Risk of ineffective cardiac, cerebral and renal perfusion
   1. S/SX
      1. SIGNS/SYMPTOMS
         1. PT FINDINGS
      2. untreated or uncontrolled BP stage 3
      3. BP > 200/120
      4. VS, altered LOC
      5. Edema, anxiety, cough , crackles
      6. Renal dysfunction, dec UO, increased renal labs
   2. NIC
      1. NURSING INTERVENTIONS
         1. PT RESPONSE
      2. Admin anti-HTN
      3. Titrate meds to lower BP gradually
      4. Monitor UO, LOC
      5. Assess Lungs, Sao2
4. Deficient Knowledge: Nature of and/or COmplications
   1. S/SX
      1. SIGNS & SYMPTOMS
         1. PT FINDINGS
      2. Request for information
      3. Pt shows lack of interest in disease
      4. Educational level
      5. Cultural considerations
      6. Discharge
   2. NIC
      1. NURSING INTERVENTIONS
         1. PT RESPONSE
      2. Assess for knowledge of disease and RX
      3. Monitor BP
      4. Provide info on community resources
      5. Instruct about sodium restriction, weight
      6. Educate pt on all meds
5. Risk for Ineffective therapeutic regimen
   1. S/SX
      1. SIGNS & SYMPTOMS
         1. PT FINDINGS
      2. therapeutic regiment is complex
      3. financial costs high
      4. social support lacking
      5. conflicting health values
      6. fears
      7. financial issues
   2. NIC
      1. assess pt's health beliefs
         1. PT RESPONSE
      2. assess risk factors that may affect compliance
      3. simplify drug regimen
      4. instruct pt how to check BP
      5. instruct family or SO about HTN
      6. Initiate referral group if needed