Inpatient Management of Acute Hypertension

Abstract

Abstract

One of every 4 patients admitted to U.S hospitals has hypertension. Few hypertension guidelines address the management of inpatient hypertension. The body of evidence suggests that management of hypertension in an inpatient setting may cause overtreatment with the potential for subsequent adverse events once the patient returns to their physiological baseline post-discharge. Patients often experience acute hypertensive episodes and remain hypertensive at discharge and follow up. Responsibilities of Advanced Practice Nurses in inpatient settings relative to hypertension include continuous monitoring and evaluation of vasoactive drugs, hypertensive crisis management and initiation of additional adjunct hypertensive therapy as needed. Further research is needed to provide consistent, detailed practice recommendations for treating acute severe hypertension. The purpose of this project was to determine treatment patterns for inpatient hypertension in a rural hospital. Rogers’ diffusion of innovation theory provided a theoretical framework for the project. A retrospective review of 100 randomly selected records was conducted to determine what pharmacologic strategies were being used to treat severe acute hypertension, and if those practices were consistent with evidence. Data indicated inconsistency in management practices, though target blood pressures were close to goals set by the Eighth Joint National Committee. Clearer diagnostic guidelines and therapeutic recommendations may result in better control of hypertension in inpatient populations.