Hypertension Nurse Protocol
Run the HTN nursing workflow — home BP review, adherence support, and emergency recognition.
Learning Objectives
- 1.Review home BP logs and coach accurate technique.
- 2.Support adherence and lifestyle within nurse scope.
- 3.Recognize hypertensive emergencies.
Purpose
Most BP control happens between visits via home monitoring and adherence. The nurse reviews logs, coaches technique, supports adherence, and catches emergencies — without changing doses independently.
What to ask / review
- •Home BP log — pattern and technique used.
- •Medication adherence and side effects.
- •Symptoms: headache, chest pain, vision changes, dyspnea?
- •Lifestyle: salt, alcohol, missed meds, new OTC/decongestants?
What to measure
- •In-clinic BP with correct technique (rested, correct cuff, arm supported); recheck/average if high.
Red flags
- •BP ≥180/120 WITH symptoms (chest pain, dyspnea, neuro changes, severe headache) → hypertensive emergency.
- •Neurologic symptoms or vision loss.
Escalate
Crisis-range BP with symptoms → 911/ED. Asymptomatic high readings → recheck and route to provider; the nurse does not adjust doses independently.
Meds/labs that matter
- •Common classes: ACE/ARB, calcium channel blockers, thiazides, beta-blockers; monitor potassium/creatinine with ACE/ARB + diuretics.
What to send the provider
- •Home BP pattern, adherence/side effects, symptoms, in-clinic recheck values.
Patient education script
- •"Check your BP at the same times, rested, and bring the log."
- •"Don’t stop a BP medicine on your own. Watch for chest pain, trouble breathing, severe headache, or weakness — call 911 for those."
Spanish phrase
Please bring your home blood pressure log to your next visit.
Por favor traiga su registro de presión arterial de casa a su próxima cita.
por fah-VOR TRAH-ee-gah soo reh-HEES-troh deh preh-SYON ar-teh-RYAL deh KAH-sah ah soo PROK-see-mah SEE-tah
Mini case
A patient’s home log shows readings consistently 150s/90s; they feel well and admit skipping their pill on busy days.
What now?
Show answer
No emergency (asymptomatic, not crisis-range). Address adherence (the skipped doses), reinforce technique, and route the log/pattern to the provider for possible regimen review. Don’t change the dose yourself.
Checklist
- Reviewed home BP log and technique.
- Assessed adherence and side effects.
- Screened for emergency symptoms.
- Routed pattern to provider without changing doses.