RECOMMENDATION *LEVEL OF EVIDENCE |
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Practice Recommendations |
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Detection and Diagnosis |
1.1 Nurses will take every appropriate opportunity to assess the blood pressure of adults in order to facilitate early detection of hypertension. |
IV |
1.2 Nurses will utilize correct technique, appropriate cuff size and properly maintained/calibrated equipment when assessing clients’ blood pressure. |
IV |
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1.3 Nurses will be knowledgeable regarding the process involved in the diagnosis of hypertension. |
IV |
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1.4 Nurses will educate clients about self/home blood pressure monitoring techniques and appropriate equipment to assist in potential diagnosis and the monitoring of hypertension. |
IV |
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1.5 Nurses will educate clients on their target blood pressure and the importance of achieving and maintaining this target. |
IV |
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Assessment and Development of a Treatment Plan |
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Lifestyle Interventions |
2.1 Nurses will work with clients to identify lifestyle factors that may influence hypertension management, recognize potential areas for change and create a collaborative management plan to assist in reaching client goals, which may prevent secondary complications. |
IV |
Diet |
2.2 Nurses will assess for and educate clients about dietary risk factors as part of management of hypertension, in collaboration with dietitians and other members of the healthcare team. |
IV |
2.3 Nurses will counsel clients with hypertension to consume the DASH Diet (Dietary Approaches to Stop Hypertension), in collaboration with dietitians and other members of the healthcare team. |
Ib |
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2.4 Nurses will counsel clients with hypertension to limit their dietary intake of sodium to the recommended quantity of 65-100 mmol/day, in collaboration with dietitians and other members of the healthcare team. |
Ia |
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Healthy Weight |
2.5 Nurses will assess clients’ weight, Body Mass Index (BMI) and waist circumference. |
IV |
2.6 Nurses will advocate that clients with a BMI greater than or equal to 25 and a waist circumference over 102 cm (men) and 88 cm (women) consider weight reduction strategies. |
IV |
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Exercise |
2.7 Nurses will assess clients’ current physical activity level. |
IV |
2.8 Nurses will counsel clients, in collaboration with the healthcare team, to engage in moderate intensity dynamic exercise to be carried out for 30-60 minutes, 4 to 7 times a week. |
Ia |
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Alcohol |
2.9 Nurses will assess clients’ use of alcohol, including quantity and frequency, using a validated tool. |
Ib |
2.10 Nurses will routinely discuss alcohol consumption with clients and recommend limiting alcohol use, as appropriate to a maximum of:
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III |
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Smoking |
2.11 Nurses will be knowledgeable about the relationship between smoking and the risk of cardiovascular disease. |
IV |
2.12 Nurses will establish clients’ tobacco use status and implement Brief Tobacco Interventions at each appropriate visit, in order to facilitate smoking cessation. |
Ia |
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Stress |
2.13 Nurses will assist clients diagnosed with hypertension to understand how they react to stressful events and to learn how to cope with and manage stress effectively. |
IV |
Medications |
3.1 Nurses will obtain clients’ medication history, which will include prescribed, over-the-counter, herbal and illicit drug use. |
IV |
3.2 Nurses will be knowledgeable about the classes of medications that may be prescribed for clients diagnosed with hypertension. |
IV |
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3.3 Nurses will provide education regarding the pharmacological management of hypertension, in collaboration with physicians and pharmacists. |
IV |
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Assessment of Adherence |
4.1 Nurses will endeavour to establish therapeutic relationships with clients. |
IV |
4.2 Nurses will explore clients’ expectations and beliefs regarding their hypertension management. |
III |
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4.3 Nurses will assess clients’ adherence to the treatment plan at each appropriate visit. |
III |
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Promotion of Adherence |
4.4 Nurses will provide the information needed for clients with hypertension to make educated choices related to their treatment plan. |
III |
4.5 Nurses will work with prescribers to simplify clients’ dosing regimens. |
Ia |
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4.6 Nurses will encourage routine and reminders to facilitate adherence. |
Ia |
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4.7 Nurses will ensure that clients who miss appointments receive follow-up telephone calls in order to keep them in care. |
IV |
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Monitoring and Follow-up |
5.1 Nurses will advocate that clients who are on antihypertensive treatment receive appropriate follow-up, in collaboration with the healthcare team. |
IV |
Documentation |
6.1 Nurses will document and share comprehensive information regarding hypertension management with the client and healthcare team. |
IV |
Practice Recommendations
Chronic Disease
Nursing Management of Hypertension
Practice Recommendations