Registered Nurses' Association of Ontario

Follow-up of medication therapy

a) Follow-up should include:

1. Necessary blood work (serum potassium and creatinine, every 6-12 months)

2. Blood pressure measure and weight

3. Enquiry regarding general health status, side effects and any treatment

4. Reinforce or advise on non-pharmacological measure to control blood pressure

5. Annual urine test for proteinuria

b) With   Stage   2 (consistent with   Grade 2  of  the   WHO/ISH  classifications)  or  complicated hypertension, clients require more frequent follow-up


➪ Practice Point:

Factors to consider when target blood pressure is not being reached:

  • Difficulty following treatment regimen (e.g., complexity, socioeconomic barriers, psychological factors).
  • Lifestyle (e.g., inability to lose weight, excessive alcohol intake).
  • Treatment prescribed may be ineffective.
  • Isolated clinic (white-coat) hypertension.
  • Use of inappropriate cuff size.
  • Use of drugs that raise blood pressure (e.g., NSAIDs, sympathomimetics, herbal remedies)
  • Volume overload (e.g., high sodium intake, renal insufficiency, inadequate or ineffective diuretic therapy)
  • Unsuspected secondary cause (e.g., renal or endocrine disorders, sleep apnea).
Chronic Disease
Nursing Management of Hypertension
Point of Care Resources