What is Hypertensive Crisis and How is it Managed?

Hypertensive crisis is the sudden rise in the blood pressure of the hypertensive patient beyond 250/150mmHg. The onset is usually with little or no warning signs, and it is characterized by severe headache, nausea, vomiting, dizziness, visual disturbances and disorientation. In some cases these symptoms are accompanied by a cerebral spasm which brings about cerebral ischaemia, oedema, and thrombosis. Hypertensive crisis is such a dangerous medical condition that an immediate medical intervention would be needed to save the patient’s life. It is therefore medical emergency.
Hypertensive crisis is managed through the administration of administration of a vasodilator such as Hydralazine (Apresoline) intravenously to help dilate the blood vessel, and a diuretic e.g. Furosemide (Lasix) intravenously to help to help patient lose excess fluids and sodium.
The patient should be placed on strict bed rest and the vital signs –blood pressure, pulse and respiration monitored every 5-10 minutes. His neurological signs should also be monitored. Patient’s fluid intake and output should also be monitored to determine the level of progress made. The possibility of acute hypotensive reaction is quite high as a result the anti-hypertensive drugs hence patient should be strictly monitored and not allowed to get up suddenly from bed.
Everything medically possible should be done to see that the patient does not suffer any further stress as this is capable of making the patient suffer more complication such as stroke. Therefore, patient should be keep in a quiet environment with visitors restricted to allow for both physical and mental rest and aid speedy recovery. His physical care should be taken care of by the nurses.