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Hypertensive Emergency

  • Admission orders

    • Admit: ICU
    • Diagnosis: Hypertensive Emergency
    • Condition: Critical
    • Vital Signs: ICU routine, plus continuous BP monitoring with arterial line
    • Allergies:
    • Nursing: neuro check q 2 hour, I/O
    • Diet: Low-Sodium Diet
    • Activity: Bedrest
    • Labs:
      • CBC with smear, chem
      • CK, troponin
      • Urinalysis, Utox
      • EKG
      • CXR
      • head CT
    • IV: KVO
    • Special: neuro consult if stroke hx
    • Medications:
      • Sodium nitroprusside IV (contraindicated in pregnancy, consult neuro if stroke). Begin at 0.1 mg/kg/min, and titrate every 15 minutes to achieve MAP of 120 within first 2 hours. Max dose 5 ug/kg/min.
      • alternative: IV labetalol
    • Call house officer: SBP > 190 mmHg, DBP > 110 mmHg, any neurologic change
  • Discharge

    • course: transitioned to PO antihypertensive.
    • meds: labetalol or short-acting Ca blocker
    • f/u within 1 week

  • Print | Citations

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