hypertensive crisis


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Related to hypertensive crisis: Hypertensive encephalopathy

crisis

 [kri´sis] (pl. cri´ses) (L.)
1. the turning point of a disease for better or worse; especially a sudden change, usually for the better, in the course of an acute disease.
2. a sudden paroxysmal intensification of symptoms in the course of a disease.
addisonian crisis (adrenal crisis) the symptoms accompanying an acute onset or worsening of addison's disease: anorexia, vomiting, abdominal pain, apathy, confusion, extreme weakness, and hypotension; if untreated these progress to shock and then death.
aplastic crisis a sickle cell crisis in which there is temporary bone marrow aplasia.
blast crisis a sudden, severe change in the course of chronic granulocytic leukemia, characterized by an increased number of blasts, i.e., myeloblasts or lymphoblasts.
catathymic crisis an isolated, nonrepetitive act of violence that develops as a result of intolerable tension.
celiac crisis an attack of severe watery diarrhea and vomiting producing dehydration and acidosis, sometimes occurring in infants with celiac disease.
developmental crisis maturational crisis.
hemolytic crisis an uncommon sickle cell crisis in which there is acute red blood cell destruction with jaundice.
hypertensive crisis dangerously high blood pressure of acute onset.
identity crisis a period in the psychosocial development of an individual, usually occurring during adolescence, manifested by a loss of the sense of the sameness and historical continuity of one's self, confusion over values, or an inability to accept the role the individual perceives as being expected by society.
life crisis a period of disorganization that occurs when a person meets an obstacle to an important life goal, such as the sudden death of a family member, a difficult family conflict, an incident of domestic violence (spouse or child abuse), a serious accident, loss of a limb, loss of a job, or rape or attempted rape.
maturational crisis a life crisis in which usual coping mechanisms are inadequate in dealing with a stress common to a particular stage in the life cycle or with stress caused by a transition from one stage to another. Called also developmental crisis.
myasthenic crisis the sudden development of dyspnea requiring respiratory support in myasthenia gravis; the crisis is usually transient, lasting several days, and accompanied by fever.
oculogyric crisis a symptom of an acute dystonic reaction in which the person demonstrates a fixed gaze, usually upward; also, the uncontrollable rolling upwards of the eye. It can be a result of encephalitis or a reaction to antipsychotic medications.
salt-losing crisis see salt-losing crisis.
sickle cell crisis see sickle cell crisis.
tabetic crisis a painful paroxysm occurring in tabes dorsalis.
thyroid crisis (thyrotoxic crisis) see thyroid crisis.
vaso-occlusive crisis a sickle cell crisis in which there is severe pain due to infarctions in the bones, joints, lungs, liver, spleen, kidney, eye, or central nervous system.

hypertensive crisis

Etymology: Gk, hyper + L, tendere, to stretch; Gk, krisi, turning point
a sudden, severe increase in blood pressure to a level exceeding 200/120 mm Hg, occurring most frequently in individuals who have untreated hypertension or who have stopped taking prescribed antihypertensive medication. See also malignant hypertension.
observations Characteristic signs include severe headache, vertigo, diplopia, tinnitus, photophobia, nosebleed, twitching of muscles, tachycardia or other cardiac arrhythmia, distended neck veins, narrowed pulse pressure, nausea, and vomiting. The patient may be confused, irritable, or stuporous, and the condition may lead to convulsions, coma, myocardial infarction, renal failure, cardiac arrest, or stroke.
interventions Treatment consists of antihypertensive drugs and diuretics; anticonvulsants, sedatives, and antiemetics may be used if indicated. The patient is usually placed on a cardiac monitor in a bed with the head elevated and is maintained in a quiet environment. The diet is low in calories, and sodium and fluids may be restricted. As the patient's condition improves, progressive ambulation is permitted, but the patient is carefully observed for symptoms of orthostatic hypotension, such as pallor, diaphoresis, or faintness, which may be side effects of the antihypertensive drugs.
nursing considerations The major concerns of the nurse are to observe and report any sign of hypotension. In preparation for discharge the nurse advises the patient to recognize symptoms of any dramatic increase or decrease in blood pressure, to adhere to the prescribed diet and medication, and to avoid fatigue, heavy lifting, use of tobacco products, and stressful situations.

hypertensive crisis

A rare clinical event characterized by a severe and/or acutely ↑ diastolic BP > 120-130 mm Hg; an HC is a medical emergency if accompanied by rapid or progressive CNS–encephalopathy, infarction or hemorrhage, cardiovascular–myocardial ischemia, infarction, aortic dissection, pulmonary edema, and renal deterioration, eclampsia or microangiopathic hemolytic anemia Etiologic factors Pre-existing chronic HTN; renovascular HTN; renal parenchymal disease; scleroderma and collagen vascular disease; drugs–sympathomimetics, tricyclic antidepressants, withdrawal from antihypertensives, recreational–eg, crack cocaine; spinal cord syndromes; pheochromocytoma Clinical Severe headache, transient blindness, vomiting, rapid deterioration of renal function Complications Acute end-organ damage–eg, myocardial ischemia/infarction, renal failure, aortic dissection, stage 3 or 4 hypertensive retinopathy Treatment Organ-targeted therapy with CCBs, Lobetalol, loop diuretics, nitroglycerin, nitroprusside Prognosis Untreated 5-yr mortality is 100%

hypertensive crisis

Any severe elevation in blood pressure (usually a diastolic pressure greater than 130 mm Hg) with or without damage to internal organs or other structures, e.g., brain, heart, aorta, kidneys. In hypertensive emergencies, end organs are damaged, and antihypertensive drugs usually are given intravenously to try to lower the blood pressure within an hour. Agents used in hypertensive emergencies include sodium nitroprusside, nitroglycerin, labetalol, and enalaprilat.

In hypertensive urgencies, the blood pressure is extremely elevated, but there is no sign or immediate threat of organ damage. Typically, oral beta blockers, ACE inhibitors, or clonidine, alone or in combination, are given to lower pressures over 1 or 2 days.

See also: crisis
References in periodicals archive ?
Patient with severe pulmonary artery hypertension are at high risk for pulmonary hypertensive crisis during surgical procedures, therefore immediate recognition and prompt treatment is the mainstay of successful management.
Objectives: To evaluate efficacy and safety of nifedipine and captopril in hypertensive crisis in children.
Of particular surgical significance, glomus body tumors may actively secrete catecholamines similar to pheochromocytoma and manipulation may provoke hypertensive crisis (Boulos, Schwartz, & Popp, 2000).
Many studies have shown that both labetalol and nifedipine can be used successfully in treating hypertensive crisis in pregnancy.
The clinical entity extravagantly referred to as a hypertensive crisis describes an elevated systolic blood pressure of >180mmHg with diastolic pressure of >120mmHg.
Lisdexamfetamine is contraindicated in patients who are taking a monoamine oxidase inhibitor, because of a risk of hypertensive crisis.
Also, patients prescribed MAOIs are required to follow a tyramine-restricted diet to prevent the onset of hypertensive crisis.
Borisov was admitted to hospital with a hypertensive crisis for two times in a single week after his resignation on February 21.
The World Bank Country Office later said Alexander Kremer had hypertensive crisis.
Precautions need to be taken to avoid complications during tumour manipulation as transient hypertensive crisis can occur, leading to serious consequences.
Thus, it is critically important to provide clinicians with evidence-based guidance regarding the safe and effective lowering of BP into a predefined target range, particularly with the large number of patients treated annually for acute hypertensive crisis, Weisman added.

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