hypertensive crisis

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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 ?
They discuss the underlying basic science and cerebrovascular physiology of the critically ill neurological patient, hypertensive emergency, airway management, traumatic brain injury and intracranial hypertension, acute spinal cord injury, subarachnoid and intracerebral hemorrhage, cerebral ischemia, and epilepsy, and critical aspects related to cerebrovascular disease, infections of the nervous system, neuromuscular disorders, and neurological complications and consultations in general intensive care, ending with a section on neuroimaging and neuromonitoring.
The patient was diagnosed with hypertensive emergency.
Successful treatment of a monoamine oxidase inhibitor-tyramine hypertensive emergency with intravenous labetalol.
Both initiatives are designed to provide insights into the demographics, clinical descriptors, contemporary treatment, and outcomes of patients with hypertensive emergency.
The 64-year-old Serb had a life-threatening condition called hypertensive emergency, where surges in blood pressure can damage the heart, kidneys and central nervous system.
The patients had 36 episodes of hypertensive emergency during the study: 11 from acute cardiovascular syndrome, 14 postoperatively, and 11 after trauma.
In the setting of hypertensive emergency patients, minorities in general--and Hispanics in particular--are at greater risk for poor blood pressure control because of the lack of a primary care physician and health insurance, said Dr.
Selection of the most appropriate antihypertensive drug depends on whether the patient is having a hypertensive emergency or urgency.
Only recently has nicardipine become available in Ready-to-Use bags which can be kept at the point-of-care and immediately available to treat the patient presenting with a hypertensive emergency.
Patient records from the hospital's Health Information Management and Patient Financial Services were reviewed for the following exclusion criteria: Patients less than 18 years of age, AIS unable to be validated by chart review, IV or intra-arterial thrombolysis performed or concomitant diagnosis of acute renal failure, hypertensive encephalopathy, aortic dissection, pulmonary edema, acute myocardial infarction or hypertensive emergency.
Hypertensive emergency with multiorgan dysfunction was diagnosed and a labetalol drip was initiated to normalize the systemic blood pressure.
Rapid and precise blood pressure control can help improve outcomes for millions of people who experience a hypertensive emergency or urgency, or high blood pressure during or after surgery," said Jerrold Levy, M.

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