Hypotension Nursing Care Plan & Interventions

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What is Hypotension?
Causes
Signs & Symptoms
Assessment
Hypotension Nursing Diagnosis
Expected Outcomes & Goals
Hypotension Nursing Interventions
Hypotension Care Plan Examples
Additional Resources

Low blood pressure can sneak up quietly but lead to serious symptoms like dizziness, fainting, or poor organ perfusion.

That’s why a hypotension nursing care plan maps out exactly what to assess, monitor, and manage. The goal: restore adequate circulation and prevent complications before they start.

What is Hypotension?

Hypotension is a blood pressure reading lower than 90/60 millimeters of mercury (mm Hg).

While some individuals may have naturally low blood pressure without adverse effects, others might experience symptoms due to insufficient blood flow to vital organs.

Causes and Risk Factors

Hypotension doesn’t have a single cause.

It’s often the result of underlying conditions, medication effects, or fluid imbalances. Understanding these risk factors helps nurses anticipate complications and tailor interventions that support circulation and organ perfusion.

Dehydration: Reduced blood volume from inadequate fluid intake or excessive loss

Heart conditions: Bradycardia, heart valve issues, or heart attacks

Endocrine disorders: Conditions like adrenal insufficiency

Blood loss: Significant internal or external bleeding

Infections: Severe infections leading to septic shock

Nutritional deficiencies: Lack of essential vitamins like B-12 and folate

Types of Hypotension

Orthostatic (postural): A sudden drop in blood pressure upon standing

Postprandial: Blood pressure drops after eating

Neurally mediated: Occurs after standing for long periods

Severe: Associated with shock, a life-threatening condition

Signs and Symptoms of Hypotension

When blood pressure drops, the body sends warning signs.

Keep an eye out for these classic hypotension symptoms that the patient might report.

Common Clinical Manifestations

Dizziness or lightheadedness
Fainting
Blurred or narrowed vision
Nausea
Fatigue
Lack of concentration

Severe Hypotension and Emergency Symptoms

Confusion, especially in older adults
Cold, clammy, pale skin
Rapid, shallow breathing
Weak and rapid pulse

Nursing Process for Hypotension

Managing hypotension isn’t guesswork.

It’s all about following the nursing process step by step. From assessment to evaluation, each phase helps keep blood pressure steady and the patient safe.

Nursing Assessment for Hypotension

Every good care plan starts with a health assessment.

Here’s what to look, listen, and ask for when assessing a patient for hypotension.

Patient History and Risk Factors

Review medical history for conditions like heart disease or diabetes.
Assess medication use that may lower blood pressure.
Inquire about dietary habits and fluid intake.

Physical Assessment Findings

Measure blood pressure in different positions (lying, sitting, standing) to detect orthostatic changes.

Evaluate heart rate and rhythm.

Observe skin color, temperature, and moisture.

Diagnostic Tests and Lab Work

Electrocardiogram (ECG) to assess heart activity
Blood tests to check for anemia or endocrine issues
Tilt table test for diagnosing orthostatic hypotension

Nursing Diagnosis for Hypotension

With the assessment complete, the next step is identifying how hypotension affects the patient.

These nursing diagnoses highlight the most common complications and provide a roadmap for targeted interventions.

Decreased Cardiac Output

Related to altered heart rate or rhythm

Ineffective Tissue Perfusion

Due to reduced blood flow to organs

Risk for Shock

Potential for inadequate blood flow leading to organ failure

Risk for Unstable Blood Pressure

Susceptibility to fluctuations in blood pressure

Impaired Gas Exchange

Secondary to decreased oxygen delivery

Nursing Goals and Expected Outcomes

What does success look like when treating hypotension?

Hint: It’s not just a better BP reading.

Success means setting clear, measurable goals that show progress — like stable vitals, improved perfusion, and symptom relief.

Patient will maintain blood pressure within the normal range for the patient.

Patient will exhibit adequate tissue perfusion as evidenced by warm extremities and normal capillary refill.

Patient will report absence of dizziness or lightheadedness.

Patient will demonstrate understanding of the condition and management strategies.

These outcomes help measure the success of nursing interventions for low blood pressure.

Nursing Interventions for Hypotension

These nursing interventions for hypotension target the root causes, support circulation, and help bring blood pressure back into a safe zone.

Monitor Vital Signs and Assess Fluid Status

Regularly check blood pressure and heart rate.
Monitor intake and output to assess hydration status.

Implement Fluid Replacement Therapy

Administer intravenous (IV) fluids as prescribed to increase blood volume.

Adjust Patient Positioning to Prevent Orthostatic Hypotension

Advise patients to change positions slowly.
Encourage sitting up and dangling legs before standing.

Administer Medications as Prescribed

Administer vasopressors to constrict blood vessels and raise blood pressure.
Adjust current medications that may contribute to hypotension.

Educate Patient and Family on Lifestyle Modifications

Increase salt intake if appropriate.
Maintain adequate hydration.
Use compression stockings to improve blood flow.

Nursing Care Plans for Hypotension

These care plans take the guesswork out of managing low blood pressure by walking through targeted nursing diagnoses, clear goals, and interventions that help restore stability.

Care Plan #1 – Decreased Cardiac Output

Diagnostic Statement

Decreased cardiac output related to altered heart rate and rhythm secondary to hypotension, as evidenced by hypotension, fatigue, and diminished peripheral pulses

Expected Outcomes

Patient will maintain blood pressure within normal limits for age and condition

Patient will demonstrate adequate tissue perfusion as evidenced by warm extremities and strong peripheral pulses

Patient will report increased energy levels and reduced fatigue

Assessment

Monitor blood pressure, heart rate, and rhythm regularly.

Assess for signs of decreased perfusion, such as cool, clammy skin and delayed capillary refill.

Evaluate the patient’s level of consciousness and orientation.

Interventions

1. Monitor Vital Signs

Regularly assess blood pressure and heart rate to detect trends indicating decreased cardiac output.

2. Administer Medications as Prescribed

Administer vasopressors or inotropes to support blood pressure and enhance cardiac output as ordered.

3. Positioning

Position the patient in a supine position with legs elevated to promote venous return and improve cardiac output.

4. Fluid Management

Administer IV fluids as prescribed to increase intravascular volume and support blood pressure.

5. Patient Education

Educate the patient on the importance of adhering to medication regimens and recognizing signs of decreased cardiac output.

Care Plan #2 – Ineffective Tissue Perfusion

Diagnostic Statement

Ineffective tissue perfusion related to decreased blood pressure secondary to hypotension, as evidenced by altered mental status, decreased urine output, and cool extremities

Expected Outcomes

Patient will exhibit signs of adequate tissue perfusion, including normal mentation and urine output

Patient’s skin will remain warm and dry with normal capillary refill

Assessment

Monitor neurological status, including level of consciousness and orientation.
Assess urine output to evaluate renal perfusion.
Inspect skin color, temperature, and moisture regularly.

Interventions

1. Monitor Perfusion Indicators

Regularly assess mental status, urine output, and skin condition to detect signs of inadequate perfusion.

2. Administer Oxygen Therapy

Provide supplemental oxygen as needed to enhance oxygen delivery to tissues.

3. Fluid Resuscitation

Administer prescribed fluids to improve intravascular fluid volume and tissue perfusion.

4. Medication Administration

Administer vasopressors as ordered to maintain adequate blood pressure and perfusion.

5. Patient Positioning

Position the patient to optimize blood flow and reduce the risk of pressure injuries.

Care Plan #3 – Risk for Shock

Diagnostic Statement

Risk for shock related to inadequate blood flow secondary to severe hypotension

Expected Outcomes

Patient will maintain stable vital signs within normal limits
Patient will not exhibit signs of shock, such as altered mental status or organ dysfunction

Assessment

Monitor for early signs of shock, including hypotension, tachycardia, and altered mental status.

Assess skin perfusion and temperature.

Evaluate urine output and laboratory values indicative of organ function.

Interventions

1. Early Detection

Continuously monitor vital signs and clinical status to identify early indicators of shock.

2. Fluid Management

Administer IV fluids promptly as prescribed to support circulatory volume.

3. Medication Support

Administer vasopressors or inotropes as ordered to maintain hemodynamic stability.

4. Oxygenation

Provide supplemental oxygen to ensure adequate tissue oxygenation.

5. Patient Education

Educate the patient and family on recognizing signs of shock and the importance of seeking immediate medical attention.

Preventing Complications of Hypotension

Hypotension can go from mild to major in minutes.

Staying ahead of complications means acting early, monitoring closely, and making small moves that prevent big problems.

Regular Monitoring

Conduct frequent blood pressure and heart rate assessments to detect and promptly address hypotensive episodes.

Hydration Maintenance

Encourage adequate fluid intake to prevent dehydration-related hypotension.

Medication Review

Regularly evaluate and adjust medications that may contribute to hypotension.

Patient Positioning

Advise patients to change positions slowly to prevent orthostatic hypotension.

Education on Lifestyle Modifications

Discuss dietary adjustments, exercise routines, and the importance of avoiding triggers that may exacerbate hypotension.

Patient Education and Discharge Planning

The care doesn’t end when the patient leaves the floor.

Teaching them how to manage hypotension at home is just as important.

Understanding Hypotension

Provide clear explanations about the condition, its causes, and potential symptoms.

Medication Adherence

Emphasize the importance of taking prescribed medications as directed and discussing any side effects with health care providers.

Lifestyle Adjustments

Encourage dietary changes, such as increasing salt intake if appropriate, and implementing regular, moderate exercise.

Safety Measures

Instruct on strategies to prevent falls, including rising slowly from seated or lying positions and using assistive devices if necessary

Don’t Let Hypotension Slip Under the Radar

Hypotension might not sound as urgent as hypertension, but it can spiral fast if left unchecked.

Having a care plan ensures that nursing interventions for hypotension aren’t just reactive, but proactive — helping prevent emergencies before they happen.

Remember: low pressure doesn’t mean low priority.

Nursing Care Plan Resources

References and Sources

American Heart Association. (n.d.). Low blood pressure – when blood pressure is too low. Retrieved March 27, 2025.

Gulanick, M., & Myers, J. L. (2021). Nursing care plans: Diagnoses, interventions, and outcomes (10th ed.). Elsevier.

Kim, M. J., & Farrell, J. (2022). Orthostatic hypotension: A practical approach. American Family Physician, 105(1), 39–49. Retrieved March 27, 2025.

Mayo Clinic Staff. (n.d.). Low blood pressure (hypotension) – Diagnosis and treatment. Mayo Clinic. Retrieved March 25, 2025.

Sharma, S., Hashmi, M. F., & Bhattacharya, P. T. (2023). Hypotension. In StatPearls. StatPearls Publishing. Retrieved March 27, 2025.