Elevated blood pressure

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ReadingChoose oneFirst line

MeasurementChoose one

Four-extremityChoose any

Symptoms presentChoose any

Symptoms absentChoose any

Possible contributorsChoose any

Recheck planChoose one

LifestyleChoose any

NutritionChoose any

ReferralChoose one

DispositionChoose one

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Counseling

A high blood pressure reading in a child often comes down on repeat measurement, so the diagnosis depends on several readings over time. Recommended supportive care with an emphasis on less salt and fewer sugary drinks, more fruits and vegetables, daily physical activity, and regular sleep. Return precautions given including severe headache, vision changes, chest pain, trouble breathing, weakness or confusion, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Elevated blood pressure
• Elevated readings repeated manually with an appropriately sized cuff
• No headache, vision changes, chest pain, or confusion
• Plan to repeat manual blood pressure 3 times over the next 2 weeks at nurse visits
• Lifestyle counseling provided on diet, salt, sugary drinks, activity, and sleep
• Will refer to cardiology or nephrology if blood pressure remains elevated
• Follow up after the repeat blood pressures

A high blood pressure reading in a child often comes down on repeat measurement, so the diagnosis depends on several readings over time. Recommended supportive care with an emphasis on less salt and fewer sugary drinks, more fruits and vegetables, daily physical activity, and regular sleep. Return precautions given including severe headache, vision changes, chest pain, trouble breathing, weakness or confusion, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Reading category (elevated, stage 1, stage 2)
Manual confirmation with the right cuff; automated only; normal on repeat; white coat HTN on ABPM
Four-extremity BP and femoral pulses
Symptoms present or absent (headache, vision, chest pain, confusion)
Contributors (weight, salt, sugary drinks, activity, sleep, caffeine, stimulants, decongestants, anxiety)
Recheck plan: 3 times over 2 weeks; 6 months; within 1 week; ABPM
Lifestyle: DASH-style diet, activity, sleep
Nutrition or weight management referral
Refer if still elevated vs nephrology vs cardiology
ED for symptomatic severe HTN

Return precautions in the template

severe headachevision changeschest paintrouble breathingweakness or confusion

Elevated blood pressure

What the sources cover

Return precautions in the template

Sources