Hypertension

Template

Hypertension, follow-up

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MonthChoose anyFirst line

StatusChoose oneFirst line

Blood pressureChoose one

Home readingsChoose any

LifestyleChoose any

Medication toleranceChoose one

Medication planChoose one

Medication labsChoose any

Additional planChoose any

SportsChoose one

Testing and referral statusChoose any

ReferralChoose one

DispositionChoose one

Follow-upChoose one

Follow-up reasonChoose anyJoins the line above

Counseling paragraphChoose oneParagraph

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

Hypertension, follow-up
November 2026: Doing well.
• Blood pressure at goal, below the 90th percentile (below 130/80 for age 13 and older)
• Continue lifestyle changes with a DASH-style diet, less salt, fewer sugary drinks, daily physical activity, and good sleep
• No medication change planned at this time
• Follow up in 3 months to recheck blood pressure readings

Blood pressure is at goal, and keeping up the healthy habits and any medicine every day keeps it there and protects the heart and kidneys. Recommended supportive care with an emphasis on less salt, fewer sugary drinks, and daily activity. Return precautions given including a severe headache, vision changes, chest pain, trouble breathing, confusion, fainting, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Blood pressure improved; at goal; above goal
Home log
Continue lifestyle changes
Medication tolerance and adherence
Medication plan with AAP reasons (start, increase, add a thiazide)
Electrolytes on diuretic; ABPM; echo; ACE/ARB and pregnancy; weight
Nephrology, cardiology
Severe symptomatic hypertension

Return precautions in the template

a severe headachevision changeschest paintrouble breathingconfusionfainting

Sources

RCH Melbourne: Hypertension
The Cribsiders: #36, Off the Cuff: Managing Pediatric Hypertension (October 13, 2021)
Cribsiders show notes: #95 Acne (October 11, 2023)

Template

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ConfirmationChoose one

AssessmentChoose one

Symptoms presentChoose any

Symptoms absentChoose any

Four-extremityChoose one

ReviewedChoose any

LabsChoose any

ImagingChoose any

GoalChoose any

TreatmentChoose one

Medication toleranceChoose oneNot in the note with these choices

Additional planChoose any

SportsChoose one

ReferralChoose any

DispositionChoose one

Follow-upChoose one

Follow-up reasonChoose anyJoins the line above

Counseling

Steady changes in eating, activity, sleep, and weight can lower blood pressure in children, and treatment protects the heart and kidneys 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

Hypertension
• Confirmed by manual readings at or above the 95th percentile at 3 separate visits
• Likely primary hypertension given age 6 or older, family history or excess weight, and no findings suggesting a secondary cause
• No headache, vision changes, chest pain, or confusion
• Four-extremity blood pressures and femoral pulses normal
• Nutrition, salt intake, sugary drinks, physical activity, sleep, and weight reviewed
• Medications and substances that raise blood pressure reviewed, including stimulants, decongestants, caffeine, and energy drinks
• Goal blood pressure below the 90th percentile, and below 130/80 for ages 13 and older
• Lifestyle changes as first-line treatment with a DASH-style diet and regular physical activity
• Follow up in 3 months

Steady changes in eating, activity, sleep, and weight can lower blood pressure in children, and treatment protects the heart and kidneys 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

Stage 1 or 2
Confirmation: 3 visits, ABPM, ABPM ordered, known
Primary vs evaluating for secondary (under 6, findings)
Symptoms of hypertensive emergency present or absent
Four-extremity BP and femoral pulses; coarctation concern
Lifestyle, medication and substance contributors reviewed
Labs and optional tests
Renal ultrasound, echo, sleep study
Treatment goal
Lifestyle first; start (two reasons), continue, increase, add a second medicine

Show 6 more

Amlodipine, Lisinopril, Losartan, Enalapril, Hydrochlorothiazide
Adherence and side effects
Home log; electrolytes on a diuretic; ACE/ARB pregnancy counseling
Sports clearance or high-static restriction
Nephrology, cardiology, nutrition referral
Follow-up 3 months (lifestyle), 4-6 weeks (medication)

Used to decide, kept out of the note

ECG for LVH

Return precautions in the template

severe headachevision changeschest paintrouble breathingweakness or confusion

Sources

The Cribsiders: #36, Off the Cuff: Managing Pediatric Hypertension (October 13, 2021)