What symptom would alert a nurse to the possibility of a hypertensive crisis?

In assessing a potential hypertensive crisis, the symptoms to be vigilant for typically include severe and sudden elevations in blood pressure, often exceeding 180/120 mm Hg, accompanied by symptoms that indicate possible end-organ damage. Dyspnea, or difficulty breathing, can occur during a hypertensive crisis, particularly when high blood pressure affects the lungs, leading to pulmonary edema. Edema (swelling) can also indicate fluid retention associated with decompensated heart function, which can be exacerbated by a significant increase in blood pressure.

Both dyspnea and edema are critical signs that suggest the patient may be experiencing complications related to uncontrolled hypertension, thus indicating the possibility of a hypertensive crisis. Recognizing these symptoms allows for prompt intervention and treatment to prevent serious complications such as stroke, heart attack, or acute kidney failure.

Other symptoms listed—pallor with low blood pressure, foul-smelling sputum, and black tarry stools—are not typically associated with a hypertensive crisis or do not directly indicate elevated blood pressure. Therefore, dyspnea and edema stand out as crucial indicators for monitoring a patient at risk of this serious condition.