What Causes Elevated Blood Pressure Level Along With Nausea And Dizziness?

My blood pressure has been elevated lately. Usually around 130/85 as high as 150/90. This has been this way for a few months so the doctor prescribed Losartan/HCTZ 50/12.5mg. I've been taking it, but I missed a dose and I had a blood pressure spike while at work. I work as a nurse in a busy long term care facility, so one of my fellow nurses checked my bp. It was 190/110. I was also having shakiness and headache, nausea and tachycardia at 126bpm. There is a small emergency department next door to the facility I work in. I went there to get checked out by then my bp went down some to 150/80. I was discharged after blood work came back normal ( bmp, cbc, troponin) The doctor said to continue my bp medicine and follow up with my doctor within 48 hours. I stayed home from work the next day as I was still feeling nauseous and light headed, also I notice a lot of shaking in my hands that's hard to control. It's better if I lie down and relax but when I am active I don't feel well. I also notice I tend to sweat a lot but mostly on my head, face and neck when I am active. In fact the slightest activity causes sweating. I don't know if there is any correlation between these things. Other medications I am on are: Lamotrigine 50mg, Nexium 40mg, Paxil CR 37.5mg, Gabapentin 300mg three times daily, and Klonopin 0.25mg PRN. I have bipolar disorder, anxiety, fibromyalgia. I hope I have provided enough information. Thank you for your time.