Med Surg CH 27

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?

"I chose broiled chicken with a baked potato for dinner."

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize?

"Sit quietly for 5 minutes prior to taking blood pressure."

According to the DASH diet, how many servings of vegetables should a person consume each day?

4 or 5

The nurse is assessing the blood pressure for a patient who has hypertension and the nurse does not hear an auscultatory gap. What outcome may be documented in this circumstance?

A high diastolic or low systolic reading

A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply.

Coronary artery disease Myocardial infarction Stroke

A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The physician orders a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement?

Echocardiography

A patient arrives at the clinic for a follow-up visit for treatment of hypertension. The nurse obtains a blood pressure reading of 180/110 but finds no evidence of impending or progressive organ damage when performing the assessment on the patient. What situation does the nurse understand this patient is experiencing?

Hypertensive urgency

Which term describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage?

Hypertensive urgency

Which finding indicates that hypertension is progressing to target organ damage?

Retinal blood vessel damage

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?

Secondary

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply.

Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured.

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress

decreases the production of neurotransmitters that constrict peripheral arterioles.

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for?

dizziness

What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply.

hypertension diabetes obesity family history of early cardiovascular events

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine

increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specify about this client's target blood pressure?

130/80 or lower

A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

Essential (primary)

The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium?

Spironolactone

A client has been prescribed three medications for hypertension and the nurse measured a blood pressure of 180/80. Which question will the nurse ask the client first?

"Are you still taking the medication?"

A 77-year-old client presents to the local community center for a blood pressure (BP) screening; BP is recorded as 180/90 mm Hg. The client has a history of hypertension but currently is not taking the prescribed medications. Which question is most appropriate for the nurse to ask the client first?

"Can you tell me the reasons you aren't taking your medications?"

The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure?

Heart and blood vessels

A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend?

Purchasing a self-monitoring BP cuff

Which term describes high blood pressure from an identified cause, such as renal disease?

Secondary hypertension

A client in a clinic setting has just been diagnosed with hypertension. When the client asks what the end goal is for treatment, what is the nurse's best response?

To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less

The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension?

Maintain adequate dietary intake of fruits and vegetables

A client diagnosed with hypertension begins drug therapy using an antihypertensive agent. The nurse instructs the client's spouse to remove any objects in the home that can lead to falls. Which client statement confirms that the teaching has been successful?

"Antihypertensive drugs can lead to falls."

A client with a history of hypertension is receiving client education about structures that regulate arterial pressure. Which structure is a component of that process?

kidneys

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response?

"Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg."

A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?

"Flex your calf muscles, avoid alcohol, and change positions slowly."

A 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client's BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is most important for the nurse to ask the client next?

"Have you taken your prescribed clonidine today?"

The nurse is caring for a client who has had 25 mg of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. Which instruction should the nurse give the client?

"Increase the amount of fruits and vegetables you eat."

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by up to which percentage in the first hour?

25%

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed the client hydrochlorothiazide and enalapril. What will the nurse be sure to include in educating this client?

Change positions (lying or sitting to standing) slowly.

The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce?

Changing positions slowly related to possible hypotension

When administering benazepril with spironolactone, the nurse should be aware that which electrolyte imbalance may occur?

Hyperkalemia

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.)

Heart rate Heart rhythm Character of apical and peripheral pulses

A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect?

Hyperkalemia

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?

Hypertensive emergency

Which of the following would be inconsistent with a hypertensive urgency?

Intracranial hemorrhage

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?

Potassium level

The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?

Loss of arterial elasticity

The nurse would screen a client from which ethnic background hypertension at an early age?

Population of African descent

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for?

Postural hypotension and resulting injury

A client with hypertension has a blood pressure of 132/88 mm Hg. For which type of hypertension will the nurse prepare teaching for this client?

Prehypertension

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true?

Pressures should not differ more than 5 mm Hg between arms.

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension? Select all that apply.

Smoking Diabetes mellitus Physical inactivity

The nurse is assessing a client with hypertension. Which actions will the nurse take when measuring the client's blood pressure? Select all that apply

Wrap the cuff firmly around the arm. Measure two readings, 1 to 2 minutes apart. Place the client's arm at the level of the heart. Center the cuff bladder over the brachial artery.

The nurse is administering metoprolol to a client. What type of medication should the nurse educate the client about?

beta blocker

The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents?

continuous IV infusion

A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include?

nonpharmacological interventions

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through:

ophthalmic examination.

It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position

provide time for the heart to increase the rate of contraction to resupply oxygen to the brain.

Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued?

rebound

A 65-year-old client is beginning medical management of recently diagnosed hypertension. The most important strategy in this client's treatment is reducing:

systolic pressure below 150 mm Hg.