Ch 27 PrepU

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 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 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 nurse is teaching a client with newly diagnosed hypertension who asks if there is any harm in stopping antihypertensive medication. What is the nurse's best response?

"Rebound hypertension can occur."

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

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

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

Hyperkalemia

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

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

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 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.

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?

Renal dysfunction resulting from atherosclerosis

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

Retinal blood vessel damage

Hypertension that can be attributed to an underlying cause is termed

Secondary hypertension may be caused by a tumor of the adrenal gland (e.g., pheochromocytoma). Primary, or essential, hypertension has no known underlying cause. Isolated systolic hypertension is demonstrated by readings in which the systolic pressure exceeds 140 mm Hg and the diastolic measurement is normal or near normal (less than 90 mm Hg).

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

Sit on the edge of the chair and rise slowly.

The nurse is conducting a service project for a local elderly community group on the topic of hypertension. The nurse will relay that which risk factors and cardiovascular problems are related to hypertension? Select all that apply.

Smoking Overweight/obesity Age ≥65 in women

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

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.

The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should

check the client's heart rate.

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

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

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?"

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

A hypertensive emergency is a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage. Hypertensive urgency is a situation in which blood pressure is severely elevated but there is no evidence of actual or probable target organ damage. Secondary hypertension is high blood pressure from an identified cause, such as renal disease. Primary hypertension denotes high blood pressure from an unidentified source.

Which diuretic medication conserves potassium?

Spironolactone is known as a potassium-sparing diuretic. Furosemide causes loss of potassium from the body. Chlorothiazide and chlorthalidone cause mild hypokalemia.

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.

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?

stroke

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 instructing a student on the proper technique for measuring blood pressure (BP). Which student action indicates a need for further teaching?

Positions the arm at waist level

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 or primary hypertension, about 95% of cases, is sustained elevated BP with no known cause. This client does not have secondary, pathologic, or malignant hypertension.

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."

An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine?

A possible adverse effect of blood pressure medicine is dizziness when you stand