Ch.27 assessment & management of hypertension

"Hypertension greatly increases your risk of stroke and heart disease."

A 55 yr old client comes to the clinic for a routine check up. The clients BP is 159/100 mmHg and the health care provider diagnoses hypertension after referring to previous readings. The client asks why it is important to treat hypertension, since the client denies any discomfort. What would be the nurses best response?

" a single elevated blood pressure does not confirm hypertension. Diagnosis requires multiple elevated readings."

A 56 yr old client at a screening event has a blood pressure reading of 146/96 mmHg. Upon hearing the reading, the client states, "my pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" What is the nurses best response?

Exercise on a regular basis

A client has been diagnosed as being prehypertensive. What should the nurse encourage this client to do to aid in preventing a progression to a hypertensive state?

Normalizing BP within 24 to 48 hours

A client in hypertensive urgency is admitted to the hospital. The nurse should be aware of which goal of treatment for a client in hypertensive urgency?

Chronic kidney disease

A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged uncontrolled hypertension is at risk for developing which health problem?

Tobacco use increases the clients concurrent risk of heart disease.

A client newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the client and advises that the client should avoid tobacco use. What is the primary actions rationale behind that advice to the client?

"To make sure your health is stable"

A client with newly diagnosed hypertension has come to the clinic for a follow-up visit. The client asks the nurse why the client has to come in so often. Which response by the nurse would best?

Retinal blood vessel damage

A client with primary hypertension comes to the clinic reporting a gradual onset of blurry vision and decreased visual acuity over the past several weeks. The nurse is aware that these symptoms could be indicative of which condition?

Rising slowly from a lying or sitting position

A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize?

Has a specific cause

A client with secondary hypertension has come into the clinic for a routine check up. When comparing this clients diagnosis to primary hypertension, the nurse recognizes that secondary hypertension.

Increased urine output

A clients medication regiment for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect?

The clients potassium level

A clients recently elevated BO has prompted the primary care to provider to prescribe furosemide. The nurse should closely monitor which of the following levels?

African Americans

A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group?

"This medication can cause low blood pressure and dizziness , especially when you get up suddenly."

A newly diagnosed client with hypertension is prescribes a thiazide diuretic. What client education should the nurse provide to this client?

Obesity and high intake of sodium and saturated fat

A nurse is teaching an client about the risk factors for hypertension. Which factors should the nurse explain as risk factors for primary hypertension?

Use strategies to prevent falls stemming from orthostatic hypotension

An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. Which topic should the nurse include in health education?

Family history of hypertension

At a blood pressure screening, the nurse learns that a client has a family history of hypertension, high cholesterol, and elevated lipid levels. The client says reports smoking one pack of cigarettes daily and drinking " about a pack of beer" every day. The nurse notes which nonmodifible risk factor for hypertension?

Elevated

During an adult clients last two office visits, the nurse obtained BP readings of 122/76 and 128/78, respectively. How would this clients BP be categorized?

Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy

The community health nurse cares for many clients who have hypertension. What nursing diagnosis is most common among clients who are being treated for this health problem?

Sodium nitroprusside

The critical care nurse is caring for a client just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication?

" do you ever see spots in front of your eyes?"

The home health nurse is caring for a client who has a diagnosis of hypertension. What assessment question most directly addresses the possibility of worsening hypertension?

Client takes medication as prescribed and reports any adverse effects.

The nurse identifies a nursing diagnosis of ineffective health maintenance related to non adherence to therapeutic regimen in a client with hypertension who has not been taking their medications as prescribed. When planning this clients care, which outcome would be appropriate?

Lack of adherence to prescribed drug therapy

The nurse is assessing a client new to the clinic. The records brought to the clinic show that the clients hypertension has not improved. What contributing factors should the nurse first explore in an effort to identify the cause of the clients inadequate BP control?

Decrease the systolic blood pressure by no more than 25% within the first hr.

The nurse is caring for a client in the emergency department who was admitted for a hypertensive emergency. The nurse knows the goal of intravenous vasodilator therapy for a hypertensive emergency would be which outcome?

Pay close attention to hydration status because of increased sensitivity to extracellular volume depletion.

The nurse is caring for an older adult with a diagnosis of hypertension who is being treated with a diuretic and beta blocker. Which item should the nurse integrate into the management of this clients hypertension?

Reduced intake fat and sodium

The nurse is collaborating with dietitian and a client with hypertension to plan dietary modifications. Which modifications should be the priority?

Client will reduce NA+ intake to less than 2g daily

The nurse is developing a nursing care plan for a client who is being treated for hypertension. Which outcome is most appropriate for the nurse to include?

Every 5 minutes

The nurse is monitoring blood pressure for a client with unstable readings. How often should the nurse check the clients blood pressure?

130/70 mmHg or lower

The nurse is planning the care of a client who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, which blood pressure would be the goal of treatment?

Atherosclerosis

The nurse is providing care for a client with a diagnosis of hypertension. The nurse should consequently assess the client for signs and symptoms of which other health problem

Client will return demonstrates measuring a blood pressure.

The nurse is providing education to a client newly diagnosed with hypertension. Which outcome would be most appropriate for this client?

"Structural and functional changes in the cardiovascular system that occur with age contribute to an increase in blood pressure."

The nurse is providing health education to an older adult client. What should the nurse teach the client about the relationship between hypertension and age?

Decreased peripheral resistance Decreased blood volume Decreased strength and rate of myocardial contractions

The nurse is reviewing the medication administration record of a client who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensive should the nurse identify? Select all that apply.

Less than 120/0 mmHg

The nurse is screening a number of adults for hypertension. Which range of blood pressure is considered normal?

Transient Ischemic Attack (TIA) Cerebrovascular disease Retinal hemorrhage

The nurse is teaching a client about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply.

Stage 2 hypertensive

The nurse takes the clients blood pressure, and the reading is 161/101 mmHg. The nurse knows this blood pressure would be classified as which type?

Taking the BP 10 minutes after nicotine or coffee ingestion

The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure accurate measurement, the lab instructor would teach the students to avoid which action?

Hypertensive emergencies are associated with evidence of target organ damage

The staff educator is teaching emergency department nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in which way?