Chapter 31 - Hypertension
1 year
A patient has been diagnosed with preHTN & has been encouraged to exercise regularly & begin a weight loss program. After what period of time does the nurse tell the patient to return for a follow up visit?
It takes 2-3 months for the taste buds to adapt to changes in salt intake
A patient informs the nurse, "I can't adhere to the dietary sodium decrease that is required for the treatment of my HTN." What can the nurse educate the client about regarding this statement?
Isolated systolic hypertension
A patient is being seen at the clinic on a monthly basis for assessment of BP of 158/64 indicates?
Reduce the BP by 20% - 25% within the first hour of treatment
A patient is brought to the ED with complaints of a bad headache and BP of 260/180 mmHg. What is the therapeutic goal for reduction of the mean BP?
Rebound hypertension
A patient is flying overseas for 1 week for business & packed antihypertensive meds in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. What can be a concern with no medication?
Potassium level
A patient is taking amiloride (Midamor) & Lisinopril (Zestril) for the treatment of HTN. What lab studies should the nurse monitor while the patient is taking these 2 meds together?
Gradually reducing the HCTZ & the atenolol & continuing to reduce sodium intake
A patient with HTN has been able to maintain a BP of 130/70 for 1 year while reducing dietary sodium & taking hydrochlorothiazide (HCTZ) & atenolol (Tenormin). What treatment plan will the nurse educate the patient about?
Creatinine & Blood Urea Nitrogen (BUN)
A patient with HTN is waking up several times a night to urinate and knows what lab studies may indicate pathologic changes in the kidneys due to HTN?
Clonidine (catapres)
A patient with severe coronary artery disease (CAD) & HTN. What med orders should the nurse consult with the physician about that is contraindicated for a patient with severe CAD?
Hypertensive urgency
A pt with BP of 180/110 finds no evidence of impending or progressive organ damage when performing the assessment of the patient. What situation does the nurse understand this patient is experiencing?
Echocardiography
A pt with long-standing HTN is admitted to the hospital with hypertensive urgency. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement?
Cardiovascular damage
A risk factor assessment is needed to classify & guide the treatment of hypertensive people at risk for?
50%
An estimated what % of patients discontinue their medications within 1 year of beginning to take them?
30%
Approximately what % of adults have hypertension
Cardiac output x peripheral resistance
Blood pressure is the product of what multiplied by what?
Heart rate x stroke volume
Cardiac output is the product of what multiplied by what?
Rebound hypertension
Patients may experience what if antihypertensive meds are suddenly stopped?
130mm Hg
The desired goal for the systolic BP for a person with diabetes or chronic kidney disease is
A high diastolic or low systolic reading
The nurse is assessing the BP for a patient who has HTN & the nurse does not hear an auscultatory gap. What outcome may be documented in this circumstance?
Heart rate, heart rhythm, Character of apical & peripheral pulses
The nurse is performing an assessment on a patient to determine the effects of HTN on the heart and blood vessels. What 4 specific assessment data will assist in determining this complication?
Lowering & controlling the BP w/o adverse effects & w/o undue cost
The nurse is planning the care of a patient admitted to the hospital with HTN. What objective will help to meet the needs of this patient?
Hypertensive emergency & hypertensive urgency
What are the 2 classes of hypertensive crisis that require immediate intervention?
Inderal
What blocks beta adrenergic receptors
Lasix
What blocks reabsorption of sodium and water in kidneys
Aldomet
What displaces norepinephrine from storage sites
Aldactone
What inhibits aldosterone
Tenex
What stimulates alpha2 adrenergic receptors
Corlopam
What stimulates dopamine and alpha2 adrenergic receptors
Papilledema
When performing a focused assessment of the eyes, what does the nurse understand may be observed related to the HTN?