Honan Nursing Management Patients with Hypertension Ch 12

The nurse is performing patient education for a patient who has been prescribed hydrochlorothiazide and metoprolol (Lopressor) for the treatment of hypertension. What teaching point should the nurse emphasize when teaching the patient about this medication regimen? -"It's best not to take aspirin for pain while you're taking your antihypertensives." -"Avoid taking over-the-counter decongestants because they can increase your blood pressure (BP)." -"Most allergy medications can't be taken with BP meds, so make sure to check with your doctor or pharmacist." -"If you get an infection, make sure that your care provider knows you have hypertension before he or she prescribes an antibiotic."

"Avoid taking over-the-counter decongestants because they can increase your blood pressure (BP)."

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? -"Are you having trouble paying for your medications?" -"Can you tell me the reasons you aren't taking your medications?" -"What medications are you prescribed?" -"Are you able to get to your pharmacy to pick up your medications?"

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

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? -"Your blood pressure is fine. Just keep doing what you're doing." -"The current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower." -"The lower the better. Blood pressure of 130/80 mm Hg is best for everyone." -"Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg."

"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? -"Avoid drinking alcohol and straining at stool, and eat a low-protein snack at night." -"Wear elastic stockings, change positions quickly, and hold onto a stationary object when rising." -"Flex your calf muscles, avoid alcohol, and change positions slowly." -"Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily."

"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?" "Do you have a dry mouth or nasal congestion?" "Are you having chest pain or shortness of breath?" "Did you take any medication for your headache?"

"Have you taken your prescribed clonidine today?"

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." What is the best response by the nurse? "Hypertension often causes no symptoms." "Hypertension often kills early in the disease process." "Hypertension often causes no pain." "Hypertension is difficult to diagnose."

"Hypertension often causes no symptoms."

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? -"Take this medication before going to bed." -"Increase the amount of fruits and vegetables you eat." -"You may develop nasal congestion or depression while taking this medication." -"You may drink alcohol while taking this medication."

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

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? -"A glass of red wine each day will lower my blood pressure." -"I should eliminate caffeine from my diet to lower my blood pressure." -"If I include less fat in my diet, I'll lower my blood pressure." -"Limiting my salt intake to 2 grams per day will improve my blood pressure."

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

A newly diagnosed client with hypertension is prescribed a thiazide diuretic. What client education should the nurse provide to this client? -"Eat a banana every day because this medication causes moderate hyperkalemia." -"Take over-the-counter potassium pills because this medication causes your kidneys to lose potassium." -"This medication can cause low blood pressure and dizziness, especially when you get up suddenly." -"This medication increases sodium levels in your blood, so cut down on your salt."

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

The nurse is performing health education-related lifestyle modifications for a patient who has been newly diagnosed with hypertension. As a component of these modifications, the DASH (Dietary Approaches to Stop Hypertension) eating plan has been recommended to the patient. Which of the nurse's recommendations is most congruent with this eating plan? -"Try to buy and consume as many organic and natural foods as you can." -"Try to replace the complex carbohydrates in your diet with protein-rich foods." -"Try to reduce the overall amount of fat that is in your diet." -"If you eat four of five small meals each day, you'll find that you're able to reduce your calorie intake."

"Try to reduce the overall amount of fat that is in your diet."

elevated BP

120-129/<80

Stage 1 HTN

130-139/80-89

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? 160/90 mm Hg or lower 100/80 mm Hg or lower Average of two BP readings of 150/80 mm Hg 130/80 mm Hg or lower

130/80 mm Hg or lower

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? 145/95 or lower 130/80 or lower 150/95 or lower 125/85 or lower

130/80 or lower

The nurse is talking with a patient about her hypertension and her antihypertensive drug therapy. The patient enjoys generally good health apart from her high blood pressure. When assessing the response to an antihypertensive drug regimen what blood pressure would be the goal of treatment? 156/96 mm Hg or lower 140/90 mm Hg or lower Average of 2 BP readings of ≤150/80 mm Hg 120/80 mm Hg or lower

140/90 mm Hg or lower

Hypertensive emergency is defined as adult blood pressure (BP) greater than what? and experiencing symptoms

180/120

Orthostatic hypotension is defined as a decline in systolic blood pressure (SBP) of more than how many mm Hg moving from a supine to a standing position?

20

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% 35% 40% 45%

25%

How long should you avoid caffeine before having your blood pressure (BP) taken?

30 mins

According to the DASH diet, how many servings of vegetables should a person consume each day? 2 or fewer 2 or 3 4 or 5 7 or 8

4 or 5

How much does blood pressure (BP) normally variate between arms?

5mmHg

Stage 2 HTN

>140 or >90

HTN emergency

>180/120 with end organ damage - blurred vision, ALOC, headache, coma, seizure, arrhythmia

The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream? Beta-blocker ACE inhibitor Loop diuretic Calcium channel blocker

ACE inhibitor

HTN medication that reduce vascular resistance

ACE inhibitors: lisinopril ARBs: valsartan BB: metoprolol alpha blockers: prazosin -combo alpha+beta blockers: labetalol vasodilators

After a series of visits to her care provider, a 40-year-old woman has been diagnosed with primary hypertension and metabolic syndrome. In addition to her persistently high blood pressure (BP) readings, what criterion would contribute to the woman's diagnosis of metabolic syndrome? Serum sodium levels of ≥135 mmol/L Abnormal lipid levels Increased serum creatinine and/or blood urea nitrogen (BUN) levels Presence of proteinuria

Abnormal lipid levels

Which of the following conditions would prevent you from using the left limb for a blood pressure reading? Select all that apply. a. DVT in the left limb b. Postbilateral lymph node dissection c. Cast on the right limb d. Arteriovenous (AV) fistula right limb e. Postleft axillary vascular repair

Answer: a, b, e. BP cuffs should never be placed on an extremity with a deep vein thrombosis, grafts, ischemic changes, an arteriovenous (AV) fistula or graft, or breast or axillary surgery (on that side).

A patient is admitted with aortic dissection and hypertensive emergency. On admission, the BP is 240/120. The nurse recognizes which of the following is consistent with current BP management strategies? Select all that apply. -Treatment in the first hour is important to prevent end-organ damage. -In 1 hour, the patient's target SBP should be less than 120 mm Hg. -The blood pressure can be monitored on a medical unit every 15 minutes. -The nurse should anticipate using oral medications for hypertensive emergency. -The nurse should anticipate the administration of a continuous IV infusion of short-acting titratable antihypertensive agent.

Answer: a, b, e. Treatment is needed immediately to prevent end-organ damage with a continuous infusion of a short-acting antihypertensive agent that is titrated according to the BP. Oral medications of fast-acting agents may be recommended for the treatment of hypertensive urgencies. Since this is a case of an aortic dissection, systolic BP should be reduced to less than 120 mm Hg, which is a cardiac surgical emergency if it involves the ascending aorta. Hypertensive emergency requires a critical care unit with continuous BP monitoring.

You are working in a primary care clinic and are evaluating a patient for hypertension. Place the actions in the correct order. a. Inform the patient to not talk during the reading. b. Bring the patient into the room but wait 5 minutes before auscultating the blood pressure. c. Sit the patient in chair with back supported and legs firmly on the floor. d. Record the point on the manometer when you hear the first clear sound that reflects the systolic BP and the point at which the sound disappears (diastolic BP). e.Deflate the cuff pressure 2 mm of Hg per second. f. -Place the cuff no less than 1 in from the antecubital fossa.

Answer: b, c, a, f, e, d. The patient is brought into the room and asked to sit quietly for 5 minutes before the BP measurement is obtained. The patient sits in a chair with their back supported and their feet placed firmly on the floor. The patient is told not to speak during the reading; the cuff is placed ∼1 in above the antecubital space and deflated at 2 mm Hg while the provider listens for the Korotkoff sounds and recorded.

Which of the symptoms below suggest acute end-organ dysfunction seen in hypertensive emergency? Select all that apply. a. Polyuria b. Chest pain c Pulse pressure of 40 mm Hg d. Seizures e. Oliguria

Answer: b, d, e. End-organ damage refers to changes to organs that are dependent on the circulatory system such as the heart, kidneys, brain, and eyes that can result in coronary heart disease/myocardial infarction and heart failure (heart), proteinuria and renal failure (kidneys), vascular and hemorrhagic stroke (brain), retinopathy (eyes); in the vasculature, and atherosclerotic changes in the blood vessels including the development of stenoses and aneurysms. The symptom of chest pain can be related to vascular changes and MI; seizures indicate neurologic impact; oliguria indicates renal dysfunction.

The nurse is teaching a patient about BP self-monitoring. What direction should be included in the plan of care? Select all that apply. a. You may sit or stand when taking your BP. b. Do not eat or drink for at least 2 hours before measuring your BP. c. Make sure the cuff is loose enough to avoid squeezing your arm too tightly. d. Keep your arm at heart level. e. Avoid talking during BP measurement.

Answer: d, e. BP should be measured in the seated position with the patient relaxed and the arm at heart level. It is not necessary to refrain from food or drink for 2 hours; rather, the patient is told to avoid smoking cigarettes or ingesting nicotine, exercising, or drinking caffeine for 30 minutes before BP is measured. The cuff should fit snugly to avoid a false low reading.

A nurse is providing education to a client about monitoring blood pressure readings at home. What reminders will the nurse review with the client? Select all that apply. -Avoid smoking cigarettes for 1 hour prior to taking blood pressure. -Avoid talking during the measurement. -Sit with both feet on the ground during the measurement. -Ensure at least 5 minutes of quiet rest before measurements. -Be sure the forearm is well supported at heart level while taking blood pressure

Avoid talking during the measurement. Sit with both feet on the ground during the measurement. Ensure at least 5 minutes of quiet rest before measurements. Be sure the forearm is well supported at heart level while taking blood pressure

The nurse is administering metoprolol to a client. What type of medication should the nurse educate the client about? Beta blocker Diuretic Angiotensin-converting enzyme (ACE) inhibitor Vasodilator

Beta blocker

An adult patient's blood pressure readings have ranged from 138/92 to 154/100 during the past several weeks. As a result, the patient's nurse practitioner has ordered diagnostic follow-up. Which of the following diagnostic tests should the nurse prioritize when assessing the patient for target organ damage? C-reactive protein (CRP) levels Sodium, chloride, and potassium levels Arterial blood gas (ABG) results Blood urea nitrogen (BUN) and creatinine levels

Blood urea nitrogen (BUN) and creatinine levels

HTN medication that reduce the strength and rate of myocardial contraction

Calcium channel blockers: diltiazem BB: metoprolol

The nurse identifies a nursing diagnosis of Ineffective Health Maintenance related to nonadherence to therapeutic regimen in a client with hypertension who has not been taking their medication as prescribed. When planning this client's care, which outcome would be appropriate? Client takes medication as prescribed and reports any adverse effects. Client's BP remains consistently below 140/90 mm Hg. Client denies signs and symptoms of hypertensive urgency. Client is able to describe modifiable risk factors for hypertension.

Client takes medication as prescribed and reports any adverse effects.

The nurse is providing education to a client newly diagnosed with hypertension. Which outcome would be most appropriate for this client? Client will have no visual disturbances. Client will demonstrate measuring a blood pressure. Client will state two side effects of not taking antihypertensives. Client will lose two pounds within two weeks.

Client will demonstrate measuring a blood pressure.

The nurse is reviewing medications for a client with cardiovascular disease. The client is currently taking an ACE inhibitor for hypertension and takes over-the-counter ibuprofen frequently for pain caused by arthritis. What should the nurse teach this client? -Consider using acetaminophen for pain management instead of ibuprofen. -Nonsteroidal anti-inflammatory drugs (NSAIDs) increase blood flow to the kidneys. -Consider decreasing fluid intake to less than 1,500 mL per day. -Antihypertensive drugs are amplified when taken with nonsteroidal anti-inflammatories.

Consider using acetaminophen for pain management instead of ibuprofen.

HTN medication that decrease the blood volume

Diuretic (thiazide type): hydrochlorothiazide (loop): furosemide(lasix)- potassium wasting K+ sparing (spironolactone)-caution if using an ACE inhibitor too

A client with newly diagnosed hypertension asks how to decrease the risk for related cardiovascular problems. What risk factor is modifiable by the client? Age Impaired renal function Family history Dyslipidemia

Dyslipidemia

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? Echocardiography Electrocardiography Blood chemistry Blood urea nitrogen

Echocardiography

The nurse is teaching a client who is experiencing dizziness to rise slowly from a sitting or lying position. What is the rationale for the teaching? -Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain. -Gradual changes in position help reduce the blood pressure to resupply oxygen to the brain. -Gradual changes in position help reduce the heart's work to resupply oxygen to the brain. -Gradual changes in position provide time for the heart to reduce its rate of contraction to resupply oxygen to the brain.

Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain.

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 Respiratory rate Heart rhythm Character of apical and peripheral pulses Lung sounds

Heart rhythm Character of apical and peripheral pulses heart rate

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 Hypokalemia Hypernatremia Hyponatremia

Hyperkalemia

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

Hyperkalemia

A team of public health nurses are strategizing around a new initiative that will address screening, education, and management of hypertension in residents of the community. Which of the following facts surrounding hypertension should underlie the nurses' design of this health initiative? Many of the pathophysiological effects of hypertension are poorly understood in the health literature. Hypertension is difficult to identify in many of the individuals who are at highest risk of the problem. Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem. Hypertension is among the health problems that are most difficult to treat successfully.

Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem.

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 Hypertensive emergency Primary hypertension Secondary hypertension

Hypertensive urgency

A client is being seen at the clinic on a monthly basis for assessment of blood pressure. The client has been checking blood pressure at home as well and has reported a systolic pressure of 158 and a diastolic pressure of 64. What does the nurse suspect this client is experiencing? Isolated systolic hypertension Secondary hypertension Primary hypertension Hypertensive urgency

Isolated systolic hypertension

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. The taste buds never adapt to decreased salt intake. There is usually no need to change alcohol consumption for clients with hypertension. A person with hypertension should never consume alcohol.

It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient? -Lowering and controlling the blood pressure without adverse effects and without undue cost -Making sure that the patient adheres to the therapeutic medication regimen -Instructing the patient to enter a weight loss program and begin an exercise regimen -Scheduling the patient for all follow-up visits and making phone calls to the home to ensure adherence

Lowering and controlling the blood pressure without adverse effects and without undue cost

The nurse is assessing a patient with severe hypertension. When performing a focused assessment of the eyes, what does the nurse understand may be observed related to the hypertension? Cataracts Glaucoma Retinal detachment Papilledema

Papilledema

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 hypertension and resulting injury Rebound hypertension Sexual dysfunction Postural hypotension and resulting injury

Postural hypertension and resulting injury

A patient comes to the walk-in clinic. While assessing the patient's vital signs, the nurse assesses the patient's blood pressure at 128/89 mm Hg. According to JNC7, how would this patient's blood pressure be classified? Hypertensive Normal Slightly hypertensive Prehypertensive

Prehypertensive

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 Discussing methods for stress reduction Advising smoking cessation Administering glycemic control

Purchasing a self-monitoring BP cuff

The nurse is caring for a client who has just received a diagnosis of hypertension. What lifestyle change(s) should the nurse recommend to the client to decrease the consequences of hypertension? Select all that apply. Restrict salt/sodium. Manage stress effectively. Use smokeless tobacco. Adhere to an exercise plan. Reduce caffeine intake.

Restrict salt/sodium. Manage stress effectively. Adhere to an exercise plan. Reduce caffeine intake.

Which finding indicates that hypertension is progressing to target organ damage? Retinal blood vessel damage Urine output of 60 mL over 2 hours Blood urea nitrogen concentration of 12 mg/dL Chest x-ray showing pneumonia

Retinal blood vessel damage

HTN urgency

Severe (≥ 180/≥ 120 mmHg) hypertension without acute end-organ damage.

The nurse is instructing a client with hypertension. What will the nurse teach the client to do before measuring the blood pressure at home? Select all that apply. Drink a glass of water. Sit quietly for 5 minutes. Do not smoke for 30 minutes. Avoid talking during measurement. Place the forearm at heart level on a firm surface.

Sit quietly for 5 minutes. Do not smoke for 30 minutes. Avoid talking during measurement. Place the forearm at heart level on a firm surface.

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. Gallbladder disease Smoking Diabetes mellitus Physical inactivity Frequent upper respiratory infections

Smoking Diabetes mellitus Physical inactivity

A 40-year-old man newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advice to the patient? Smoking directly causes high blood pressure. Smoking increases the risk of heart disease. Smoking causes obesity, which exacerbates hypertension. Smoking increases cardiac output.

Smoking increases the risk of heart disease.

Which diuretic medication conserves potassium? Furosemide Spironolactone Chlorothiazide Chlorthalidone

Spironolactone

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? -The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. -The incidence and prevalence of hypertension increase with age. -Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. -Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults.

The incidence and prevalence of hypertension increase with age.

The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure? The kidney retains sodium and water. The kidney excretes sodium and water. The kidney retains sodium and excretes water. The kidney retains water and excretes sodium.

The kidney excretes sodium and water.

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 -To prevent complications/death by achieving and maintaining a blood pressure of 145/95 or less -To stop smoking and increase physical activity to 30 minutes/day most days of the week -To lose weight, achieve a body mass index of 24 or less, and to eat a diet rich in fruits and vegetables

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

The nurse is working with a patient who has uncontrolled hypertension. The patient asks the nurse what can happen if his blood pressure is not brought under control. What are potential consequences of uncontrolled hypertension? Select all that apply. Transient ischemic attacks Cerebrovascular accident Retinal hemorrhage Venous insufficiency Right ventricular hypertrophy

Transient ischemic attacks Cerebrovascular accident Retinal hemorrhage

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? -Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker -Maintaining a diet high in dairy to increase protein necessary to prevent organ damage -Use of strategies to prevent falls stemming from orthostatic hypotension -Limiting exercise to avoid injury that can be caused by increased intracranial pressure

Use of strategies to prevent falls stemming from orthostatic hypotension

The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of what? Thyroid gland Adrenal gland Pituitary gland Thymus

adrenal gland

Beta blockers

adrenergic inhibitors that slow HR and reduce myocardial contractility metoprolol

Primary or essential hypertension accounts for about 95% of all hypertension diagnoses with an unknown etiology. Secondary hypertension accompanies specific conditions that create hypertension as a result of tissue damage. Which condition contributes to secondary hypertension? arterial vasoconstriction hepatic function calcium deficit acid-base imbalance

arterial vasoconstriction

HTN complications

blood vessel damage (heart, kidney, brain, eyes) MI HF LV hypertrophy renal failure stroke/TIA impaired vision

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 sublingual intramuscular oral

continuous IV infusion

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress ______________. -increases the production of neurotransmitters that constrict peripheral arterioles. -increases the resistance that the heart must overcome to eject blood. -increases blood volume and improves the potential for greater cardiac output. -decreases the production of neurotransmitters that constrict peripheral arterioles.

decreases the production of neurotransmitters that constrict peripheral arterioles.

When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures _________ must be equal in both arms. may vary 10 mm Hg or more between arms. differ no more than 5 mm Hg between arms. may vary, with the higher pressure found in the left arm.

differ no more than 5 mm Hg between arms.

a community health leader is teaching a group of adults about hypertension. What is a risk factor that the nurse should mention? a. cardiac dysrhythmias b. hyponatremia c. hyperkalemia d. dyslipidemia

dislipidemia

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 persistent cough blurred vision tremor

dizziness

A diabetic client visits a walk-in clinic and asks the nurse to take a blood pressure (BP) reading. The measurements are 150/90 mm Hg. Which of the following would the nurse expect as the treatment to normalize the client's BP? Smoking cessation programs Low-fat diet Daily exercise Drug therapy

drug therapy

your patient has been diagnosed with prehypertension. what would you encourage this patient to do to aid in preventing progression to a hypertensive state? manage stress more effectively exercise routine eat less protein and more vegetables drink more water

exercise

T or F Angiotensin-converting enzyme (ACE) inhibitors may cause hypokalemia.

false

T or F Of the patients with hypertension, 95% have secondary hypertension.

false

T or F One of the criteria used to differentiate prehypertension from hypertension is the absence of characteristic signs and symptoms of high blood pressure

false that is the difference between Hypertensive urgency (no symptoms) and emergency

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? Lung and arteries Heart and blood vessels Brain and sympathetic nervous system Kidneys and autonomic nervous system

heart and blood vessels

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 lowered triglyceride levels active lifestyle family history of early cardiovascular events

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

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

The nurse is discussing aging and the incidence of hypertension with an older adult. What lifestyle change will lower blood pressure for the older adult? Add salt to foods for taste. Exercise once a week. Keep weight stable. Sleep four hours each night.

keep weight stable

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 parasympathetic nervous system limbic system lungs

kidneys

The nurse encourages the client diagnosed with hypertension to rise slowly from a sitting or lying position because gradual changes in position _______ -help reduce the blood pressure to resupply oxygen to the brain. -help reduce the work required by the heart to resupply oxygen to the brain. -provide time for the heart to increase the rate of contraction to resupply oxygen to the brain. -provide time for the heart to reduce the rate of contraction to resupply oxygen to the brain.

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

What term is used to identify the difference between the systolic and diastolic pressure?

pulse pressure

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem? Renal failure Right ventricular hypertrophy Glaucoma Anemia

renal failure

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? Primary Essential Secondary Malignant

secondary

Which term describes high blood pressure from an identified cause, such as renal disease? Primary hypertension Secondary hypertension Rebound hypertension Hypertensive emergency

secondary HTN

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? Use a pillbox to store daily medication. Sit on the edge of the chair and rise slowly. Do not operate a motor vehicle. Take the medication at the same time daily.

sit on the edge of the chair and rise slowly

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize? "Avoid smoking cigarettes for 8 hours prior to taking blood pressure." "Sit quietly for 5 minutes prior to taking blood pressure." "Sit with legs crossed when taking your blood pressure." "Be sure the forearm is well supported above heart level while taking blood pressure."

sit quietly for 5 mins prior to taking blood pressure

The nurse takes the client's blood pressure, and the reading is 161/101 mm Hg. The nurse knows this blood pressure would be classified as which type? Elevated Normal Stage 1 hypertensive Stage 2 hypertensive

stage 2 HTN

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? peripheral edema right-sided heart failure stroke pulmonary insufficiency

stroke

The nurse understands that an overall goal of hypertension management is that _____________. keep the blood pressure low. there is no indication of target organ damage. there is no report of postural hypotension. there are no reports of sexual dysfunction.

there is no indication of target organ damage.

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 be best? "To identify any of the early symptoms of a stroke" "To determine how your blood pressure changes throughout the day" "To see how often you should change your medication dose" "To make sure your health is stable"

to make sure your health is stable

T or F Cigarette smoking is a risk factor for high BP.

true

T or F Hypertension increases with aging.

true

T or F Reducing table salt to about 1 teaspoon per day can reduce systolic blood pressure by 2 to 8 mm Hg.

true

The nurse is discussing the role of lifestyle modifications with a patient who has a diagnosis of primary hypertension. Which of the following lifestyle modifications typically results in the greatest reduction in blood pressure (BP)? Reduction in salt intake Weight loss Vigilant blood pressure monitoring Reduction in alcohol intake

weight loss