Brunner Ch. 31- Assessment and Management of Patients with Hypertension

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. 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 55-year-old man newly diagnosed with hypertension returns to his physician's office for a routine follow-up appointment after several months of treatment with Lopressor (metoprolol). During the nurse's initial assessment the patient's blood pressure (BP) is recorded as 180/90 mm Hg. The patient states he does not take his medication as prescribed. The best response by the nurse is which of the following?

"The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?"

A nurse is discussing with a nursing student how to accurately measure blood pressure. Which of the following points does the nurse emphasize?

A cuff that is too small will give a false high blood pressure.

A female client, aged 82 years, visits the clinic for a blood pressure (BP) check. Her hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about her blood pressure medicine?

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

Which of the following conditions contributes to secondary hypertension?

Arterial vasoconstriction

The nurse is administering the morning mediations to a patient on the cardiac telemetry unit. Atenolol has been prescribed for this patient. Prior to administration, the nurse would tell the patient that the medication is which type of antihypertensive?

Beta blocker

The treatment goal for those with stage 2 hypertension (hypertension with compelling indications or complications) includes lifestyle modifications and multiple drug therapies. Thiazide diuretics are part of this treatment approach for most complications except for:

Chronic kidney disease

You are doing the final checklist before sending home a 63-year-old female who has been newly diagnosed with hypertension. She is going to be starting her first antihypertensive medicine. What is one of the main things you should tell her and her husband to watch for?

Dizziness

Which diagnostic is the recommended method of determining whether left ventricular hypertrophy has occurred?

Echocardiogram

Which of the following diagnostic tests may reveal an enlarged left ventricle?

Echocardiography

A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best?

Green pepper stuffed with diced tomatoes and chicken

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

The nurse understands that patient education related to antihypertensive medication should include all of the following instructions except which of the following?

If a dosage of medication is missed, double up on the next one to catch up

A patient is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The patient's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV Nitropress (nitroprusside). Upon assessment, which of the following patient findings requires immediate intervention by the nurse?

Left arm numbness and weakness

The nurse is caring for an 82-year-old male 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

A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern?

Rebound hypertension

The nurse is caring for a client newly diagnosed with secondary hypertension. Which of the following conditions contributes to the development of secondary hypertension?

Renal disease

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

Renal dysfunction resulting from atherosclerosis

According to the classification of hypertension diagnosed in the older adult, hypertension that can be attributed to an underlying cause is termed:

Secondary

Hypertension that can be attributed to an underlying cause is termed which of the following?

Secondary

You are part of a group of nursing students who are making a presentation on chronic hypertension. What is one subject you would need to include in your presentation as a possible consequence of untreated chronic hypertension?

Stroke

The nurse is seeing a client for the first time and has just checked the client's blood pressure. For what value would the nurse consider the client prehypertensive?

Systolic BP is between 120 and 130 mm Hg.

Lifestyle modifications are recommended to prevent and manage hypertension. Select the modification that has been found to have the greatest effect in reducing blood pressure measurements.

Weight reduction

A blood pressure of 140/90 mm Hg is considered to be:

hypertension

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

• Smoking • Physical inactivity • Diabetes mellitus