Ch31 HTN

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."

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."

According to the DASH diet, how many servings of vegetables should a person consume each day?

4 or 5

Management of hypertension includes three of the following four goals, depending on the primary and secondary causes. Select all that apply. Impairing the synthesis of norepinephrine. Modifying the rate of myocardial contraction. Increasing the force of cardiac output to overcome peripheral resistance. Decreasing renal absorption of sodium.

Impairing the synthesis of norepinephrine. Modifying the rate of myocardial contraction. Decreasing renal absorption of sodium.

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? Renal dysfunction resulting from atherosclerosis Anemia resulting from bone marrow suppression Hyperglycemia resulting from insulin receptor resistance Emphysema related to poor gas exchange

Renal dysfunction resulting from atherosclerosis

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.

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

diagnostic method is recommended to determine whether LV hypertrophy has occurred?

echocardiography

A cuff that is too small will give a false

high blood pressure.

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through:

ophthalmic exam

A nurse educator is providing information to a small group of clients about HTN without comorbidities. What does the nurse explain about the target goals of the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC8)?

150/90 or lower

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

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.

The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if:

systolic BP is between 120 and 139 mm Hg.

A 65-year-old client is beginning medical management of recently diagnosed hypertension. The most important strategy in this client's treatment is reducing: systolic pressure below 150 mm Hg. systolic pressure below 130 mm Hg. diastolic pressure below 90 mm Hg. diastolic pressure below 80 mm Hg.

systolic pressure below 150 mm Hg.

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."

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean BP by up to which% in the first hour?

25%

The nurse is explaining the DASH diet to a client diagnosed with hypertension. The client inquires about how many servings of fruit per day can be consumed on the diet. What is the nurse's best response?

4-5 servings

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension? A client experiencing depression A client diagnosed with kidney disease A client of advanced age A client with excessive alcohol intake

A client diagnosed with kidney disease

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?

ACE inhibitor

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

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? Numbness and weakness in the left arm Nausea and severe headache Chest pain score of 3 (on a scale of 1 to 10) Urine output of 40 mL over the past hour

Numbness and weakness in the left arm

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 hypotension and resulting injury

Which adrenergic inhibitor acts directly on the blood vessels, producing vasodilation? Prazosin Reserpine Propranolol Clonidine

Prazosin

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? Pressures must be equal in both arms. Pressures may vary 10 mm Hg or more between arms. Pressures should not differ more than 5 mm Hg between arms. Pressures may vary, with the higher pressure found in the left arm.

Pressures should not differ more than 5 mm Hg between arms.

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.

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

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

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

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

It is important for the nurse to encourage the client 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.

A client is brought to the ER with reports of a bad HA and an increase in PB. The BP reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?

reduce BP by 20-25% w/in first hour of treatment