Chapter 47

A patient has had blood pressure of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order:

A thiazide diuretic

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient?

ACE inhibitors.

A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100 mm Hg. After 1 month of drug therapy, the patient's blood pressure is 130/90 mm Hg. The nurse will contact the provider to discuss:

Adding a calcium channel blocker to this patient's drug regimen.

. A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. which statement by the student indicates a need for further teaching?

Beta blockers block the actions of angiotensin II.

A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. She asks whether she should continue taking the medication while she is pregnant What will the nurse tell her?

Discuss using methyldopa instead while she is pregnant.

A patient is taking clonidine for hypertension and resorts having dry mouth and drowsiness. What will the nurse tell the patient?

Drink extra fluids and avoid driving when drowsy.

The nurse is caring for a pregnant patient who is in labor. The women reports having had mild preeclampsia with a pervious pregnancy. The nurse notes that the women has a blood pressure of 168/102mm Hg. The nurse will contact the provider to request an order for which drug?

Hydralazine [Apresoline]

Which two-drug regimen would be appropriate for a patient with hypertension who does not have other compelling conditions?

Hydrochlorothiazide and nadolol

A patient has three separate blood pressure readings of 120/100 mm Hg, 138/92 mm Hg and 126/96 mmHg/ Which category describes this patients BP?

Hypertension

A patient has been taking chlorthalidone to treat hypertension. The patient's prescriber has just ordered the addition of spironolactone to the patient's drug regimen. Which statement by the patient indicates a need for further teaching?

I will need to take potassium supplements when adding this drug.

A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient?

Move slowly from sitting to standing when taking this drug.

. A patient with hypertension with a blood pressure or 168/110 mm Hg begins taking hydrochlorothiazide and verapamil/ The patient returns to the clinic after 2 weeks of drug therapy, and the nurse notes a blood pressure of 140/85 mm Hg and a heart rate of 98 beats per minute. What will the nurse do?

Notify the provider and ask about adding a beta blocker medication.

A hospitalized patient has a BP of 145/96 mm Hg. The nurse caring for this patient notes that the blood pressure readings of 1362/98 mm Hg. The patient reports ambulatory blood pressure readings of 136/98 and 138/92 mm Hg. The patient has a history of a previous myocardial infarction and has adopted a lifestyle that includes use of the DASH diet and regular exercise. What will the nurse do?

Notify the provider and discuss ordering a beta blocker for this patient.

A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg/ What will the nurse do?

Recheck the patient's blood pressure in the other arm.

A 60 years old African American patient has a blood pressure of 120/80 mm Hg and reports a family history of hypertension. The patient has a BMI of 22.3. The patient reports consuming alcohol occasionally. Which therapeutic lifestyle change will the nurse expect to teach this patient?

Sodium restriction.

A patient who does not consume alcohol or nicotine products despots a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and BMI for height and age. The nurse will expect to teach this patient about:

The DASH diet, sodium restriction and exercise.

A nursing student asks the nurse why multi-drug therapy is often used to treat hypertension. Which statement by the student indicates a need for further teaching?

Two or more drugs will lower blood pressure more quickly.

A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching?

When my symptoms subside, I may discontinue the medications.

A 5-year old patient seen in an outpatient clinic is noted to have hypertension on three separate visits. Ambulatory blood pressure monitoring confirms that the child has hypertension. As an initial intervention with the child's parents, the nurse will expect to:

perform a detailed healthy history on the child.