UNIT 5 - CH 31 w rationa
The nurse is teaching a client about recommended follow-up for a person initially diagnosed with prehypertension. What time frame will the nurse advise the client to have the blood pressure (BP) rechecked? 1 year 2 years Confirm within 2 months Evaluate within 1 month
1 year Explanation: A client with an initial BP in the prehypertension range should have another BP check in 1 year. A normal BP should be rechecked in 2 years. Grade 1 hypertension should be confirmed and followed up within 2 months. Grade 2 hypertension should be evaluated or referred to a source of care within 1 month.
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 or 5 servings per day 7 or 8 servings per day 2 or 3 servings per day 2 or fewer servings per day
4 or 5 servings per day Explanation: The client can consume 4 or 5 servings of fruit per day on the DASH diet. The servings for grains and grain product is 7 or 8. Two or 3 servings of low-fat or fat-free dairy foods can be consumed per day. Meat, fish, and poultry servings are 2 or fewer per day.
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 Explanation: Metoprolol is classified as a beta blocker. Beta blockers block beta adrenergic receptors of the sympathetic nervous system, causing vasodilation and decreased cardiac output and heart rate. Metoprolol is not classified as a diuretic, ACE inhibitor, or vasodilator.
Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? Echocardiography Electrocardiography Blood chemistry Blood urea nitrogen
Echocardiography Explanation: An echocardiogram is recommended method of determining whether hypertrophy has occurred. Electrocardiography and blood chemistry are part of the routine workup. Renal damage may be suggested by elevations in blood urea nitrogen and creatinine concentrations.
Which condition(s) indicates target organ damage from untreated/undertreated hypertension? Select all that apply. Heart failure Retinal damage Diabetes Hyperlipidemia Stroke
Heart failure Retinal damage Stroke Target organs include the heart, kidney, brain, and eyes. Hyperlipidemia and diabetes are risk factors for development of hypertension.
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 rate Heart rhythm Character of apical and peripheral pulses During the physical examination, the nurse must also pay specific attention to the rate, rhythm, and character of the apical and peripheral pulses to detect the effects of hypertension on the heart and blood vessels.
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? Hypertensive emergency Hypertensive urgency Primary hypertension Secondary hypertension
Hypertensive emergency Explanation: A hypertensive emergency is a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage. Hypertensive urgency is a situation in which blood pressure is severely elevated but there is no evidence of actual or probable target organ damage. Secondary hypertension is high blood pressure from an identified cause, such as renal disease. Primary hypertension denotes high blood pressure from an unidentified source.
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. Explanation: Normally, in the absence of disease of the vasculature, arm pressures differ by no more than 5 mm Hg. The pressures in each arm do not have to be equal to be considered normal. Pressures that vary more than 10 mm Hg between arms are an abnormal finding. The left arm pressure is not anticipated to be higher than the right as a normal anatomical variant.
Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through: ophthalmic examination. using a sphygmomanometer. laboratory tests. an MRI.
ophthalmic examination. Explanation: Papilledema is an edema of the optic nerves, and thus needs an ophthalmic examination for detection.
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." Explanation: Thiazide diuretics cause loss of sodium, potassium, and magnesium, so the client should be encouraged to eat fruits and vegetables that are high in potassium. Diuretics cause increased urination; the client should not take the medication before going to bed. Thiazide diuretics do not cause dry mouth or nasal congestion; both side effects are associated with alpha2-agonists. Postural hypotension may be potentiated by alcohol.
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 or 5 servings per day 7 or 8 servings per day 2 or 3 servings per day 2 or fewer servings per day
4 or 5 servings per day Explanation: The client can consume 4 or 5 servings of fruit per day on the DASH diet. The servings for grains and grain product is 7 or 8. Two or 3 servings of low-fat or fat-free dairy foods can be consumed per day. Meat, fish, and poultry servings are 2 or fewer per day.
You are teaching a health class at the local YMCA. What body system would you explain regulates arterial blood pressure? Cardiovascular system Immune system Lymphatic system Autonomic nervous system
Correct response: Autonomic nervous system Explanation: The autonomic nervous system, the kidneys, and various endocrine glands regulate arterial pressure. The cardiovascular system, immune system, and lymphatic systems do not regulate arterial blood pressure.
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 Explanation: The autonomic nervous system, the kidneys, and various endocrine glands regulate arterial pressure.
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. Explanation: It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position provide time for the heart to increase its rate of contraction to resupply oxygen to the brain, not blood pressure or heart rate.
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. Explanation: It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position provide time for the heart to increase its rate of contraction to resupply oxygen to the brain, not blood pressure or heart rate.
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?" Explanation: It is important for the nurse to first ascertain why the client is not taking prescribed medications. Adherence to the therapeutic program may be more difficult for older adults. The medication regimen can be difficult to remember, and the expense can be a challenge. Monotherapy (treatment with a single agent), if appropriate, may simplify the medication regimen and make it less expensive. The other questions are appropriate, but the priority is to determine why the medication regimen is not being followed.
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." Explanation: An individual with diabetes mellitus should strive for blood pressure of 120/80 mm Hg or less. An individual without diabetes should strive for blood pressure of 140/90 mm Hg or less.
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." Explanation: Measures that minimize orthostatic hypotension include flexing the calf muscles to boost blood return to the heart, avoiding alcohol and straining at stool, changing positions slowly, eating a high-protein snack at night, wearing elastic stockings, and holding onto a stationary object when rising. Although the client should rest between demanding activities and consume plenty of fluids and fiber (contained in fruits and vegetables) to maintain a balanced diet, these measures don't directly relieve orthostatic hypotension.
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?" Explanation: The nurse must ask whether the client has taken his prescribed clonidine. Clients need to be informed that rebound hypertension can occur if antihypertensive medications are suddenly stopped. Specifically, a side effect of clonidine is rebound or withdrawal hypertension. Although the other questions may be asked, it is most important to inquire whether the client has taken the prescribed hypertension medication given the client's severely elevated BP.
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." Explanation: Hypertension is sometimes called the "silent killer" because people with it are often symptom free. Physical examination may reveal no abnormalities other than elevated blood pressure. People with hypertension may remain asymptomatic for many years. The usual consequences of prolonged, uncontrolled hypertension are myocardial infarction, heart failure, renal failure, strokes, and impaired vision. Pain is not usually an issue, but that is not why hypertension is called the "silent killer." Hypertension is easily diagnosed by taking a series of blood pressure readings.
A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective? "I can still eat a ham-and-cheese sandwich with potato chips for lunch." "I chose broiled chicken with a baked potato for dinner." "I chose a tossed salad with sardines and oil and vinegar dressing for lunch." "I'm glad I can still have chicken bouillon."
"I chose broiled chicken with a baked potato for dinner." Explanation: The client's choice of a baked potato with broiled chicken indicates effective nutrition teaching because potatoes and chicken are relatively low in sodium. Ham, sardines, and bouillon are extremely high in sodium and shouldn't be included in a low-sodium diet.
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." Explanation: To lower blood pressure, a client should limit daily salt intake to 2 g or less. Alcohol intake is associated with a higher incidence of hypertension, poor compliance with treatment, and refractory hypertension. Moderate caffeine and fat intake don't significantly affect blood pressure
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 Explanation: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) specifies a lower goal pressure of 130/80 for people with diabetes mellitus.
A nurse is discussing with a nursing student how to accurately measure blood pressure. What statement by the student indicates an understanding of the education? A cuff that is too small will give a false high blood pressure. A cuff that is too small will give a false low blood pressure. A cuff that is too large will give a false high blood pressure. The size of the cuff does not matter as long as it fits snugly around the arm.
A cuff that is too small will give a false high blood pressure. Explanation: Using a cuff that is too small will give a false high blood pressure measurement, while using a cuff that is too large results in a false low blood pressure measurement.
An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed the client hydrochlorothiazide and enalapril. What will the nurse be sure to include in educating this client? Change positions (lying or sitting to standing) slowly. Check blood pressure every day for signs of rebound hypertension. Do not become dependent on canes, walkers, or handrails. Eat plenty of salty food to prevent hypotension.
Change positions (lying or sitting to standing) slowly. Explanation: Antihypertensive medications can cause hypotension, especially postural hypotension that may result in injury. The nurse teaches clients to change positions slowly when moving from a lying or sitting position to a standing position. Rebound hypertension occurs when antihypertensive medications are stopped abruptly. The nurse also counsels elderly clients to use supportive devices such as handrails and walkers to prevent falls that could result from dizziness. Eating salty foods could defeat the purpose of taking the antihypertensive medications.
The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce? Changing positions slowly related to possible hypotension Eating extra potassium due to loss of potassium related to medications Being sure to keep follow-up appointments Walking as far as the client is able every day
Changing positions slowly related to possible hypotension Explanation: The elderly have impaired cardiovascular reflexes and thus are more sensitive to the extracellular volume depletion caused by diuretics and to the sympathetic inhibition caused by adrenergic antagonists. The nurse teaches clients to change positions slowly when moving from a lying or sitting position to a standing position. This will help prevent falls. Eating extra potassium is not a good idea if taking a potassium-sparing diuretic. The other choices are good teaching points, but not necessarily safety precautions.
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore blood pressure below hypertensive levels? Increase iodine intake Decrease sodium intake Increase fluid intake Avoid over-the-counter decongestants
Decrease sodium intake Explanation: The nurse should instruct clients with prehypertension to avoid or decrease sodium and iodine intake. Increasing fluid intake raises circulating blood volume and systemic vascular resistance. Over-the-counter decongestants decrease pulmonary congestion and not hypertension.
A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have? Secondary Pathologic Malignant Essential (primary)
Essential (primary) Explanation: Essential or primary hypertension, about 95% of cases, is sustained elevated BP with no known cause. This client does not have secondary, pathologic, or malignant hypertension.
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."
Explanation: Instructions for the client regarding measuring the blood pressure at home include the following: (1) Avoid smoking cigarettes or drinking caffeine for 30 minutes before measuring blood pressure. (2) Sit quietly for 5 minutes before the measurement. (3) Have the forearm supported at heart level, with both feet on the ground during the measurement of the blood pressure.
When administering benazepril with spironolactone, the nurse should be aware that which electrolyte imbalance may occur? Hyperkalemia Hypokalemia Hypercalcemia Hypocalcemia
Hyperkalemia Explanation: ACE inhibitors like benazepril (Lotensin) and angiotensin receptor blockers (ARBs) block aldosterone and may cause hyperkalemia when used with a potassium sparing diuretic such as spironolactone (Aldactone). Hypercalcemia and hypocalcemia would not occur as an imbalance.
Which diuretic medication conserves potassium? Furosemide Spironolactone Chlorothiazide Chlorthalidone
Spironolactone Explanation: Spironolactone is known as a potassium-sparing diuretic. Furosemide causes loss of potassium from the body. Chlorothiazide and chlorthalidone cause mild hypokalemia.
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 Decrease in blood volume Increase in calcium intake Decrease in cardiac output
Loss of arterial elasticity Explanation: In older clients, systolic BP may be elevated because of loss of arterial elasticity (arteriosclerosis). Systolic BP would not become elevated by a decrease in blood volume, an increase in calcium intake, or a decrease in cardiac output.
The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension? Reduce smoking to no more than four cigarettes per day Limit aerobic physical activity to 15 minutes, three times per week Stop alcohol intake Maintain adequate dietary intake of fruits and vegetables
Maintain adequate dietary intake of fruits and vegetables Explanation: Guidelines include adopting the Dietary Approaches to Stop Hypertension (DASH) eating plan: consume a diet rich in fruits, vegetables, and low-fat dairy products and reduced amounts of saturated and total fat; reduce dietary sodium intake to no more than 100 mmol/day (2.4 g sodium or 6 g sodium chloride); engage in regular aerobic physical activity such as brisk walking (at least 30 min/day, most days of the week); moderate alcohol consumption, limiting consumption to no more than two drinks (e.g., 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day in most men and to no more than one drink per day in women and lighter-weight people. Tobacco should be avoided because anyone with high blood pressure is already at increased risk for heart disease, and smoking amplifies this risk.
The nurse teaches the client which guideline regarding lifestyle modification for hypertension? Reduce smoking to no more than four cigarettes per day Limit aerobic physical activity to 15 minutes, three times per week Stop alcohol intake Maintain adequate dietary intake of potassium
Maintain adequate dietary intake of potassium Explanation: In general, one serving of a potassium-rich food such as banana, kale, broccoli, or orange juice will meet the daily need for potassium. The client should be guided to stop smoking. The general guideline is to advise the client to increase aerobic activity to 30 to 45 minutes most days of the week. In general, alcohol intake should be limited to no more than 1 oz ethanol/day.
A client with hypertension has a blood pressure of 132/88 mm Hg. For which type of hypertension will the nurse prepare teaching for this client? Elevated Prehypertension Stage 1 hypertension Stage 2 hypertension
Prehypertension Explanation: According to the ACC and the AHA, a blood pressure of 132/88 mm Hg is considered stage 1 hypertension. According to the ACC and the AHA, elevated blood pressure is between 120 and129 mm systolic and less than 80 mm diastolic. The term "prehypertension" is not used in the ACC/AHA classifications. It was used in previous classifications. According to the ACA/AHA, a blood pressure greater than or equal to 160 mm systolic or greater than or equal to 100 mm Hg is classified as stage 2 hypertension.
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. Explanation: Normally, in the absence of any disease of the vasculature, arm pressures differ by no more than 5 mm Hg. The pressures in each arm do not have to be equal to be considered normal. Pressures that vary more than 10 mm Hg between arms are an abnormal finding. The left arm pressure is not anticipated to be higher than the right as a normal anatomic variant.
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 Explanation: Because this client finds visiting the doctor time-consuming just for a BP reading, as the nurse, you can suggest the use of an automatic cuff at a local pharmacy, or purchasing a self-monitoring cuff. Discussing methods to reduce stress, advising smoking cessation, and achieving glycemic control would constitute client education in managing hypertension.
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 Explanation: Symptoms suggesting that hypertension is progressing to the extent that target organ damage is occurring must be detected early so that appropriate treatment can be initiated. All body systems must be assessed to detect any evidence of vascular damage. An eye examination with an ophthalmoscope is important because retinal blood vessel damage indicates similar damage elsewhere in the vascular system. The client is questioned about blurred vision, spots in front of the eyes, and diminished visual acuity. The heart, nervous system, and kidneys are also carefully assessed. A BUN concentration of 12 mg/dL and urine output of 60 mL over 2 hours are normal findings. The presence of pneumonia does not indicate target organ damage.
Which term describes high blood pressure from an identified cause, such as renal disease? Primary hypertension Secondary hypertension Rebound hypertension Hypertensive emergency
Secondary hypertension Explanation: Secondary hypertension is high blood pressure from an identified cause, such as renal disease. Primary hypertension denotes high blood pressure form an unidentified source. Rebound hypertension is pressure that is controlled with therapy and becomes uncontrolled (abnormally high) when that therapy is discontinued. A hypertensive emergency is a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage.
A nurse is teaching a client with severe hypertension about the damage this condition can cause to the body. What system/organs will the nurse note are particularly targeted for damage due to severe hypertension? Sensory Musculoskeletal Gastrointestinal Integumentary
Sensory Explanation: Prolonged elevated blood pressure eventually damages blood vessels throughout the body, particularly in target organs such as the heart, kidneys, brain, and eyes. The usual consequences of prolonged, uncontrolled hypertension are: myocardial infarction, heart failure, renal failure, strokes, and impaired vision.
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 Explanation: Risk factors for cardiovascular problems in clients with hypertension include smoking, dyslipidemia, diabetes mellitus, impaired renal function, obesity, physical inactivity, age, and family history.
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 Explanation: The end goal of hypertension treatment is to prevent complications and death by achieving and maintaining arterial blood pressure at 140/90 or lower for most people. To achieve this end goal, the client is taught to make the following lifestyle changes (these are not end goals; they are ways to reach the end goal listed above): (1) maintaining a normal body mass index (about 24; greater than 25 is considered overweight); maintaining a waist circumference of less than 40 inches for men and 35 inches for women; limiting alcohol intake to no more than 2 drinks for men and 1 drink for women per day; engaging in aerobic activity at least 30 minutes per day most days of the week.
Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. Using a BP cuff that is too large will give a higher BP measurement. The client's BP should be measured 1 hour before consuming alcohol. The client should sit quietly while BP is being measured.
Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured. These statements are all true when measuring a BP. When using a BP cuff that is too large, the reading will be lower than the actual BP. The client should avoid smoking cigarettes or drinking caffeine for 30 minutes before BP is measured.
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 Explanation: The medications of choice in hypertensive emergencies are best managed through the continuous IV infusion of a short-acting titratable antihypertensive agent. The nurse avoids the sublingual and IM routes as their absorption and dynamics are unpredictable. The oral route would not have as quick an onset as a 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. Explanation: Reduced stress decreases the production of neurotransmitters that constrict peripheral arterioles. Reduced stress may assist in reducing blood volume and resistance to the heart.
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 Explanation: Risk factors for atherosclerotic heart disease include hypertension, dyslipidemia (including high total, low-density lipoprotein [LDL], and triglyceride levels as well as low high-density lipoprotein [HDL] levels), obesity, diabetes, a family history of early cardiovascular events, metabolic syndrome, a sedentary lifestyle, and obstructive sleep apnea.
A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include? nonpharmacological interventions pharmacological interventions procedural interventions observation only
nonpharmacological interventions Explanation: Nonpharmacologic interventions are used for clients with prehypertension.
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 Explanation: A stroke occurs if vessels in the brain rupture and bleed. If an aneurysm has developed in the aorta from chronic hypertension, it may burst and cause hemorrhage and shock. Peripheral edema, right-sided heart failure, and pulmonary insufficiency are not usually consequences of untreated chronic hypertension.