ch33 hypertension

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more diagnostic testing may be needed to determine the cause of the hypertension.

A 52-year-old patient who has no previous history of hypertension or other health problems suddenly develops a BP of 188/106 mm Hg. After reconfirming the BP, it is appropriate for the nurse to tell the patient that

Tell the patient how to self-monitor and record BPs at home.

A patient has been diagnosed with possible white coat hypertension. Which action will the nurse plan to take next?

Change position slowly to help prevent dizziness and falls.

A patient has just been diagnosed with hypertension and has a new prescription for captopril (Capoten). Which information is important to include when teaching the patient?

asthma.

A patient is diagnosed with hypertension and nadolol (Corgard) is prescribed. The nurse should consult with the health care provider before giving this medication upon finding a history of

Have you been consistently taking your medications?

A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and has a BP of 240/118 mm Hg. Which question should the nurse ask first?

Ask the patient to request assistance when getting out of bed

After giving a patient the initial dose of oral labetalol (Normodyne) for treatment of hypertension, which action should the nurse take?

The patient has a glass of low-fat milk with each meal.

After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented, which diet choice indicates that the teaching has been effective?

The patient has developed wheezes throughout the lung fields

During change-of-shift report, the nurse obtains this information about a hypertensive patient who received the first dose of propranolol (Inderal) during the previous shift. Which information indicates that the patient needs immediate intervention?

Set up the automatic blood pressure machine to take BP every 15 minutes.

The RN is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside (Nipride). Which of the following nursing actions can the nurse delegate to an experienced LPN/LVN?

increase the dietary intake of high-potassium foods

The charge nurse observes a new RN doing discharge teaching for a hypertensive patient who has a new prescription for enalapril (Vasotec). The charge nurse will need to intervene if the new RN tells the patient to

"I won't worry if I have a little swelling around my lips and face."

The nurse has just finished teaching a hypertensive patient about the newly prescribed quinapril (Accupril). Which patient statement indicates that more teaching is needed?

43-year-old with a BP of 190/102 who is complaining of chest pain

The nurse in the emergency department received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?

The patient is unable to move the left arm and leg when asked to do so.

The nurse is assessing a patient who has been admitted to the intensive care unit (ICU) with a hypertensive emergency. Which finding is most important to report to the health care provider?

Serum creatinine of 2.6 mg/dL

The nurse is reviewing the laboratory tests for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

No regular aerobic exercise

The nurse obtains this information from a patient with prehypertension. Which finding is most important to address with the patient?

Question the patient about whether the medication is actually being taken.

When a patient with hypertension who has a new prescription for atenolol (Tenormin) returns to the health clinic after 2 weeks for a follow-up visit, the BP is unchanged from the previous visit. Which action should the nurse take first?

128/76 mm Hg

Which BP finding by the nurse indicates that no changes in therapy are needed for a patient with stage 1 hypertension who has a history of heart failure?

Use an automated noninvasive blood pressure machine to obtain frequent BP measurements

Which action will be included in the plan of care when the nurse is caring for a patient who is receiving sodium nitroprusside (Nipride) to treat a hypertensive emergency?

Have the patient sit in a chair with the feet flat on the floor.

Which action will the nurse in the hypertension clinic take in order to obtain an accurate baseline blood pressure (BP) for a new patient?

Blood potassium level of 3.0 mEq/L

Which assessment finding for a patient who is receiving furosemide (Lasix) to treat stage 2 hypertension is most important to report to the health care provider?

Hypertension is usually asymptomatic until significant organ damage occurs.

Which information should the nurse include when teaching a patient with newly diagnosed hypertension?

Have the patient record dietary intake for 3 days

Which nursing action should the nurse take first in order to assist a patient with newly diagnosed stage 1 hypertension in making needed dietary changes?


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