Med Surg: Patients with HTN
What maximum blood pressure should a patient with DM strive for?
130/80 or less
Stage 1 hypertension is demonstrated by a systolic pressure of ____ to ____, or a diastolic pressure of _____ to _____
140 to 159, 90 to 99
What maxium blood pressure should a patient without DM strive for?
140/90 or less
To lower blood pressure, a patient should limit daily salt intake to __ g or less.
2
According to the DASH diet, you should consume how many servings of low-fat or fat-free dairy foods per day?
2 or 3
A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by up to which percentage in the first hour? 25% 35% 40% 45%
25% The therapeutic goals are reduction of the mean BP by up to 25% within the first hour of treatment, a further reduction to a goal pressure of about 160/100 mm Hg over a period of 2 to 6 hours, and then a more gradual reduction in pressure to the target goal over a period of days.
According to the DASH diet, you should consume how many servings of fruit per day?
4 or 5
According to the DASH diet, you should consume how many servings of grains and grain products per day?
7 or 8
Which ethnic population has the highest risk for development of HTN?
African
What are catecholamines?
Catecholamines are hormones made by your adrenal glands, which are located on top of your kidneys. Examples include dopamine; norepinephrine; and epinephrine (this used to be called adrenalin or adrenaline). Your adrenal glands send catecholamines into your blood when you're physically or emotionally stressed.
Spironolactone is known as a...
Potassium-sparing diuretic
How might OTC decongestants affect your BP?
They can increase your BP
What is arteriosclerosis?
Hardening or thickening of the arterial walls, typically occurring in old age
A systolic blood pressure of 135 mm Hg would be classified as
Prehypertension A systolic blood pressure of 135 mm Hg is classified as prehypertension. A systolic BP less than 120 mm Hg is normal. A systolic BP of 140 to 159 mm Hg is stage I hypertension. A systolic BP greater than or equal to 160 is classified as stage 2 hypertension.
What type of high blood pressure is from an identified cause; such as renal disease?
Secondary HTN
A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? -It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. -The taste buds never adapt to decreased salt intake. -There is usually no need to change alcohol consumption for clients with hypertension. -A person with hypertension should never consume alcohol.
It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.
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 are measures that minimize...
Orthostatic hypotension
___________ hypertension is elevated BP that results from or is secondary to some other disorder.
Secondary
According to the DASH diet, you should consume how many servings of Meat, fish, and poultry per day?
2 or fewer
What type of Diuretic is Amiloride (Midamor)?
A potassium-sparing diuretic; meaning that it causes potassium retention.
What is Papilledema?
An edema of the optic nerves, and thus needs an ophthalmic examination for detection. Common symptom of HTN
The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following? The thyroid gland The adrenal gland The pituitary gland The thymus
The Adrenal Gland The 24-hour urine collection specimen is ordered to determine dysfunction of the adrenal gland. The 24-hour urine detects elevated catecholamines. The other options are not evaluated by a 24-hour urine.
What is the Loop of Henle and what does it do?
The part of a kidney tubule which forms a long loop in the medulla of the kidney, from which water and salts are re-adsorbed into the blood.
Severe headache, epistaxis, and anxiety are associated with Hypertensive _______
Urgency
The nurse is performing patient education for a patient who has been prescribed hydrochlorothiazide and metoprolol (Lopressor) for the treatment of hypertension. What teaching point should the nurse emphasize when teaching the patient about this medication regimen? "It's best not to take aspirin for pain while you're taking your antihypertensives." "Avoid taking over-the-counter decongestants because they can increase your blood pressure (BP)." "Most allergy medications can't be taken with BP meds, so make sure to check with your doctor or pharmacist." "If you get an infection, make sure that your care provider knows you have hypertension before he or she prescribes an antibiotic."
"Avoid taking over-the-counter decongestants because they can increase your blood pressure (BP)." Patients should be cautioned to avoid over-the-counter medications, especially nasal decongestants containing vasoconstrictors, which can further elevate BP. Aspirin, antibiotics, and antihistamines are not necessarily contraindicated in patients being treated for hypertension.
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?" 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 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."
"Sit quietly for 5 minutes prior to taking blood pressure." Instructions for the client regarding measuring the blood pressure at home include the following: (1) Avoid smoking cigarettes or drinking caffiene 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.
At least three of which symptoms must be present for Metabolic Syndrome; or Syndrome X?
-BP elevation greater than 130/85 -Insulin resistance -Dyslipidemia Abdominal obesity (Waist circumference: >40 in men, >35 in women)
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 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.
Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period. 140, 90 130, 80 110, 60 120, 70
140, 90
Avoid smoking cigarettes or drinking caffeine for _______ before measuring blood pressure
30 minutes
About ____% of the adults in the United States have hypertension.
32.6
According to the DASH diet, how many servings of vegetables should a person consume each day?
4 or 5 Four or five servings of vegetables are recommended in the DASH diet. The diet recommends two or fewer servings of lean meat, fish, and poultry; two or three servings of low-fat or fat-free dairy foods; and seven or eight servings of grains and grain products.
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/day 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.
What could using a blood pressure cuff that is too small result in?
A false high blood pressure measurement
What could using a blood pressure cuff that is too large result in?
A false low blood pressure measurement
What is pheochromocytoma?
A tumor of the adrenal medulla
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? Beta-blocker ACE inhibitor Loop diuretic Calcium channel blocker
ACE Inhibitor The angiotensin-converting enzyme (ACE) inhibitor's primary action is to prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstricting hormone in the blood. A beta-blocker blocks the beta-adrenergic receptors decreasing sympathetic nervous system stimulation. Loop diuretics excrete water from the loop of Henle, reducing circulating blood volume. Calcium channel blockers dilate coronary and peripheral arteries.
Nadolol is an example of what type of medication?
Beta-blocker
What is a beta-blocker's primary action?
Blocks the beta-adrenergic receptors decreasing sympathetic nervous system stimulation.
An adult patient's blood pressure readings have ranged from 138/92 to 154/100 during the past several weeks. As a result, the patient's nurse practitioner has ordered diagnostic follow-up. Which of the following diagnostic tests should the nurse prioritize when assessing the patient for target organ damage? -C-reactive protein (CRP) levels -Sodium, chloride, and potassium levels -Arterial blood gas (ABG) results -Blood urea nitrogen (BUN) and creatinine levels
Blood urea nitrogen (BUN) and creatinine levels Nephropathy is a common consequence of hypertension; this problem would be manifested by increased BUN and creatinine levels. Electrolyte levels are also assessed, but these are less sensitive and specific to target organ damage. Abnormal ABGs and CRP levels are not common indicators of target organ damage.
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 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.
The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should -Check the client's heart rate. -Check the client's serum K+ level. -Check the client's urine output. -Weigh the client.
Check the client's heart rate Nadolol is a beta-blocker. A desired effect of this medication is to reduce the pulse rate in clients with tachycardia and elevated blood pressure (BP). The nurse should check the client's heart rate (HR) before administering nadolol to ensure that the pulse is not less than 60 beats per minute. The other interventions are not indicated before administering a beta-blocker medication.
A client has severe coronary artery disease (CAD) and hypertension. Which medication order should the nurse consult with the health care provider about that is contraindicated for a client with severe CAD? Clonidine Amiloride Bumetanide Methyldopa
Clonidine Clonidine (Catapres) is contraindicated for clients with severe coronary artery disease.
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 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.
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. Coronary artery disease Myocardial infarction Pancreatitis Tension pneumothorax Stroke
Coronary artery disease Myocardial infarction Stroke People with hypertension may remain asymptomatic for many years. When specific signs and symptoms appear, however, they usually indicate vascular damage. Coronary artery disease with angina and myocardial infarction are common consequences of hypertension. Cerebrovascular involvement may lead to a stroke. Tension pneumothorax and pancreatitis are not directly related to hypertension.
What is the Calcium Channel Blocker's primary action?
Dilate coronary and peripheral arteries.
What is the recommended diagnostic method for determining whether left ventricular hypertrophy has occurred?
Echocardiography
Myocardial infarction, intracranial hemorrhage, or dissecting aortic aneurysm are associated with Hypertensive _________
Emergency
________ or ________ hypertension, about 95% of cases, is sustained elevated BP with no known cause.
Essential, primary
What is the Loop Diurectic's primary action?
Excrete water from the loop of Henle, reducing circulating blood volume.
The nurse is teaching a client who is experiencing dizziness to rise slowly from a sitting or lying position. What is the rationale for the teaching? -Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain. -Gradual changes in position help reduce the blood pressure to resupply oxygen to the brain. -Gradual changes in position help reduce the heart's work to resupply oxygen to the brain. -Gradual changes in position provide time for the heart to reduce its rate of contraction to resupply oxygen to the brain.
Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain. It is important for the nurse to encourage the patient 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. Blood pressure and heart rate do not affect this process.
What is the situation called when blood pressure is severely elevated and there is evidence of actual or probable target organ damage?
Hyertensive emergency
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 -Hypokalemia -Hypernatremia -Hyponatremia
Hyperkalemia Potassium-sparing diuretics, such as spironolactone, can cause hyperkalemia, especially if given with an ACE inhibitor. Signs of hyperkalemia are nausea, diarrhea, abdominal cramps, and peaked narrow T-waves.
A blood pressure (BP) of 140/90 mm Hg is considered to be...
Hypertension A BP of 140/90 mm Hg or higher is hypertension. A blood pressure less than 120/80 mm Hg is considered normal. A BP of 120 to 139/80 to 89 mm Hg is prehypertension. Hypertensive emergency is a situation in which BP is severely elevated and there is evidence of actual or probable target organ damage.
A team of public health nurses are strategizing around a new initiative that will address screening, education, and management of hypertension in residents of the community. Which of the following facts surrounding hypertension should underlie the nurses' design of this health initiative? -Many of the pathophysiological effects of hypertension are poorly understood in the health literature. -Hypertension is difficult to identify in many of the individuals who are at highest risk of the problem. -Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem. -Hypertension is among the health problems that are most difficult to treat successfully.
Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem. Many of the deleterious effects of hypertension are due to the fact that the problem is grossly undermanaged. The negative consequences of hypertension are not primarily due to a lack of scientific understanding, difficulty in diagnosis, or a lack of treatment options.
How is Nephropathy manifested?
Increased BUN and Creatinine levels
Which of the following would be inconsistent with a hypertensive urgency? Intracranial hemorrhage Severe headache Epistaxis Anxiety
Intracranial hemorrhage Elevated blood pressure in hypertensive urgency is associated with severe headache, epistaxis, and anxiety. An example of a hypertensive emergency is a myocardial infarction, intracranial hemorrhage, or dissecting aortic aneurysm.
A client is being seen at the clinic on a monthly basis for assessment of blood pressure. The client has been checking blood pressure at home as well and has reported a systolic pressure of 158 and a diastolic pressure of 64. What does the nurse suspect this client is experiencing? -Isolated systolic hypertension -Secondary hypertension -Primary hypertension -Hypertensive urgency
Isolated systolic hypertension As a result of changes that occur with aging, the aorta and large arteries are less able to accommodate the volume of blood pumped out by the heart (stroke volume), and the energy that would have stretched the vessels instead elevates the systolic blood pressure, resulting in an elevated systolic pressure without a change in diastolic pressure. This condition, known as isolated systolic hypertension, is more common in older adults and is associated with significant cardiovascular and cerebrovascular morbidity and mortality (Chobanian et al., 2003).
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
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 Hypertensive emergencies are acute, life-threatening BP elevations that require prompt treatment in an intensive care setting because of the serious target organ damage that may occur. The finding of numbness and weakness in left arm may indicate the client is experiencing neurological symptoms associated with an ischemic stroke because of the severely elevated BP; immediate intervention is required. Urine output of 40 mL/h is within normal limits. The other findings are likely caused by the hypertension and require intervention, but they do not require action as urgently as the neurologic changes.
The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension? Pheochromocytoma Wilms' tumor Astrocytoma Lymphoma
Pheochromocytoma Predisposing conditions include kidney disease, pheochromocytoma (a tumor of the adrenal medulla), hyperaldosteronism (increased secretion of mineralcorticoid by the adrenal cortex), atherosclerosis, use of cocaine or other cardiac stimulants (e.g., weight-control drugs, caffeine), and use of oral contraceptives. Wilms' tumors, astrocytomas, and lymphomas are not predisposing conditions for secondary hypertension.
Diuretics such are Furosemide, Chlorothiazide, and Chlorthalidone may cause a loss of...
Potassium (Hypokalemia)
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? Magnesium level Potassium level Calcium level Sodium level
Potassium level Amiloride (Midamor) is a potassium-sparing diuretic, meaning that it causes potassium retention. The nurse should monitor for hyperkalemia (elevated potassium level) if given with an ACE inhibitor, such as lisinopril (Zestril) or angiotensin receptor blocker.
The nurse is completing a cardiac assessment on a client. The patient has a blood pressure (BP) reading of 126/80. What would the nurse would identify this blood pressure reading as? -Prehypertension -Normal -Stage 1 hypertension -Stage 2 hypertension
Prehypertension
The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as -Normal. -Prehypertension. -Stage 1 hypertension. -Stage 2 hypertension.
Prehypertension A systolic blood pressure of 135 mm Hg is classified as prehypertension. A systolic BP less than 120 mm Hg is normal. A systolic BP of 140 to 159 mm Hg is stage I hypertension. A systolic BP greater than or equal to 160 is classified as stage II hypertension.
A patient comes to the walk-in clinic. While assessing the patient's vital signs, the nurse assesses the patient's blood pressure at 128/89 mm Hg. According to JNC7, how would this patient's blood pressure be classified? -Hypertensive -Normal -Slightly hypertensive -Prehypertensive
Prehypertensive JNC7 defines a blood pressure of less than 120/80 mm Hg diastolic as normal, 120 to 129/80 to 89 mm Hg as prehypertension, and 140/90 mm Hg or higher as hypertensive.
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. 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.
What type of high blood pressure is from an unidentified source?
Primary HTN
What type of HTN is pressure that is controlled with therapy and becomes uncontrolled (Abnormally high) when that therapy is discontinued?
Rebound HTN
A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure? Reduce the blood pressure by 20% to 25% within the first hour of treatment. Reduce the blood pressure to about 140/80 mm Hg. Rapidly reduce the blood pressure so the client will not suffer a stroke. Reduce the blood pressure by 50% within the first hour of treatment.
Reduce the blood pressure by 20% to 25% within the first hour of treatment. A hypertensive emergency is a situation in which blood pressures are extremely elevated and must be lowered immediately (not necessarily to less than 140/90 mm Hg) to halt or prevent damage to the target organs (Chobanian et al., 2003; Rodriguez et al., 2010). Hypertensive emergencies are acute, life-threatening blood pressure elevations that require prompt treatment in an intensive care setting because of the serious target organ damage that may occur. The therapeutic goals are reduction of the mean blood pressure by 20% to 25% within the first hour of treatment, a further reduction to a goal pressure of about 160/100 mm Hg over a period of up to 6 hours, and then a more gradual reduction in pressure over a period of days.
A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem? -Renal failure -Right ventricular hypertrophy -Glaucoma -Anemia
Renal failure When uncontrolled hypertension is prolonged, it can result in renal failure, myocardial infarction, stroke, impaired vision, left ventricular hypertrophy, and cardiac failure. Glaucoma and anemia are not associated with hypertension.
A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem? Renal failure Right ventricular hypertrophy Glaucoma Anemia
Renal failure When uncontrolled hypertension is prolonged, it can result in renal failure, myocardial infarction, stroke, impaired vision, left ventricular hypertrophy, and cardiac failure. Glaucoma and anemia are not associated with 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 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.
A 40-year-old man newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advice to the patient? -Smoking directly causes high blood pressure. -Smoking increases the risk of heart disease. -Smoking causes obesity, which exacerbates hypertension. -Smoking increases cardiac output.
Smoking increases the risk of heart disease. Smoking does not cause high blood pressure, but it does increase the risk for heart disease. A patient with hypertension is already at an increased risk of heart disease. Smoking does not directly cause obesity and it does not increase cardiac output.
Risk factors for cardiovascular problems in clients with hypertension include...
Smoking, dyslipidemia, diabetes mellitus, impaired renal function, obesity, physical inactivity, age, and family history.
The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium? Furosemide Spironolactone Chlorothiazide Chlorthalidone
Spironolactone
Which diuretic medication conserves potassium? Furosemide Spironolactone Chlorothiazide Chlorthalidone
Spironolactone Spironolactone is known as a potassium-sparing diuretic. Furosemide causes loss of potassium from the body. Chlorothiazide and chlorthalidone cause mild hypokalemia.
A diastolic blood pressure of 90 mm Hg is classified as Normal. Prehypertension. Stage 1 hypertension. Stage 2 hypertension.
Stage 1 Hypertension
The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help? -Increasing fluids for low blood pressure -Stress reduction to lower prehypertensive state -Use of beta-blockers for treatment of hypertension -Diagnostic testing for determining cardiac functioning
Stress reduction to lower prehypertensive state A blood pressure of 124/84 mm Hg is now considered to be in the lower range of prehypertension. Knowledge of stress reduction may be helpful in lowering the blood pressure without medication therapy. A blood pressure of 124/84 mm Hg is not considered a low blood pressure or in need of medication therapy due to hypertension. Diagnostic testing for cardiac functioning is not typical for a client with prehypertension.
What medication are patients with hypertension, unable to be lowered by lifestyle changes, usually placed on first?
Thiazide diuretic
The nurse is obtaining a healthy history from a client with blood pressure of 146/88 mm Hg. The client states that lifestyle changes have not been effective in lowering the blood pressure. Which medication classification does the nurse anticipate first? ACE inhibitors Beta-blocker Thiazide diuretic Calcium channel blocker
Thiazide diuretic Clients with hypertension, unable to be lowered by lifestyle changes, usually are placed on a thiazide diuretic initially. However, most people with hypertension will need two or more antihypertensive medications to reduce their blood pressure.
What is the Angiotensin-converting enzyme (ACE) Inhibitor's primary action?
To prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstricting hormone in the blood.
What are some recommendations you could make as a Nurse to a client questioning lifestyle modifications to prevent and manage HTN?
Weight reduction, adoption of the DASH diet, reduction of dietary sodium, physical activity, and moderation of alcohol consumption