Chapter 22 Nursing care of patients with hypertension
The nurse is caring for a group of patients. Which patient should the nurse see first?
A patient receiving atenolol (Tenormin) with a blood pressure of 188/114 mmHg
What is the cause of primary hypertension?
unknown cause
The nurse is teaching a group of patients about hypertension. Which patient is at highest risk for developing hypertension?
A 60-year-old African American female who is 5 foot 7 inches and weighs 275 pounds
The nurse is reviewing complications of hypertension with a patient. Which should the nurse include in the teaching? (Select all that apply.)
Heart failure Stroke Myocardial infarction Kidney Failure
The nurse is caring for a patient with stage 1 hypertension. Which medication should the nurse expect to be prescribed for this patient?
Hydrochlorothiazide(HydroDIURIL)
The nurse is reinforcing teaching for a patient with hypertension. If a patient states, "I understand that if I do not eat or cook with salt, my hypertension will go away." What is the nurse's best response?
"Some patients' blood pressure may not respond to salt restriction alone."
A patient tells the nurse he has started experiencing impotence since beginning treatment for hypertension. Which statement by the nurse is most appropriate?
"I will talk to your doctor and see about referring you for sexual counseling."
The nurse is teaching a patient with hypertension about the DASH diet. Which statement made by the patient indicates a need for further teaching?
"I ate a hamburger with a small order of fries last night."
The nurse is reinforcing teaching provided to a patient who has been taught ways to decrease blood pressure. Which patient statement indicates a need for further teaching?
"I eat fried foods three times a week."
The nurse is teaching a patient about furosemide (Lasix). Which statement made by the patient indicates an understanding of the teaching?
"I should take the medication in the morning so I am not up all night going to the bathroom
A patient asks the nurse what the doctor meant by the phrase, "hypertensive emergency." Which explanation should the nurse provide?
"It refers to an episode of very high blood pressure."
A patient who has unsuccessfully implemented lifestyle modifications for high blood pressure asks what else can be done. What should the nurse respond to this patient?
"Your doctor may discuss medication with you."
The nurse is measuring blood pressures during a screening clinic. Which recommended follow-up time frame should the nurse suggest to a patient for a blood pressure reading of 118/72 mm Hg?
2 years
The nurse is contributing to a teaching session about hypertension. Which patient should the nurse identify as having the greatest risk for hypertension?
A 40-year-old man whose brother has hypertension
The nurse is planning care for a group of patients. Which individual should the nurse identify as being at the highest risk for developing hypertension?
A 56-year-old African American woman
The nurse is caring for a group of patients. Which patient should the nurse see first?
A patient with a blood pressure of 180/120 mm Hg reporting a nosebleed
The nurse becomes concerned that a male patient's blood pressure is 168/98 mm Hg after 6 months on antihypertensive medication. What question should the nurse ask after measuring this blood pressure?
Is the patient taking the medication?
The nurse is preparing to administer furosemide (Lasix) to a patient with hypertension. The nurse reviews the patient's potassium and notes a level of 4.6 mEq/L. Which action should the nurse take?
Administer the medication as prescribed
The nurse is planning care for patients with hypertension. Which ethnic group should the nurse understand is most sensitive to the effects of the beta blocker propranolol (Inderal)?
African Americans
The nurse is caring for a patient with hypertension who is being discharged home with a prescription of propranolol (Inderal). Which topics should the nurse include in the teaching? (Select all that apply.)
Check the heart rate and blood pressure before taking the medication. Get up slowly to avoid dizziness Talk to the doctor before the medication is stopped.
The nurse would include which of these as modifiable risk factors in the patient teaching plan? Select all that apply
Diet Glucose control Weight control
The nurse evaluates the patient as understanding teaching if the patient states hypertension must be managed for which time frame?
Lifelong
The nurse is taking a medication history of a patient with a chronic cough. Which medication can the nurse suspect as contributing to the cough?
Lisinopril (Zestril)
The nurse is assessing a blood pressure of a patient and obtains a reading of 110/60 mm Hg. The nurse knows the patient falls under which category?
Normal blood pressure
The nurse is preparing to administer atenolol (Tenormin) to a patient with hypertension. The patient's blood pressure is 72/40 mm Hg. Which action should the nurse take?
Notify the HCP.
The nurse is contributing to the plan of care for a patient with new onset hypertension who has requested information to manage the hypertension. Which of these nursing diagnoses is appropriate?
Readiness for Enhanced Health Literacy
The nurse is caring for a patient in hypertensive emergency. What should the nurse expect to be the goal when treatment is provided for this patient?
Reduce blood pressure by 25% in 1 hour.
A patient on antihypertensive medication has no insurance, three children, and reports feeling great and exercising daily. What should the nurse include in this patient's teaching plan to promote compliance?
Refer the patient for financial assistance.
The nurse is caring for a patient who has possible kidney damage from high blood pressure. Which action should the nurse take?
Review creatinine level.
What should the nurse include in the patient teaching plan to prevent falls when taking antihypertensive medications? Select all that apply
Sit at bedside when changing positions If dizzy, sit down. Stand up quickly. Request assistance to stand, if history of falls.
The nurse is assessing a patient who has been taking prazosin (Minipress) for 3 months. Which indicates treatment is effective?
The patient's blood pressure is 114/66 mm Hg.
The nurse is reviewing orders for a patient taking digoxin (Lanoxin). Which additional medication should the nurse question?
Verapamil (Calan SR)
The infection control nurse observes a nurse on a cardiac unit. Which actions by the nurse would require intervention by the infection control nurse? (Select all that apply.)
Wipes stethoscope with a soft cloth before each patient use Takes own stethoscope into the room of a patient on contact precautions
