Chapter 31- Assessment and Management of Patients with hypertension
A risk factor assessment, as advocated by the Seventh Report of the Joint National Committee on Prevention, Detection Evaluation and Treatment of High Blood Pressure, is needed to classify and guide the treatment of hypertensive people at risk for ___________.
A risk factor assessment, as advocated by the Seventh Report of the Joint National Committee on Prevention, Detection Evaluation and Treatment of High Blood Pressure, is needed to classify and guide the treatment of hypertensive people at risk for cardiovascular damage.
The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient? A. lowering and controlling the blood pressure without adverse effect and without undue cost b. making sure that the patient adheres to the therapeutic medication regime. c. instructing the patient to enter a weight loss program and begin an exercise regimen d. scheduling the patient for all follow- up visits and making phone calls to the home to ensure adherence
A. lowering and controlling the blood pressure without adverse effect and without undue cost
Approximately _________ % of adults have hypertension.
Approximately 30% of adults have hypertension.
As estimated ________ % of patients discontinue their medication within 1 year of beginning to take them.
As estimated 50% of patients discontinue their medication within 1 year of beginning to take them.
Blood pressure is the product of _____________ multiplied by________________.
Blood pressure is the product of cardiac output multiplied by peripheral resistance.
Cardiac output is the product of_____________ multiplied by___________________
Cardiac output is the product of heart rate multiplied by stroke volume
Patients may experience __________ if antihypertensive medications are suddenly stopped.
Patients may experience rebound hypertension if antihypertensive medications are suddenly stopped.
A patient has sever coronary artery diseases (CAD) and hypertension. Which medication prescription should the nurse consult with the healtcare provider about that is contraindicated for a patient with severe CAD? a. Clonidine b. Amiloride c. Bumetanide d. Methyldopa
a. Clonidine
A patient with hypertension is waking up several times a night to urinate. what laboratory studies should the nurse assess that may indicate pathologic changes in the kidneys due to hypertension? SATA a. Creatinine b. BUN c. CBC d. urine for culture and sensitivity e. AST and ALT
a. Creatinine b. BUN
A patient has severe coronary artery disease (CAD) and hypertension. Which medication prescription should the nurse consult with the healthcare provider about that is contraindicated for a patient with severe CAD? a. clonidine b. amiloride c. Bumetanide d. methyldope
a. clonidine
A patient with hypertension is waking up several times a night to urinate. What laboratory studies should the nurse assess that may indicate pathologic changes in the kidneys due to the hypertension (SATA) a. creatinine b. Blood urea nitrogen (BUN) c. complete blood count (CBC) d. urine culture and sensitivity e. AST and ALT
a. creatinine b. Blood urea nitrogen (BUN)
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? SATA a. heart rate b. respiratory rate c. heart rhythm d. character of apical and peripheral pulses e. lungs sounds
a. heart rate c. heart rhythm d. character of apical and peripheral pulses
A patient is being seen at the clinic on a monthly basis for assessment of blood pressure. the patient 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 patient is experiencing? a. isolated systolic hypertension b. secondary hypertension c. primary hypertension d. hypertensive urgency
a. isolated systolic hypertension
A patient is being seen at the clinic on a monthly basis for assessment of blood pressure. the patient 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 patient is experiencing? a. isolated systolic hypertension b. secondary hypertension c. primary hypertension d. hypertensive urgency
a. isolated systolic hypertension
A nurse is providing teaching for a client who has a new diagnosis of hypertension and a new prescription for spironolactone 25 mg/day. which of the following statements by the client indicates an understanding of the teaching? a. "i should eat a lot of fruits and vegetables, especially bananas and potatoes." b. " i will report any changes in heart rate to my provider." c. "i should replace the salt shaker on my table with a salt substitute" d. " i will decrease the dose of this medication when i no longer have headaches and facial redness.
b. " i will report any changes in heart rate to my provider."
A patient has been diagnosed with hypertension and has been encouraged to exercise regularly and begin a weight loss program. After what period of time does the nurse inform the patient to return for a follow-up visit? a. 2 months b. 6 months c. 1 year d. 2 years
c. 1 year
A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. After what period of time does the nurse inform the patient to return for a follow-up visit? a. 2 months b. 6 months c. 1 year d. 2 years
c. 1 year
A patient with hypertension has been able to maintain a blood pressure of 130/ 70 mm Hg for 1 year while reducing dietary sodium and taking hydrochlorothiazide and atenolol. What treatment plan will the nurse educate the patient about? a. continuing the medication and reducing dietary sodium b. discontinuing the hydrochlorothiazide and atenolol and continuing to reduce sodium intake c. Gradually reducing the hydrochlorothiazide and the atenolol an continuing to sodium intake d. Gradually reducing the atenolol and continuing the hydrochlorothiazide.
c. Gradually reducing the hydrochlorothiazide and the atenolol an continuing to sodium intake
______________ and __________ are the two classes of hypertensive crisis that require immediate intervention.
hypertensive emergency and hypertensive urgency are the two classes of hypertensive crisis that require immediate intervention.
the desired goal for the systolic blood pressure for a person with diabetes or chronic kidney disease is ______________.
the desired goal for the systolic blood pressure for a person with diabetes or chronic kidney disease is 130 mmg Hg
A patient is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the patient is taking these two medications together? a. Magnesium level b. potassium level c. calcium level d. sodium level
b. potassium level
A patient is taking amiloride and lisinopril treatment of hypertension. What laboratory studies should the nurse monitor while the patient is taking these two medications together? a. Magnesium level b. potassium level c. calcium level d. sodium level
b. potassium level
A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage has been stolen. If the patient cannot take the medication, what condition becomes a concern? a. isolated systolic hypertension b. rebound hypertension c. angina d. left ventricular hypertrophy
b. rebound hypertension
The nurse is assessing the blood pressure for a patient who has hypertension and the nurse does not hear an auscultatory gap. What outcome may be documented in this? a. A low diastolic reading b. a high systolic pressure reading c. a normal reading d. a high diastolic or low systolic reading
d. a high diastolic or low systolic reading
A patient arrives at the clinic for a follow-up visit for treatment of hypertension. The nurse obtains a blood pressure reading of 180/110 mm Hg but finds no evidence of impending or progressive organ damage when performing the assessment on the patient. what situation does the nurse determine this patient is experiencing? a. hypertensive emergency b. primary hypertension c. secondary hypetension d. hypertensive urgency
d. hypertensive urgency
The nurse is assessing a patient with sever hypertension. When performing a focused assessment of the eyes, what may be observed related to the hypertension? a. cataracts b. glaucoma c. retinal detachment d. papilledema
d. papilledema
A patient with hypertension has been able to maintain a blood pressure of 130/70 mm Hg for 1 year while reducing dietary sodium and taking hydrochlorothiazide and atenolol. What treatment plan will the nurse educate the patient about? a. continuing the medication and reducing dietary sodium b. discontinuing the hydrochlorothiazide and atenolol and continuing to reduce sodium intake c. gradually reducing the hydrochlorothiazide and the atenolol and continuing to reduce sodium intake d. Gradually reducing the atenolol and continuing the hydrochlorothiazide
c. gradually reducing the hydrochlorothiazide and the atenolol and continuing to reduce sodium intake
A patient is brought to the emergency depatemtn reporting 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 education of the mean blood pressure? a. reduce the blood pressure by 20 % to 25% within the first hour treatment b. reduce the blood pressure to about 140/ 80 mm Hg c. rapidly reduce the blood pressure so the patient will not suffer a stroke d. reduce the blood pressure by 50% within the first hour of treatment
a. reduce the blood pressure by 20 % to 25% within the first hour treatment
a nurse is screening a client for hypertension. The nurse should identify that which of the following actions by the client increase the risk for hypertension? SATA a. drinking 8 oz nonfat milk daily b. eating popcorn at the movie theater d. consuming 36 ox beer daily e, getting a massage once a week
b. eating popcorn at the movie theater d. consuming 36 ox beer daily
a nurse is an urgent care clinic is obtaining a history from a client who has type 2 diabetes mellitus and a recent diagnosis of hypertension. this is the second time in 2 weeks that the client experienced hypoglycemia. Which should the nurse report to the provider? a. takes psyllium daily as a fiber laxative b. drinks skim milk daily as a bedtime snack c. takes metoprolol daily after meals d. drinks grapefruit juice daily with breakfast.
c. takes metoprolol daily after meals
A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The healthcare provider order a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement? a. Cardiac catheterization b. echocardiography c. stress test d. tilt table test
b. echocardiography
A patient with long-standing hypertension us admitted to the hospital with hypertensive urgency. the healthcare provider orders a chest x-ray, which reveal an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement? a. cardiac catheterization b. echocardiography c. stress test d. tilt-table test
b. echocardiography
A nurse is providing discharge teaching for a client who has a prescription for furosemide 40 mg PO daily. the nurse should instruct the client to take this medication at which of the following times of day? a. morning b. immediately after lunch c. immediately before dinner d. bedtime
b. immediately after lunch
A patient informs the nurse, " i cant adhere to the dietary sodium decrease that is required for the treatment of my hypertension." What can the nurse educate the client about regarding this statement? a. if dietary sodium isn't restricted, the patient will be unable to control the blood pressure and will be at risk for stroke b. the patient can speak to the healthcare provider about increasing the dosage of medication instead of reducing the added salt c. it takes 2-3 months for the taste buds to adapt to changes in salt intake d. the patient should use other methods of flavoring foods
c. it takes 2-3 months for the taste buds to adapt to changes in salt intake
A nurse is caring for a client who is admitted to the emergency department with a blood pressure 266/147 mm Hg. the client reports a headache and double vision. the client states, " i ran out of my diltiazem 3 days ago, and i am unable to purchase more." which of the following actions should the nurse take first? a. administer acetaminophen for headache b. provide teaching regarding the importance of not abruptly stopping an antihypertensive c. obtain IV access and prepare to administer an IV antihypertensive d. call social services for a referral for financial assistance in obtaining prescribed medication
c. obtain IV access and prepare to administer an IV antihypertensive
