Client with HTN (final)

1 (before starting heparin infusion, it is essential for the nurse to know the clients baseline blood coagulation values (hct, hgb, RBC and Plt counts). In addition, the partial thromboplastin time (PTT) should be monitored closely during the process. The clients stool would be tested only if internal bleeding is suspected. Although monitoring VS such as apical pulse is important in assessing potential signs and symptoms of hemorrhage or potential adverse reactions to the medication, VS are not the most important data to collect before administering heparin. Intake and output are not important assessments for heparin administration unless the client has fluid and volume problems or kidney disease)

A client has an acute arterial occlusion. The healthcare provider has prescribed IV heparin. Before starting the medication, the nurse should: 1. review the blood coagulation laboratory values 2. test the clients stools for occult blood 3. count the clients apical pulse for 1 min 4. check the 24 hour urine output record

1,3,5 (Clonidine is central acting adrenergic antagonist. It reduces sympathetic outflow from the CNS. Dry mouth, impotence, and sleep disturbances are possible adverse effects. Hyperkalemia and pancreatitis are NOT anticipated with use of this drug)

A client is taking clonidine for treatment of HTN. The nurse should teach the client about which common adverse effects of this drug? Select all that apply 1. dry mouth 2. hyperkalemia 3. impotence 4. pancreatitis 5. sleep disturbance

a (​Rationale: If the diuretics do not control the​ client's blood​ pressure, the healthcare provider will prescribe another antihypertensive medication in addition to the diuretic. Nonpharmacologic methods are used in conjunction with medication. An antihypertensive would be added in addition to the diuretic. The new medication would not replace the diuretic. A low​ sodium-diet would be implemented prior to pharmacologic therapy.)

A client is visiting the outpatient clinic because of an increase in blood pressure despite taking diuretics as prescribed. What treatment changes would the health care provider​ prescribe? a Prescribe another antihypertensive in addition to the diuretics b Recommend nonpharmacologic methods of blood pressure reduction c Suggest a​ low-sodium diet d Change the diuretics to another antihypertensive

a,b,d,e (Rationale The role of stress in primary hypertension is not clear. Frequent or continued stress may cause vascular smooth muscle hypertrophy or affect central integrative pathways of the brain. Insulin resistance has been found in people of normal weight and is linked with hypertension by its effects on the sympathetic nervous​ system, vascular smooth​ muscle, renal regulation of sodium and​ water, and changes in ion transport across cell membrane. Low magnesium intake contributes to hypertension by unknown mechanisms. Hypertension primarily affects​ middle-aged and older​ adults: More than​ 50% of people age 60dash-74 and about​ 75% of those 75 and older are hypertensive. Studies show a genetic link in up to​ 40% of people with primary hypertension.)

A client who exercises 30 minutes every day and maintains a normal body weight develops primary hypertension. The client asks how this could have happened. Which findings in the​ client's health history will the nurse include in the response to the​ client? ​(Select all that​ apply.) a Working as an air traffic controller b Family history of hypertension c High magnesium intake ​d Age: 62 years e Insulin resistance

1,2,4,6 (metoprolol is a beta-adrenergic blocker indicated for HTN, angina and myocardial infarction. The tablets should be taken with food at the same time each day; they should not be chewed or crushed. The HCP should be notified if pulse falls below 50 for several days. Blood glucose should be checked regularly during therapy since increased episodes of hypoglycemia may occur. It may mask evidence of hypoglycemia such as palpitations, tachycardia, and tremor. Use of all OTC decongestants, asthma and cold remedies and herbal preparations must be avoided. Fainting spells may occur due to excercise or stress, and the dosage of the drug may be reduced or discontinued)

A client who has diabetes is taking metoprolol for HTN. What should the nurse instruct the client to do? Select all that apply 1. take the tablets with food at the same time each day 2. do not crush or chew the tablets 3. notify the HCP if pulse is 82 bpm 4. Have a blood glucose level drawn every 6-12 months during therapy 5. use an appropriate decongestant if needed 6. Report any fainting spells to the HCP

3 (the client is experiencing a rebound tachycardia from abrupt withdrawal of the beta blocker. The beta blocker should be restarted due to the tachycardia, history or HTN, and the desire to reduce the risk of postoperative myocardial morbidity. The bypass surgery should correct the claudication and need for pentoxifylline. The furosemide and increase in fluids are not indicated since the urine output and BP are satisfactory and there is no indication of bleeding. The nurse should also determine the K level before starting furosemide)

A client with a history of HTN and peripheral vascular disease underwent an aorto-bifemoral bypass graft. Preop meds include pentoxifylline, metoprolol, and furosemide. On post op day 1, the 1200 VS are as follows: T 98.9 F, HR 132, RR 20, and BP 126/78. Urine output is 50-70 mL/hr. The hemoglobin and hematocrit are stable. The meds have not been prescribed for administration after surgery. Using the SBAR technique for communication, the nurse contacts the HCP and recommends to : 1. continue the pentoxifylline 2. increase the IV fluids 3. restart the metoprolol 4. resume the furosemide

a (Rationale The client has a​ high-stress lifestyle. This client would benefit from stress reduction techniques such as meditation. Meditation is a nonpharmacologic treatment option. A diet low in potassium is thought to contribute to hypertension.​ However, a diet high in potassium will not help this client maintain normal blood pressure. Aerobic exercise for 30 minutes 5 to 6 days a week is an important nonpharmacologic method of helping maintain normal blood pressure. Three days a week is not sufficient for blood pressure maintenance. Competitive sports could potentially increase the​ client's stress level. Physical exercise without adding additional stress is considered beneficial in controlling blood pressure.)

A highly stressed client is newly diagnosed with hypertension. What nonpharmacologic treatment option would best help the client maintain normal blood​ pressure? a Meditation b Competitive sports c Aerobic exercise 3 days a week d ​High-potassium diet

a,c,d,e (Rationale Smoking is closely associated with cardiovascular​ disease, which is a complication of hypertension. In​ addition, smoking interferes with some antihypertensive medications. Clients with hypertension should drink only in moderation. The recommended alcohol intake is one alcoholic beverage per day. A diet high in fruits and vegetables will help maintain a normal weight and lower blood pressure. The client will also benefit from a diet low in fat. This client has experienced a hypertensive crisis. Failure to take medications as prescribed can cause hypertensive crisis. A routine that includes taking medications at a set time each day will help the client remember to take medications as prescribed. Exercise 5 days a week lasting 30 to 45 minutes per day is recommended. Exercise helps with stress​ reduction, weight​ loss, and general feelings of​ well-being.)

A nurse is evaluating teaching for a client who has recently experienced a hypertensive crisis. Which statements by the client indicate understanding of the​ instructions? (Select all that​ apply.) a ​"I will set a schedule to remind me to take my medications each​ day." ​b "I will exercise 3 days a​ week." ​c "I must stop​ smoking." d ​"I need to restrict my alcohol intake to no more than 20 oz of beer a​ day." ​e "I will increase fruits and vegetables in my​ diet."

b (Rationale Elevated cholesterol is closely related to cardiovascular disease. The body manufactures​ 85% of the cholesterol found in the body. The other​ 15% comes from the diet. The American Heart Association recommends eating a diet low in fat to maintain normal cholesterol levels. The client can lower cholesterol and the risk of cardiovascular complications by eating a diet low in saturated fats. Aerobic exercise 5 days a week is recommended to lower blood pressure and cholesterol. Smoking is not directly linked to hypertension.​ However, smoking is closely linked to cardiovascular disease. In​ addition, smoking can interfere with some antihypertensive medications. Smoking cessation does not lower cholesterol. Stress is known to cause vasoconstriction because of the release of hormones.​ However, stress reduction alone will not reduce cholesterol levels.)

A nurse is planning client teaching for a client with hypertension. The​ client's cholesterol is elevated. What instructions by the nurse would help the client lower cholesterol​ levels? a Exercise occasionally for 15 to 30 minutes per session b Eat a diet low in saturated fat c Practice smoking cessation d Participate in stress reduction

c (Rationale African American women have a higher prevalence of hypertension. In the African American​ population, more women than men are affected by hypertension. Of the entire African American adult​ population, nearly​ 40% have hypertension. Adult Whites as a whole have lower risk of developing hypertension than African Americans. Among the members of the adult White population with​ hypertension, more men than women are affected. Clients of Asian​ descent, both male and​ female, have the lowest incidence of hypertension. Clients of Hispanic descent are not considered to be at high risk for hypertension. Among the members of the Hispanic population with​ hypertension, more men than women are affected.)

A nurse is planning to present information on primary hypertension at a local community center. Which adult population would the nurse consider as being most likely to​ benefit, based on higher prevalence of primary​ hypertension? a White men b Men of Asian descent c African American women d Women of Hispanic descent

d (The levels of calcium channel blockers are increased when grapefruit or grapefruit juice is consumed, potentially causing hypotension.)

A patient is prescribed a calcium channel blocker to treat primary hypertension. When teaching the patient about the medication, which of these foods will the healthcare provider advise the patient to avoid? Choose 1 answer: Choose 1 answer: A Eggs B Bananas C Oranges D Grapefruit

a (Orthostatic or postural hypotension results when the patient's blood pressure is not maintained during position changes (i.e. from lying to either sitting or standing). When blood pressure drops, the body will try to compensate for the decreased pressure. Orthostatic hypotension is defined as a decrease of more than 20 mmHg systolic or more than 10 mmHg diastolic and a 10% - 20% increase in heart rate.)

A patient is prescribed a new medication for the treatment of hypertension. While supine, the patient's blood pressure is 112/70 mmHg and the heart rate is 80/minute. The healthcare provider assesses the patient when the patient changes to a sitting position. Which of the following indicates the patient is experiencing orthostatic hypotension? Choose 1 answer: Choose 1 answer: a BP 88/62, HR 100 b BP 90/60, HR 68 c BP 100/66, HR 90 d BP 120/84, HR 82

b (A hypertensive emergency may cause hypertensive retinopathy, resulting in hemorrhages, exudates, and/or papilledema.)

A patient presents to the emergency department with a blood pressure of 180/130 mmHg, headache, and confusion. Which additional finding is consistent with a diagnosis of hypertensive emergency? Choose 1 answer: Choose 1 answer: a Bradycardia b Retinopathy c Urinary retention d Jaundice

d

A patient tells the healthcare provider, "I stopped taking my medication because it kept me up at night with a dry cough." When reviewing the patient's medical record, which of these antihypertensive medications will the healthcare provider identify as the likely cause of this patient's report? Choose 1 answer: Choose 1 answer: A Beta blocker B Calcium channel blocker C Loop diuretic D Angiotensin-converting enzyme (ACE) inhibitor

d (The kidneys are common targets of hypertension. Microalbuminuria detected by urinalysis is an indication the kidneys have been damaged.)

A patient who is newly diagnosed with stage 1 hypertension is being evaluated by a healthcare provider. Which of the following laboratory tests would indicate organ damage that may result from hypertension? Choose 1 answer: Choose 1 answer: a Complete blood count b Serum aldosterone c Coagulation panel d Urinalysis

1 (The effect of a beta blocker is a decrease in HR, contractility and afterload, which leads to a decrease in BP.. The client at first may have an increase in fatigue when starting the beta blocker. The mechanism of action does not improve blood sugar or urine output)

Metoprolol is added to the pharmacologic therapy of a diabetic female diagnosed with stage 2 hypertension who has been initially treated with furosemide and ramipril. An expected therapeutic effect is: 1. decrease in HR 2. lessening of fatigue 3. improvement in blood sugar level 4. increase in urine output

a (Mrs.​ Batista's symptoms of elevated blood pressure and a headache in the back of her head and​ neck, that present every morning when she wakes and subside during the​ day, are manifestations of primary hypertension. Her symptoms of nocturia and visual disturbances are associated with target organ damage caused by primary hypertension. Some of Mrs.​ Batista's symptoms could be associated with secondary hypertension or a hypertensive​ crisis, but the headache in the back of her head and neck that is present upon waking is a strong indication of primary hypertension. Mrs.​ Batista's symptoms are not associated with a​ pheochromocytoma, which can be a cause of secondary hypertension.)

Mrs. Batista has come to her doctor to get help for a headache in the back of her head and neck that presents every morning when she wakes and subsides during the day. She says she is waking up more often in the middle of the night to go to the​ bathroom, and she reports that sometimes during the​ day, she has visual disturbances. In your physical examination of Mrs.​ Batista, you find that her blood pressure is elevated. Which of the following conditions is Mrs. Batista most likely to​ have? a Primary hypertension b Hypertensive crisis c Pheochromocytoma d Secondary hypertension

100

Optimal LDL < _____

1,3,6 (financial issues can lead to client inability to afford meds and thus chronic issues with HTN. (BUN) and creatinine levels reveal kidney function and if abnormal, are reflective of chronic HTN. Calcium levels fluctuate as Ca. leaves the bone. Calcification of major blood vessels in the body can occur. HTN is not reflective in the CBC levels. Cardiac enzymes may indicate a MI. (ALT) is a liver enzyme reflective of liver function)

The nurse is caring for a client with chronic HTN who struggles with medication compliance because of financial issues. When reviewing recent lab work results, which reflects the clients BP issues? 1. BUN 2. CBC 3. Creatinine 4. Cardiac enzymes 5. ALT 6. Ca

1 (furosemide is a diuretic often prescribed for clients with HTN or HF. The drug should not affect the clients ability to drive safely. Furosemide may cause orthostatic hypotension and clients should be instructed to be careful when changing position. Diuretics should be taken in the morning if possible to prevent sleep disturbances due to the need to get up to void. Furosemide is a loop diuretic that is not potassium sparing; clients should take prescribed K supplements and have serum K levels checked at prescribed intervals)

The nurse is discussing medications with a client with HTN who has a prescription for furosemide daily. The client needs further education when the client states: 1. I know I should not drive after taking furosemide 2. I should be careful not to stand up too quickly when taking furosemide 3. I should take the furosemide in the morning instead of before bed. 4. I need to be sure to also take the potassium supplement that the Dr. prescribed along with my furosemide.

a

The nurse is educating a client newly diagnosed with hypertension on appropriate dietary choices. Which action by the​ client, regarding dietary​ choices, indicates the need for further​ instruction? a Adding salt to most foods b Drinking one alcoholic beverage every evening c Consuming​ low-fat milk and dairy products d Decreasing fats and oils

1,2,4,5 (Orthostatic Hypotension is a drop in BP that occurs when changing positions, usually to a more upright position, Orthostatic Hypotension often occurs in elderly clients, and is a common cause of falls. Nurses must assess clients for orthostatic hypotension and assist all clients with orthostatic hypotension in standing to help prevent falls. Lower limb compression devices aid in prevention of decreased orthostatic systolic BP and reduce symptoms in elderly. Nurses must teach clients to change positions slowly, and conduct fall risk assessments. Sequential compression devices may be helpful to high risk clients and should be considered when developing a care plan. Anti hypertensive meds are not necessary for clients with orthostatic hypotension and may precipitate a dangerous drop in BP. The clients should be encouraged to be ambulatory.)

The nurse is planning care for a group of elderly clients who are affected by orthostatic hypotension. What should the nurse do? Select all that apply. 1. Assist the clients to stand to help prevent falls 2. Teach clients how to gradually change their position 3. Request a prescription for antihypertensive medications for clients at hight risk 4. conduct "fall risk" assessments 5. Consider use of SCD's for high risk clients 6. Place clients on bed rest

b,c,e (Rationale Uncontrolled hypertension can place the client at an increased risk for​ stroke, heart​ failure, and coronary artery disease. Hypertension does not cause the development of diabetes mellitus. Diabetes mellitus contributes to the development of hypertension. Hypertension can lead to kidney​ failure, but it is not associated with liver failure.)

The nurse is providing care to a client with uncontrolled hypertension. Based on this​ diagnosis, which heath problems is the client at risk for​ developing? ​(Select all that​ apply.) a Diabetes mellitus b Stroke c Coronary artery disease d Liver failure e Heart failure

c (Rationale The client needs to understand that she may be asymptomatic even when her blood pressure is significantly elevated. The increased systemic vascular resistance seen with high blood pressure causes an increased workload for the left ventricle and may result in heart failure. Increased pressure in the cerebral vessels can lead to development of microaneurysms and an increased risk for cerebral hemorrhage. High blood pressure can result in poor renal perfusion. Nocturia​ (night-time urination) is one symptom that can appear.)

The nurse is providing instruction to a client about possible complications of hypertension. Which​ statement, if made by the​ client, indicates a need for further​ instruction? ​a "Going to the bathroom more often at night may mean my blood pressure is not under good​ control." ​b "High blood pressure makes my heart work harder to pump blood to my​ body." ​c "I will feel the difference if my blood pressure goes up too​ much." d ​"Hypertension can cause an increased pressure in the blood vessels in my brain and increases my risk for a​ stroke."

1 (atenolol is a beta-adrenergic antagonist indicated for mngmt of HTN. Sudden D/C of the drug is dangerous because it may exacerbate symptoms. The med should not be D/C without a prescription. BP needs to be monitored more frequently than annually in a client who is newly diagnosed and treated for HTN. Clients are not usually placed on a 2-g Na diet for HTN.)

The nurse is teaching the client with HTN about taking atenolol. The nurse should instruct the client to: 1. avoid sudden D/C of the drug 2. monitor BP annually 3. follow a 2-g Na diet 4. D/C the med if severe headaches develop

3 (Processed and cured meat products such as cold cuts, ham, and hot dogs are all high in both sodium and fat and should be avoided on a low cal, low fat, low sodium diet. Dietary restrictions of all types are complex and difficult to implement with clients who are basically assymptomatic)

The nurse teaches a client who has recently been diagnosed with HTN about following a low calorie, low fat, low sodium diet. Which of the following menu choices would best meet the clients' needs? 1. mixed green salad with blue cheese dressing, crackers, cold cuts. 2. ham sandwich on rye bread and an orange 3. baked chicken, an apple, and a slice of whitebread 4. hot dogs, baked beans, and celery and carrot sticks

3 ( In most instances clients with HTN require lifelong treatment and their HTN cannot be managed successfully without changes in health behavior. The client must first commit to making long term changes. The clients changes will involve taking meds, stopping smoking, and losing weight, but the client must accept the need for lifelong management and establish a vision and plan to control the HTN)

What is the most important long term goal for an obese client with HTN who smokes? 1. take meds as prescribed 2. stop smoking 3. make a commitment to long-term lifestyle changes 4. lose weight

1 (propranolol is a beta-adrenergic blocking agent. Actions of propranolol include reducing HR, decreasing myocardial contractility, and slowing conduction. )

When teaching a client about propranolol hydrochloride the nurse should base the information on the knowledge that propranolol: 1. blocks beta-adrenergic stimulation and thus causes decreased HR, myocardial contractility, and conduction 2 increases norepinephrine secretion and thus decreases BP 3. is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers BP 4. is an angiotensin-converting enzyme inhibitor that reduces BP by blocking the conversion of angiotensin I to angiotensin II

b,c,d

Which conditions cause secondary​ hypertension? ​(Select all that​ apply.) a Asthma b Kidney disease c Diabetes d Pregnancy e Lupus

a (Decreased sodium intake is recommended for the client with hypertension. Also recommended are ncreasing intake of​ low-fat dairy​ products, limiting alcohol consumption to ​½ to 1 ounce each​ day, and decreasing intake of saturated fats.)

Which dietary modification should be implemented for a client with​ hypertension? a Decreased sodium b Increased alcohol consumption to 2 oz per day c Decreased​ low-fat dairy products d Increased saturated fats

d (An appropriate nursing diagnosis for a client with hypertension is imbalanced nutrition. Chronic​ pain, impaired​ mobility, and risk for dry eye are not nursing diagnoses that are appropriate for a client with hypertension.)

Which nursing diagnosis is appropriate for a client with​ hypertension? a Impaired mobility b Chronic pain c Risk for dry eye d Imbalanced nutrition

2 (There was a sig. change in both BP and HR with position change. This indicates inadequate blood volume to sustain normal values. Normal postural changes allow for an increased HR of 5-20 bpm, a possible slight decrease of <5 mm Hg in systolic BP, and a possible sligh increase of <5 mmHg in diastolic BP.)

Which set of postural VS (BP and HR) indicate inadequate blood volume? 1. Supine 124/76 88 Sitting 124/74 92 Standing 122/74 92 2. Supine 120/70 70 Sitting 102/64 86 Standing 100/60 92 3. Supine 138/86 74 Sitting 136/84 80 Standing 134/82 82 4. Supine 100/70 72 Sitting 100/68 74 Standing 98/68 80

b (The mean arterial pressure is defined as the average pressure in the arteries throughout the cardiac cycle. Systolic blood pressure is defined as the highest pressure that occurs during the peak ventricular contraction. The diastolic pressure is defined as the lowest pressure that occurs during ventricular relaxation. The pulse pressure is the difference between the systolic and diastolic blood pressures.)

Which term is defined as the average pressure in the arteries throughout the cardiac​ cycle? a Systolic blood pressure b Mean arterial pressure c Pulse pressure d Diastolic blood pressure

3 ( a plan to cease smoking begins with establishing the clients personal daily smoking pattern and activities associated with smoking.)

Which would be more helpful when coaching a client to quit smoking? 1. review the neg effects of smoking on the body 2. discuss the effects of passive smoking on environmental pollution 3. establish the clients daily smoking pattern 4. explain how smoking worsens BP

4

Which would most likely assist the client with htn in maintaining an exercise program? 1. give the client a written exercise program 2. explain the exercise program to the clients spouse 3. reassure the client that he or she can do the program 4. tailor a program to the clients needs and abilities

40

You do not want your HDL levels below _____

a,b,d (Rationale Salt intake can cause retention of fluids and increases in blood pressure. Dairy products are​ beneficial, but reducing fats will decrease risk factors for development of atherosclerosis. Cholesterol should be lowered but not eliminated from the diet. Dietary guidelines are 4dash-5 servings per day for vegetables and fruits. Saturated fats should be​ limited; unsaturated fats are preferred.)

You teach a client with hypertension about lifestyle changes that may help control the disorder. Which dietary changes should you include in the​ teaching? ​(Select all that​ apply.) a Eat 4 -5 servings of fruits and vegetables each day b Switch to​ low-fat dairy products c Limit fat intake to saturated types of fat d Use salt substitutes e Eliminate cholesterol from diet

1,2,3,5 (chlorothiazide causes increased urination and decreased swelling (edema) and weight loss. It is important to check and record weight two to three times per week at the same time of day with similar clothing. Clients should not drink alcohol or take other meds without the approval of the HCP. Reducing Na intake in the diet helps the diuretic drugs to be more effective and allows smaller doses to be taken. Smaller doses are less likely to produce adverse effects, and therefore excessive table salt as well as salty foods should be avoided. Chlorothiazide is a diuretic that is prescribed for lower BP and may cause dizziness or faintness when the client stands up suddenly. Instruct to change position slowly. If dizziness is severe notify HCP. Diuretics may cause sensitivity to sunlight, hence the need to avoid prolonged exposure, use sunscreen, protective clothing. Do not change dosage without HCP, and take in am to prevent sleep disturbances)

A client diagnosed with primary (essential) HTN is taking chlorothiazide. The nurse determines teaching about this medication is effective when the client makes which statement? "I will..... select all that apply 1. take my weigh daily at the same time each day 2. not drink alcohol while on this med 3. reduce salt intake in my diet 4. reduce my dosage if I have severe dizziness 5. use sunscreen if I have prolonged exposure to sunlight 6 take the drug late in the evening

a (Rationale: Diuretics are antihypertensives that reduce the fluid volume in vessels, thereby decreasing systemic pressure. The priority nursing intervention is to assess the client's hydration status. Other priority interventions include monitoring serum electrolyte levels, obtaining daily weights, monitoring breath sounds, and teaching compliance. Monitoring pulse rates, angioedema, and CBC are important for ACE inhibitors and ARBs. )

A client is placed on furosemide (Lasix) and hydrochlorothiazide (HCTZ) for high blood pressure. What priority intervention by the nurse is the most appropriate? a Assess hydration status. b Assess for angioedema. c Monitor pulse rate. d Monitor CBC.

HDL

Good Cholesterol:________

c (Rationale: An increase in amplitude and duration when assessing the apical impulse occurs with right ventricular pressure overload in pulmonic stenosis and pulmonary hypertension. A lift or heave may also be seen in these conditions and in chronic lung disease. High-pitched bowel sounds are normal, loud S1 is normal, and pansystolic murmurs are heard with atrioventricular valve disease. )

An 80-year-old client is admitted to the emergency room with "chest pain and a racing heart." The client also complains of SOB when walking 50 feet or less. During an initial assessment, which abnormal finding does the nurse find that is consistent with the client's diagnosis of pulmonary hypertension? a Loud S1 during heart sound assessment b Pansystolic murmur during murmur assessment c Increase in amplitude with apical impulse assessment d High-pitched bowel sounds during abdominal assessment

LDL

Bad Cholesterol ______

a (Prior to initiating treatment for​ hypertension, the healthcare provider will order a cholesterol​ panel, as this information will help to determine appropriate treatment options. The other diagnostic tests are used to diagnose secondary hypertension and would be ordered after the cholesterol panel.)

Betty Norman is an​ overweight, 57-year-old woman who works at the local diner and takes frequent smoking breaks. Mrs. Norman comes to the primary care provider for an annual physical examination. On​ assessment, her blood pressure is​ 180/96 mmHg. Which diagnostic test do you anticipate will be ordered for Mrs. Norman prior to initiating​ treatment? a Cholesterol panel b Intravenous pyelogram c Renal function tests d CT scan

c (Rationale Clients with elevated blood pressure prior to 20 weeks gestation are diagnosed with chronic hypertension. The other diagnoses may be appropriate for a client who develops hypertension after 20 weeks gestation.)

The nurse is providing care to a pregnant client with a blood pressure of​ 180/100 mmHg at 18 weeks gestation. Which diagnosis does the nurse anticipate for this​ client? a Eclampsia b Gestational hypertension c Chronic hypertension d Preeclampsia