Hypertension

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. He asks the nurse what his blood pressure should be. The nurse's most appropriate response is:

"Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg."

A nurse is educating a client about monitoring blood pressure readings at home. Which of the following will the nurse be sure to emphasise?

"Sit quietly for 5 minutes prior to taking blood pressure." Correct Explanation: 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.

A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. For a client without diabetes mellitus, the target blood pressure is 140/90 or lower. Because this client has diabetes mellitus, the target blood pressure will be which of the following?

130/80 or lower

According to the DASH diet, how many servings of vegetables should a person consume per day?

4 or 5

A nurse is assisting with with checking blood pressures at a local health care fair. To which client would the nurse pay particular attention?

A 40 year old African American man

When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following?

Continuous IV infusion Correct Explanation: 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 client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

Essential (primary)

You are writing a plan of care for your hypertensive client. What is one nursing intervention you should include in the plan of care?

Help client reduce or eliminate caffeine. Explanation: Help client reduce or eliminate caffeine. Caffeine increases heart rate and causes vasoconstriction. Appropriate nursing interventions do not include decreasing urine output, increasing fluid intake, or participating in vigorous activity.

Which of the following would be inconsistent with a hypertensive urgency?

Intracranial hemorrhage Explanation: 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.

The nurse is developing a teaching plan for a patient diagnosed with hypertension. It would be important to emphasise which of the following as part of the plan of care?

Limiting sodium intake in the diet

The nurse teaches the patient which of the following guidelines regarding lifestyle modifications for hypertension?

Maintain adequate dietary intake of potassium Correct Explanation: In general, one serving of a potassium-rich food such as banana, kale, broccoli, or orange juice will meet the daily need for potassium. The patient should be guided to stop smoking. The general guideline is to advise the patient to increase aerobic activity to 30 to 45 minutes most days of the week. In general, alcohol intake should be limited to no more than 1 oz of ethanol per day

A systolic blood pressure of 135 mm Hg would be classified as which of the following?

Prehypertension

Of the following diuretic medications, which conserves potassium?

Spironolactone

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

To lower blood pressure, a client should limit daily salt intake to 2 g or less. Alcohol intake is associated with a higher incidence of hypertension, poor compliance with treatment, and refractory hypertension. Chronic, moderate caffeine intake and fat intake don't affect blood pressure

The nurse is reviewing a patient's diet. The patient has been diagnosed with hypertension. The nurse recommends reducing or avoiding caffeine for patients with hypertension because:

caffeine increases the heart rate and causes vasoconstriction

Which of the following would be inconsistent as a component of metabolic syndrome?

hypotension

A nurse providing education to a community group about hypertension is reviewing appropriate lifestyle modifications. Which of the following are among changes that can help prevent and control hypertension? Choose all that apply

• Weight reduction • Increased physical activity • Substitution of low-fat for whole dairy products in diet

A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. Which of the following are risk factors for cardiovascular problems in clients with hypertension? Choose all that apply.

Smoking, diabetes mellitus and physical inactivity

A nursing class is practicing measurement of blood pressure. One otherwise healthy participant, 46 years old, is 138/90. This man requires follow-up. In which classification of hypertension is he according to the JNC 7 (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood pressure) recommendation?

Stage 1 hypertension is a blood pressure of 140 to 159 systolic or 90 to 99 diastolic. Stage 2 hypertension is a blood pressure greater than 160 systolic or greater than 100 diastolic. Compelling indications include heart failure, post-myocardial infarction, high cardiovascular disease risk, diabetes, chronic kidney disease, and previous stroke.

Primary or essential hypertension accounts for about 95% of all hypertension diagnoses - with an unknown etiology. Secondary hypertension accompanies specific conditions which create hypertension as a result of tissue damage. Which of the following conditions contribute to secondary hypertension?

Secondary hypertension may accompany any primary condition that affects fluid volume or renal function or causes arterial vasoconstriction.