Hypertension AQ
A patient with hypertension has been prescribed an antihypertensive medication. During a follow-up visit, the patient asks if the medication can be stopped because the blood pressure (BP) is now within the normal range. Which nursing response is appropriate? Multiple choice question "You may stop the medication because your BP is normal." "You may stop taking the medication if you maintain a healthy lifestyle." "Begin taking half-doses of the medication because the BP has decreased." "Continue the medication until your health care provider advises to discontinue it."
"Continue the medication until your health care provider advises to discontinue it." Antihypertensive medications are effective at reducing BP; however, the medications should not be stopped abruptly because this can cause a severe hypertensive reaction. The medications should be discontinued only after consulting with the primary health care provider. The medication should not be stopped even if the BP measurements show normal readings. Medications should be taken regularly for sustained therapeutic effects. A reduction of the dosage may reduce the efficacy of the drug. Lifestyle modifications are necessary to reduce cardiovascular risks; however, antihypertensive medications should also be used for effective reduction of BP.
A nurse provides education to a patient with hypertension related to lifestyle modifications to reduce overall cardiovascular risk. Which statement made by the patient indicates effective learning? Select all that apply. Multiple selection question "I should exercise for at least 30 minutes daily." "I should achieve and maintain a healthy weight." "I should limit my alcohol intake to five drinks per day." "I should restrict my salt intake to less than or equal to 1500 mg/day." "I can continue to smoke because nicotine does not affect blood pressure."
"I should exercise for at least 30 minutes daily." "I should achieve and maintain a healthy weight." "I should restrict my salt intake to less than or equal to 1500 mg/day." Lifestyle modifications play a vital role in reducing blood pressure and cardiovascular risk. Overweight people are at higher risk of cardiovascular disease. A weight loss of 22 lb may decrease systolic blood pressure by approximately 5 to 20 mm Hg. Being physically active is essential to maintain good health. It decreases the cardiovascular risk of hypertension. Sodium reduction helps to control blood pressure. A hypertensive patient should lower salt intake to 1500 mg/day. The nicotine in tobacco causes vasoconstriction and increases blood pressure. Therefore smokers who are hypertensive should stop smoking. Excessive alcohol consumption increases the risk of hypertension. Consuming three or more drinks per day increases the risk of cardiovascular disease and stroke.
The nurse provides education to a patient about the Dietary Approaches to Stop Hypertension (DASH) diet. Which statement made by the patient indicates understanding of the teaching? Multiple choice question "I should drink no more than three glasses of whole milk per day." "I should include four to five servings of fruits and vegetables daily." "I should eat three servings of red meat, such as pork or beef, daily." "I should consume whole grain products no more than once per week."
"I should include four to five servings of fruits and vegetables daily." The DASH diet encourages consumption of fruits and vegetables. Pork and beef are high in fat and therefore have to be restricted according to the DASH diet; poultry and fish have to be consumed instead of red meat. Fat-free or low-fat milk has to be used instead of whole milk according to the DASH recommendations. The DASH diet recommends a few servings of whole grain products daily.
The nurse provides medication education to a patient with hypertension that receives a prescription for doxazosin. What should the nurse include in the teaching? Multiple choice question "Monitor yourself for a fast heart rate, which is a common side effect." "The medication also improves breathing by decreasing chest congestion." "It is common for patients that take this medication to experience nausea or vomiting." "Make position changes slowly, especially when moving from lying down to standing."
"Make position changes slowly, especially when moving from lying down to standing." Doxazosin is an α-adrenergic blocker and can cause marked orthostatic hypotension. For this reason, the patient should be instructed to rise slowly, especially when moving from a recumbent to a standing position. It is recommended to take the medication at bedtime to reduce the risk of associated orthostatic hypotension. Tachycardia or respiratory effects are not evident with the medication, nor are nausea and vomiting.
A patient with hypertension asks the nurse, "What can I do to decrease my blood pressure?" How should the nurse respond? Multiple choice question "Reduce sodium intake to less than 3000 mg per day." "Restrict alcohol consumption to no more than three drinks daily." "Perform moderate-intensity aerobic physical activity for at least 30 minutes daily." "Reduce weight by 10 pounds, which can decrease systolic blood pressure by 20 to 30 mm Hg."
"Perform moderate-intensity aerobic physical activity for at least 30 minutes daily." Moderate physical activity, such as walking for at least 30 minutes, is recommended at least five days per week to reduce BP. For those with hypertension, sodium should be restricted to less than or equal to 1500 mg per day. Weight reduction by 20 lbs leads to a reduction in SBP of 5 to 20 mm Hg. Alcohol consumption should be restricted to no more than one drink per day for women and no more than two drinks per day for men.
A patient receives a new prescription for doxazosin. What should the nurse include in the patient's medication education? Multiple choice question "Weigh yourself daily and report any weight loss to your prescriber." "Increase your potassium intake by eating more bananas and apricots." "Take this drug at bedtime because of the risk of orthostatic hypotension." "The impaired taste associated with this medication usually goes away in two to three weeks."
"Take this drug at bedtime because of the risk of orthostatic hypotension." A patient who is starting doxazosin should take the first dose while lying down because there is a first-dose hypotensive effect with this medication. Taking the drug at bedtime reduces risks associated with orthostatic hypotension. The patient does not need to increase potassium intake. Doxazosin does not cause impaired taste. It does not cause weight loss, because it is not a diuretic.
The nurse obtains a health history from a patient with primary hypertension and recognizes which nonmodifiable risk factors? Select all that apply. Multiple selection question Age 65 years Excessive dietary sodium African American ethnicity Excessive alcohol consumption A family history of hypertension
Age 65 years African American ethnicity A family history of hypertension Nonmodifiable risk factors for hypertension include increasing age, African American ethnicity, and a family history of hypertension. Consumption of excessive dietary sodium and excessive alcohol consumption are considered modifiable risk factors.
The nurse observes another health care provider taking the blood pressure (BP) of an older patient. The cuff is inflated to 180 mm Hg. The care provider records the systolic blood pressure (SBP) as 180 mm Hg. The nurse recognizes that the reading is inaccurate based on what understanding of BP measurements in older adults? Multiple choice question An older patient's SBP is typically at or below 140 mm Hg. That's high. The older patient is more prone to anxiety, which can alter the SBP reading. An auscultatory gap may be present. The older patient's SBP was underestimated. The wrong size cuff was used. A cuff that fit the older patient's arms more snugly should have been obtained.
An auscultatory gap may be present. The older patient's SBP was underestimated. Careful technique is important in assessing blood pressure in older adults. Some older people have a wide gap between the first Korotkoff sound and subsequent beats. This is called the auscultatory gap. Failure to inflate the cuff high enough may result in underestimating systolic blood pressure (SBP). There is no information provided that the wrong size cuff was used or that the patient was anxious. Gerentologic changes in the older population often place the patient at risk for hypertension.
The nurse reviews the medical records of several patients and identifies that which ones are at high risk of developing hypertension? Select all that apply. Multiple selection question An elderly man who smokes A 35-year-old man with obesity A 65-year-old African American woman A female teenager with a fracture of the humerus A 50-year-old man whose parent had hypertension
An elderly man who smokes A 35-year-old man with obesity A 65-year-old African American woman A 50-year-old man whose parent had hypertension An elderly man is at risk of hypertension due to his age. In addition, smoking increases the risk of developing hypertension. African Americans have an increased risk of developing hypertension compared to their white counterparts. In addition, the woman is 65 years old; in females the risk of hypertension increases after 50 years of age. Obesity increases the risk of hypertension. The risk is even greater with abdominal obesity. A person who has a family history of hypertension is at increased risk of developing hypertension. A female teenager with a fracture is not at risk, due to her young age and female gender.
A male patient that takes nifedipine to treat hypertension continues to have blood pressure readings over 140/90 mm Hg. What action should the nurse take first? Multiple choice question Assess the patient's adherence to therapy Request a prescription for a thiazide diuretic Assist the patient in creating an exercise plan Instruct the patient to use the Dietary Approaches to Stop Hypertension (DASH) diet
Assess the patient's adherence to therapy A long-acting calcium channel blocker, such as nifedipine, causes vascular smooth muscle relaxation, resulting in decreased systemic vascular resistance (SVR) and arterial blood pressure (BP) and related side effects. A major problem in the long-term management of the patient with hypertension is poor adherence with the treatment plan. The nurse needs to assess the patient's adherence to therapy. The patient's blood pressure is still elevated and must be addressed. Asking the patient to make an exercise plan or use the DASH diet is not addressing the blood pressure. It is not necessary to request another medication without assessing if the patient actually is taking the medication prescribed.
A patient receives a prescription for nadolol 50 mg by mouth (PO) daily. The nurse questions the prescription after noting which medical diagnosis in the patient's health record? Multiple choice question Asthma Hypertension Diabetes mellitus Renal insufficiency
Asthma Nadolol is a nonselective β 1- and β2-adrenergic blocking agent that reduces blood pressure. Nonselective agents may cause bronchospasm, especially in patients with asthma. Nadolol will not worsen renal insufficiency and diabetes and will treat, not worsen, hypertension.
The nurse is preparing to administer atenolol to a patient with hypertension. The medication has what mechanism of action that makes it beneficial to a patient with this diagnosis? Multiple choice question Activates dopamine receptors Blocks β-adrenergic receptors Relaxes arterial and venous smooth muscles Reduces conversion of angiotensin I to angiotensin II
Blocks β-adrenergic receptor Atenolol is a cardioselective β-adrenergic blocker that reduces blood pressure. It also reduces cardiac output and reduces sympathetic vasoconstrictor tone. It also decreases renin secretion by kidneys. Fenoldopam, a direct vasodilator, activates dopamine receptors, resulting in systemic and renal vasodilation. Angiotensin-converting enzyme inhibitors inhibit ACE, reducing conversion of angiotensin I to angiotensin II. Nitroglycerin is a direct vasodilator, which relaxes arterial and venous smooth muscle, reducing preload and SVR.
The nurse is caring for a patient admitted with a history of hypertension. The patient's medication history includes hydrochlorothiazide daily for the past 10 years. Which parameter would indicate the optimal intended effect of this drug therapy? Multiple choice question Weight loss of 2 lb Blood pressure 128/86 Absence of ankle edema Output of 600 mL per eight hours
Blood pressure 128/86 Hydrochlorothiazide may be used alone as monotherapy to manage hypertension or in combination with other medications if not effective alone. After the first few weeks of therapy, the diuretic effect diminishes, but the antihypertensive effect remains. Because the patient has been taking this medication for 10 years, the most direct measurement of its intended effect would be the blood pressure.
A patient is scheduled for a dose of metoprolol. The nurse should withhold the medication and consult the health care provider after noting which assessment finding? Multiple choice question Migraine headache Pitting edema of +1 Blood sugar 217 mg/dL Pulse 112 beats/minute
Blood sugar 217 mg/dL Metoprolol is a β-adrenergic-blocking agent that reduces blood pressure. It should be used with caution in patients with diabetes because the drug may depress the tachycardia associated with hypoglycemia and may adversely affect glucose metabolism. Metoprolol will not worsen migraine, will decrease the elevated pulse rate, and may help with decreasing edema.
An African American patient is hospitalized for treatment of hypertension. When comparing medications used to treat high blood pressure, the nurse recalls that which type of medication provides better control for this population? Multiple choice question Beta adrenergic blockers Calcium-channel blockers Peripheral adrenergic inhibitors Angiotensin-converting enzyme inhibitors
Calcium-channel blockers
A patient is prescribed lisinopril for the treatment of hypertension. The patient asks about side effects of this medication. Which side effects should the nurse include? Select all that apply. Multiple selection question Cough Edema Impotence Hypotension Muscle stiffness
Cough Hypotension Cough and hypotension are side effects of angiotensin-converting enzyme (ACE) inhibitors. Peripheral edema is a side effect of calcium channel blockers. Impotence is a side effect of thiazide diuretics, aldosterone receptor blockers, central-acting alpha-adrenergic antagonists, peripheral-acting alpha-adrenergic antagonists, beta-adrenergic blockers, and mixed alpha 1 and beta 1 blockers. Muscle stiffness is not associated with an ACE inhibitor.
The nurse suspects that a patient is experiencing postural hypotension. The nurse recalls that the hypotension occurs when there are what changes in the blood pressure (BP) and heart rate (HR)? Multiple choice question Increased systolic BP and/or decreased HR Increased diastolic BP and/or decreased HR Decreased systolic BP, decreased diastolic BP, and/or increased HR Decreased systolic BP, increased diastolic BP, and no change in HR
Decreased systolic BP, decreased diastolic BP, and/or increased HR A decrease in both systolic and diastolic blood pressure and an increase in pulse would be seen in a patient with postural hypotension. Blood pressure drops as the volume of circulating blood decreases when a patient abruptly stands from a lying or sitting position. The pulse rate increases as the heart attempts to compensate by increasing the amount of circulating blood by increasing cardiac output. Increased systolic blood pressure and decreased pulse rate; increased diastolic blood pressure and increased pulse rate; and decreased systolic blood pressure, increased diastolic blood pressure, and no change in pulse rate are all incorrect.
A patient has been prescribed atenolol. Before administering the drug, the nurse should assess for which condition? Multiple choice question Asthma Dry cough Depression Diabetes mellitus
Diabetes mellitus Atenolol reduces blood pressure by blocking β-adrenergic effects. It should be used with caution in patients with diabetes mellitus. It depresses the tachycardia associated with hypoglycemia and may prevent diagnosing hypoglycemia. A history of asthma, dry cough, or depression does not affect administration of the drug. Nonselective blockers should not be used in patients with asthma due to the risk of bronchospasm. Angiotensin-converting enzymes may cause dry cough. Reserpine should not be administered in patients with depression because this may cause the condition to worsen.
A patient is being discharged from the hospital. The primary health care provider prescribes propranolol for hypertension. Which instruction should the nurse include in the patient's discharge teaching plan? Multiple choice question Do not stop taking the medication abruptly. Increase the intake of green leafy vegetables. Take with orange juice to prevent hypokalemia. Take a hot bath within one hour of the medication to promote vasodilation.
Do not stop taking the medication abruptly. Patients should not stop taking this medication abruptly because this may cause rebound hypertension. Beta blockers are not potassium wasting, so it is not necessary to take them with orange juice or to increase the intake of potassium-rich foods such as green leafy vegetables. The patient should be instructed to avoid hot baths within 3 hours of taking drugs that promote vasodilation; excessive hypotension may occur.
A nurse provides discharge education to a patient about care and management of hypertension. What should the teaching plan include? Select all that apply. Multiple selection question Supplement the diet with foods high in sodium. Explain the meaning of the blood pressure (BP) values. Explain the potential dangers of uncontrolled hypertension. Assure the patient that short-term therapy will cure hypertension. Exercise after taking the medication prescribed for hypertension. Do not alter medication dosage without first consulting the health care provider.
Explain the meaning of the blood pressure (BP) values. Explain the potential dangers of uncontrolled hypertension. Do not alter medication dosage without first consulting the health care provider. The nurse should explain the meaning of the systolic blood pressure (SBP) and diastolic blood pressure (DBP) values. The nurse should also explain the potential dangers of uncontrolled hypertension and dangers of altering the dosage without consulting the health care provider. The nurse should inform the patient that long-term therapy and follow-up care are essential to treat hypertension, and that therapy will not cure but should control hypertension. The patient should avoid foods high in sodium; instead, supplement diet with foods high in potassium. The patient should avoid strenuous exercise, hot baths, and excessive amounts of alcohol within three hours of medication.
The nurse provides education to a patient with hypertension about symptoms of uncontrolled hypertension. What should the nurse include in the education? Select all that apply. Multiple selection question Fatigue Dizziness Palpitations Cluster headaches Shortness of breath
Fatigue Dizziness Palpitations Uncontrolled hypertension may result in fatigue, dizziness, and palpitations. Cluster headaches and shortness of breath do not occur with uncontrolled hypertension.
A patient with a high triglyceride level takes an over-the-counter fish oil tablet every day. What risk factor should the nurse inform the patient about with the use of fish oil? Multiple choice question Fish oil may increase prostate-specific antigen (PSA) levels. Fish oil may decrease blood pressure. Fish oil may increase the risk of bleeding. Fish oil may decrease blood sugar levels.
Fish oil may increase the risk of bleeding. Fish oil is used for hypertriglyceridemia and hypertension. However, patients should be informed that the use of fish oil may increase the risk of bleeding, and the patient should be observant for related signs and symptoms. Fish oil may increase blood sugar levels. It does not have any effect on prostate cancer or blood pressure levels.
The nurse teaches a patient with hypertension that uncontrolled hypertension may damage organs in the body primarily by which mechanism? Multiple choice question Hypertension promotes atherosclerosis and damage to the walls of the arteries. Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems. Hypertension causes direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue. Hypertension increases blood viscosity, which contributes to intravascular coagulation and tissue necrosis distal to occlusions.
Hypertension promotes atherosclerosis and damage to the walls of the arteries. Hypertension is a major risk factor for the development of atherosclerosis by mechanisms not yet fully known. However, once atherosclerosis develops, it damages the walls of arteries and reduces circulation to target organs and tissues.
The nurse reviews the history of a patient that has failed to reach goal BP despite taking full doses of an appropriate three-drug therapy regimen, including a diuretic. The nurse identifies that what history finding is the likely cause of the resistant hypertension? Multiple choice question Increasing obesity Excess pepper intake Consumes peppermints Erectile dysfunction (ED) medication
Increasing obesity An increase in obesity is one of the causes of resistant hypertension. Licorice (rather than peppermint), excess salt (rather than pepper) intake, and oral contraceptives (rather than ED meds) are also possible causes of resistant hypertension.
The nurse is providing care for a patient who continues to experience hypertension despite taking a calcium channel blocker daily. A diuretic has been prescribed. How does a diuretic help control blood pressure? Select all that apply. Multiple selection question It causes vasodilation. It reduces plasma volume. It promotes sodium and water excretion. It reduces the vascular response to catecholamines. It prevents extracellular calcium from moving into the cells.
It reduces plasma volume. It promotes sodium and water excretion. It reduces the vascular response to catecholamines. Diuretics are an important component of BP treatment. Diuretics tend to reduce the plasma volume by promoting excretion of sodium and water. The net result is a reduction in the circulating volume, which causes a decrease in the BP. Diuretics also reduce the vascular response to catecholamines. The blood vessels do not constrict in response to catecholamines; as a result, the BP is reduced. Diuretics do not cause vasodilation or prevent the movement of extracellular calcium into the cells; these effects are brought about by calcium channel blockers.
A patient presents to the emergency department with a sudden rise in blood pressure (BP) and a severe headache. The patient receives a prescription for IV labetalol. The nurse recognizes that what precaution should be taken while administering the medication? Multiple choice question Maintaining seizure precautions Monitoring for severe tachycardia Keeping the patient supine during the administration Taking the patient's blood pressure every 5 minutes
Keeping the patient supine during the administration The patient is experiencing hypertensive crisis. Labetalol is an alpha- and beta-adrenergic blocker and reduces BP by causing vasodilatation and a decrease in heart rate. Patients must be kept supine during IV administration due to severe orthostatic hypotension that occurs with the medication. The BP should be assessed every 2 to 3 minutes during the initial administration of the drug. Seizure activity is not an adverse effect of the medication. The medication will decrease the heart rate.
The nurse presents information to a group of nursing students about cultural and ethnic health disparities related to hypertension. What should the nurse include in the education about Mexican Americans, when comparing them to the white and African American populations? Multiple choice question Mexican Americans have higher rates of blood pressure control. Mexican Americans are more likely to receive treatment for hypertension. Mexican Americans have the highest prevalence of hypertension in the world. Mexican Americans have lower levels of awareness of hypertension and its treatment.
Mexican Americans have lower levels of awareness of hypertension and its treatment. Mexican Americans have lower levels of awareness of hypertension and its treatment than do whites and African Americans. Mexican Americans are less likely to receive treatment for hypertension, and they have lower rates of blood pressure control. African Americans have the highest prevalence of hypertension in the world.
The nurse is caring for a patient admitted to the hospital with a diagnosis of hypertension. The primary health care provider prescribes prazosin. What should be included in the patient's plan of care? Multiple choice question Monitor for orthostatic hypotension. Observe patient for cardiac dysrhythmias. Do not give the medication with grapefruit juice. Do not give to patients with benign prostatic hyperplasia (BPH).
Monitor for orthostatic hypotension Low blood pressure or postural hypotension can cause a fall from dizziness. The medication can reduce resistance to outflow of urine in patients with BPH. Administering grapefruit juice with certain calcium channel blockers may increase the serum concentrations, resulting in toxicity. The direct vasodilator minoxidil may cause EKG changes of flattened and inverted T waves.
A nurse is counseling a patient about dietary supplements normally used for the prevention and treatment of cardiovascular disease. Which supplement has strong scientific evidence for its use? Multiple choice question Melatonin Green tea Glucosamine Omega-3 fatty acids
Omega-3 fatty acids There is strong scientific evidence for the use of omega-3 fatty acids in the treatment and prevention of hypertension, hypertriglyceridemia, and cardiovascular disease. Melatonin, green tea, and glucosamine are not indicated for prevention and treatment of cardiovascular disease. There is unclear scientific evidence for the use of green tea in the treatment of high cholesterol.
The nurse is teaching an older patient with hypertension about developing an exercise program. Which instructions should the nurse include? Multiple choice question Perform weightlifting on a daily basis. Perform flexibility and balance exercises daily. Perform high-intensity aerobic physical activity for at least 30 minutes most days. Perform muscle-strengthening activities using the major muscles of the body at least twice a week.
Perform muscle-strengthening activities using the major muscles of the body at least twice a week. All adults should perform muscle-strengthening activities using the major muscles of the body at least twice a week. Weightlifting is not recommended for a patient with hypertension because it may increase blood pressure (BP). It is recommended to perform moderate-intensity aerobic physical activity for at least 30 minutes most days (i.e., more than 5 days a week). Flexibility and balance exercises are recommended at least twice a week for older adults, especially those at risk for falls.
The nurse is caring for a patient with hypertension who is scheduled to receive a dose of esmolol. The nurse should withhold the dose and consult the prescribing health care provider for which vital sign taken just before administration? Multiple choice question Pulse 48 Respirations 24 Blood pressure 118/74 Oxygen saturation 93%
Pulse 48 Because esmolol is a β 1-adrenergic blocking agent, it can cause hypotension and bradycardia as adverse effects. The nurse should withhold the dose and consult with the health care provider for parameters regarding pulse-rate limits. Respirations, blood pressure, and oxygen saturation are not a source of concern in this case.
The nurse providing dietary instruction to a patient with hypertension should advise the patient to reduce the intake of which foods? Select all that apply. Multiple selection question Nuts Poultry Red meat Canned soup Frozen dinners
Red meat Canned soup Frozen dinners Foods high in fat and sodium, including canned soup, red meat, and frozen dinners, should be avoided by the patient with hypertension. Nuts and poultry are included in the Dietary Approaches to Stop Hypertension (DASH) eating plan
When teaching a patient about dietary management of stage 1 hypertension, which instruction is important for the nurse to provide? Multiple choice question Restrict all caffeine Restrict sodium intake Increase protein intake Use calcium supplements
Restrict sodium intake The patient should decrease intake of sodium. This will help to control hypertension, which can be aggravated by excessive salt intake, which in turn leads to fluid retention. Caffeine and protein intake do not affect hypertension. Calcium supplements are not recommended to lower blood pressure.
A 22-year-old healthy patient with a family history of hypertension asks the nurse about how to reduce the risk of developing high blood pressure. What recommendations should the nurse give to the patient? Select all that apply. Multiple selection question Restrict sodium intake to less than or equal to 2300 mg/day. Limit alcohol intake; one drink is defined as 24 oz of regular beer. Eat fish, such as salmon and catfish, at least two times per week. Perform moderate-intensity aerobic physical activity for 20 minutes a day, three days a week. Jog at a pace that substantially increases the pulse; this is an example of moderate physical activity.
Restrict sodium intake to less than or equal to 2300 mg/day. Eat fish, such as salmon and catfish, at least two times per week. Healthy adults should restrict sodium intake to less than or equal to 2300 mg/day. For healthy adults with no history of heart disease, the American Heart Association recommends eating fish at least two times per week; fatty fish such as catfish and salmon are recommended. Jogging at a pace that substantially increases the pulse is considered to be vigorous activity. One drink is defined as 12 oz of regular beer. Moderate-intensity aerobic physical activity should be performed for 30 minutes a day, at least five days a week.
When caring for a patient admitted with poorly controlled hypertension, the nurse identifies that which laboratory test result indicates the presence of target organ damage? Multiple choice question Serum uric acid of 3.8 mg/dL Serum creatinine of 2.6 mg/dL Serum potassium of 3.5 mEq/L Blood urea nitrogen (BUN) of 15 mg/dL
Serum creatinine of 2.6 mg/dL The normal serum creatinine level is 0.6 to 1.3 mg/dL. This elevated level indicates target organ damage to the kidneys. BUN of 15 mg/dL, serum uric acid of 3.8 mg/dL, and serum potassium of 3.5 mEq/L are within normal limits.
The nurse provides medication education to a patient with a new diagnosis of hypertension. The nurse should include what common effects of several of the antihypertensive medications? Select all that apply. Multiple selection question Constipation Sexual problems Impaired memory Orthostatic hypotension Urge urinary incontinence
Sexual problems Orthostatic hypotension A common side effect of several of the antihypertensive drugs is orthostatic hypotension. This condition results from an alteration of the autonomic nervous system's mechanisms for regulating BP, which are needed for position changes. Sexual problems may occur with many of the antihypertensive drugs. Problems can range from reduced libido to erectile dysfunction. Constipation, impaired memory, and urge urinary incontinence are not side effects of antihypertensive drugs.
The nurse is teaching a patient about common side effects of antihypertensive medications. Which information should the nurse include? Select all that apply. Multiple selection question Sexual problems Resistant hypertension Orthostatic hypotension Rebound hypotension if the drug is stopped abruptly Frequent voiding and dry mouth if the antihypertensive is a diuretic
Sexual problems Orthostatic hypotension Frequent voiding and dry mouth if the antihypertensive is a diuretic Reduced libido or erectile dysfunction are examples of sexual problems as a side effect of antihypertensive medications. Alteration of the autonomic nervous system mechanism by antihypertensive medications leads to orthostatic hypotension. Diuretics are one class of medications for treatment of hypertension that cause frequent urination and dry mouth. "Resistant hypertension" is a term used to describe failure to reach desired blood pressure (BP) in the patient who takes multiple antihypertensive medications. Rebound hypertension results from abrupt stopping of antihypertensive medication use.
The patient is diagnosed with stage 1 hypertension. The nurse understands that this correlates with which systolic blood pressure measurement? Multiple choice question 130mm Hg 139mm Hg 142mm Hg 162mm Hg
Stage 1 hypertension is defined as a systolic blood pressure of 140 to 159 or a diastolic blood pressure of 90 to 99 mm Hg. Systolic blood pressures of 130 and 139 are defined as prehypertension. A systolic blood pressure of 162/92 mm Hg is categorized as stage 2 hypertension.
A patient receives instructions about monitoring the blood pressure (BP) levels at home. What should the nurse teach the patient about measuring the BP in a supine position? Multiple choice question Take the reading immediately after lying down. Support the arm with a pillow during measurement. Take at least two consecutive readings one after another. Use the arm with the lower BP for all future measurements.
Support the arm with a pillow during measurement. When measuring BP in a supine position, the patient should support the arm with a small pillow to raise the position of the hand to the level of the heart. Record the average pressure by taking two consecutive readings at least one minute apart; this allows the blood to drain from the arm and prevents inaccurate readings. The first reading should be taken after two to three minutes of rest in a supine position. If bilateral BP measurements are not equal, the patient should use the arm with the highest BP for all future measurements.
A patient undergoes routine blood pressure (BP) monitoring. What actions should the nurse take when obtaining the BP measurement? Select all that apply. Multiple selection question Support the patient's arm at heart level. Deflate the cuff at a rate of 5-10 mm Hg/sec. Average two or more readings, taken at intervals of at least 1 minute. Ensure the patient has not exercised within 30 minutes before measurement. Take the measurement immediately after placing the patient in the seated position.
Support the patient's arm at heart level. Average two or more readings, taken at intervals of at least 1 minute. Ensure the patient has not exercised within 30 minutes before measurement. The nurse should ensure that the patient has not exercised, smoked, or ingested caffeine within 30 minutes before measurement. The patient's arm should be supported at heart level. The nurse should average two or more readings (taken at intervals of at least 1 minute). The nurse should obtain additional readings if the first two readings differ by more than 5 mm Hg. The radial pulse is palpated for auscultatory measurement. The nurse should begin measurement only after the patient has rested patiently for 5 minutes after sitting. The cuff should be deflated at a rate of 2 to 3 mm Hg/sec.
As treatment for hypertensive crisis, a patient has received sodium nitroprusside for three days. The nurse recognizes that it is important to assess the patient's thiocyanate levels for what reason? Multiple choice question The medication has a long half-life. The medication is metabolized to cyanide, then thiocyanate. An increased level indicates interactions with other drugs the patient is taking. An increased level indicates adverse effects on target organs caused by the medication.
The medication is metabolized to cyanide, then thiocyanate. Sodium nitroprusside causes arterial vasodilation and reduces systemic vascular resistance. This, in turn, decreases the blood pressure. Sodium nitroprusside is metabolized to cyanide and then to thiocyanate, which can reach lethal levels. Therefore thiocyanate levels should be monitored in patients receiving the drug for more than three days or at doses greater than or equal to 4mcg/kg/min. An increased level does not indicate adverse effects on target organs. It does not indicate interactions with other medications. The cause of concern and the need to assess the thiocyanate level do not relate to the medication's half-life.
A patient is diagnosed with primary hypertension. The nurse reviews the patient's history and identifies which factors that contributed to the development of the hypertension? Select all that apply. Multiple selection question Tobacco use Thyroid disease Diabetes mellitus Increased sodium intake Greater-than-ideal body weight Underproduction of sodium-retaining hormones
Tobacco use Diabetes mellitus Increased sodium intake Greater-than-ideal body weight Contributing factors to primary hypertension include increased sympathetic nervous system (SNS) activity, overproduction (not underproduction) of sodium-retaining hormones and vasoconstricting substances, increased sodium intake, greater-than-ideal body weight, diabetes mellitus, tobacco use, and excessive alcohol consumption. Thyroid disease is related to secondary hypertension.
