MedSurg Ch 27- Assessment and Management of Patients with 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. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response?

"Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg."

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

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize?

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

A nurse educator is providing information to a small group of clients about hypertension. A participant asks what her target blood pressure should be. The nurse is aware of the target goals of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). Which of the following reflects the goal for blood pressure readings for people without co-morbidities?

140/90 or lower

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true?

Pressures should not differ more than 5 mm Hg between arms.

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 had been stolen. If the patient cannot take the medication, what condition becomes a concern?

Rebound hypertension

A client is brought to the emergency department with reports of 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 reduction of the mean blood pressure?

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?

Secondary

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

Smoking Diabetes Mellitus Physical inactivity

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?

A client diagnosed with kidney disease

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred?

Echocardiography

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)

A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client names four favorite meals. Which selection would be best?

Green pepper stuffed with diced tomatoes and chicken

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? (Select all that apply.)

Heart rate Heart rhythm Character of apical and peripheral pulses

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?

Hypertensive emergency

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize?

It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse?

Numbness and weakness in the left arm

The nurse is caring for a client with long-standing hypertension. As a client advocate, what should the nurse suggest is most helpful in preventing further complications?

Obtain a regular appointment with eye doctor.

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for?

Postural hypotension and resulting injury

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is helpful?

Stress reduction to lower prehypertensive state

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?

Stroke

The nurse observes a certified nursing assistant (CNA) obtaining a blood pressure reading with a cuff that is too small for the patient. The nurse informs the CNA that using a cuff that is too small can affect the reading results in what way?

The results will be falsely elevated.

The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should

check the client's heart rate.

The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents?

continuous IV infusion

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress

decreases the production of neurotransmitters that constrict peripheral arterioles.

Hypertension that can be attributed to an underlying cause is termed

secondary hypertension.

The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if:

systolic BP is between 120 and 139 mm Hg.