PrepU Chapter 43
When describing the adverse effects associated with ACE inhibitors, which would the nurse include? (Select all that apply.)
Constipation Proteinuria Photosensitivity Cough Constipation is a possible adverse effect of ACE inhibitors. Proteinuria is a possible adverse effect of ACE inhibitors. Photosensitivity is a possible adverse effect of ACE inhibitors. Cough is a possible adverse effect of ACE inhibitors. Reflex tachycardia is a possible adverse effect of ACE inhibitors. Pancytopenia is a possible adverse effect of ACE inhibitors.
A client is receiving fosinopril. Which adverse effect would the nurse caution the cliient about to help to promote compliance?
Cough Fosinopril is associated with an unrelenting cough that can lead clients to discontinue the drug. Constipation is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug. GI irritation is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug. Photosensitivity is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug.
A nurse is caring for a client experiencing a hypertensive emergency. If blood pressure is not lowered immediately, what can occur? (Select all that apply.)
Damage to the heart Damage to the kidneys Damage to the eyes A hypertensive emergency if not recognized and treated quickly can result in damage to target organs including the heart, kidneys, and eyes.
A nurse is caring for a client experiencing a hypertensive emergency. If blood pressure is not lowered immediately, what can occur? (Select all that apply.) Damage to the heart Damage to the kidneys Damage to the gall bladder Damage to the pancreas Damage to the eyes
Damage to the heart Damage to the kidneys Damage to the eyes A hypertensive emergency if not recognized and treated quickly can result in damage to target organs including the heart, kidneys, and eyes.
When circulatory shock occurs, there is massive vasodilation causing pooling of the blood in the periphery of the body. An ICU nurse caring for a patient in circulatory shock knows that the pooling of blood in the periphery leads to: Decreased venous return Increased cardiac output Decreased heart rate Increased stroke volume
Decreased venous return Pooling of blood in the periphery results in decreased venous return. Decreased venous return results in decreased stroke volume and decreased cardiac output. Decreased cardiac output, in turn, causes decreased blood pressure and, ultimately, decreased tissue perfusion. The heart rate increases in an attempt to meet the demands of the body
When circulatory shock occurs, there is massive vasodilation causing pooling of the blood in the periphery of the body. An ICU nurse caring for a patient in circulatory shock knows that the pooling of blood in the periphery leads to: Increased stroke volume Increased cardiac output Decreased heart rate Decreased venous return
Decreased venous return Pooling of blood in the periphery results in decreased venous return. Decreased venous return results in decreased stroke volume and decreased cardiac output. Decreased cardiac output, in turn, causes decreased blood pressure and, ultimately, decreased tissue perfusion. The heart rate increases in an attempt to meet the demands of the body
The pharmacology instructor is discussing management of hypertension using angiotensin-converting enzyme (ACE) inhibitors. According to the instructor, ACE inhibitors are considered first-line antihypertensive agents for clients with what disease or condition? Diabetes mellitus Asthma Glaucoma Unstable angina pectoris
Diabetes mellitus ACE inhibitors are considered first-line antihypertensive agents for clients with diabetes mellitus because they reduce proteinuria and slow the progression of renal impairment.
A 71-year-old male client has recently been diagnosed with hypertension. Which measurement is a partial indication of effective treatment and management?
Diastolic blood pressure below 90 mm Hg Successful treatment involves reducing blood pressure below hypertensive levels. In adults, this is typically defined as a systolic pressure below 140 mm Hg and a diastolic pressure below 90 mm Hg.
Key behavioral determinants of blood pressure are related to what factor?
Dietary consumption of calories and salt Key behavioral determinants of blood pressure are related to dietary consumption of calories and salt; the prevalence of hypertension rises proportionally to average body mass index.
A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do?
Discontinue the drug The FDA has issued a black box warning for ACE inhibitors and ARBs during pregnancy, because their use can cause injury and even death to a developing fetus.
A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow up the client's statement?
Explain that drugs like ramipril often cause a cough. ACE inhibitors like ramipril may precipitate a cough and may necessitate discontinuation of the drug. This is not, however, an emergency or an indication of lung infection or lung inflammation.
The client is diagnosed with primary hypertension. The nurse is educating a client about dietary changes that help decrease blood pressure. Which menu selection indicates the need for further client education?
Ham sandwich with mustard, carrots and cheesy dip A ham sandwich with mustard and a cheesy dip has increased fat and sodium. The DASH diet includes whole grains, poultry, fish, and nuts and has reduced amounts of fats, red meats, sweets, and sugared beverages.
A nurse is caring for a client who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed. Which should the nurse assess before beginning drug therapy? Serum calcium levels Serum potassium levels Blood glucose levels Serum magnesium levels
Serum potassium levels Captopril inhibits the angiotensin-converting enzyme that is needed to change the inactive angiotensin I to the active form, angiotensin II. This reduction of angiotensin II decreases the secretion of aldosterone, preventing sodium and water retention. This action decreases peripheral vascular resistance and lowers blood pressure. Serum potassium may increase as a result of decreased aldosterone levels. It would be helpful to have a baseline level at the beginning of the drug therapy to monitor the possible effect of hyperkalemia. There is no need to monitor calcium and magnesium levels. While it is important to always know a diabetic's blood glucose level, captopril does not alter the level during therapy.
A nurse is caring for a client who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed. Which should the nurse assess before beginning drug therapy? Serum magnesium levels Blood glucose levels Serum potassium levels Serum calcium levels
Serum potassium levels Captopril inhibits the angiotensin-converting enzyme that is needed to change the inactive angiotensin I to the active form, angiotensin II. This reduction of angiotensin II decreases the secretion of aldosterone, preventing sodium and water retention. This action decreases peripheral vascular resistance and lowers blood pressure. Serum potassium may increase as a result of decreased aldosterone levels. It would be helpful to have a baseline level at the beginning of the drug therapy to monitor the possible effect of hyperkalemia. There is no need to monitor calcium and magnesium levels. While it is important to always know a diabetic's blood glucose level, captopril does not alter the level during therapy.
A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which is the appropriate action by the nurse? Give the nitroprusside at the ordered rate Obtain an order for naloxone Ask the prescriber to reduce the dose Slow the rate of the infusion
Slow the rate of the infusion Administering nitroprusside too quickly can result in abdominal pain, apprehension, diaphoresis, dizziness, headache, muscle twitching, nausea, palpitations, restlessness, retching, and retrosternal discomfort. The nurse should quickly inform the prescriber and slow the infusion. Symptoms quickly subside when the nitroprusside infusion is slowed or stopped, and usually do not return when the infusion resumes at a slower rate. Consulting the prescriber for a dose change would not help; the rate of drug administration is the issue. Continuing to give the nitroprusside at the ordered rate could be fatal.
A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which is the appropriate action by the nurse? Obtain an order for naloxone Slow the rate of the infusion Give the nitroprusside at the ordered rate Ask the prescriber to reduce the dose
Slow the rate of the infusion Administering nitroprusside too quickly can result in abdominal pain, apprehension, diaphoresis, dizziness, headache, muscle twitching, nausea, palpitations, restlessness, retching, and retrosternal discomfort. The nurse should quickly inform the prescriber and slow the infusion. Symptoms quickly subside when the nitroprusside infusion is slowed or stopped, and usually do not return when the infusion resumes at a slower rate. Consulting the prescriber for a dose change would not help; the rate of drug administration is the issue. Continuing to give the nitroprusside at the ordered rate could be fatal.
A client with a blood pressure of 165/95 mm Hg would be classified in which stage of hypertension?
Stage 2 A client is diagnosed with stage 2 hypertension when their systolic blood pressure is greater than or equal to 160 mm Hg or their diastolic blood pressure is greater than or equal to 100 mm Hg. Stage I hypertension is defined as a systolic pressure between 140 and 159 mm Hg or a diastolic pressure between 90 and 99 mm Hg. Prehypertension is defined as a systolic pressure between 120 and 130 mm Hg or a diastolic pressure between 80 and 89 mm Hg. Normotension is defined as a systolic pressure of less than or equal to 120 mm Hg or a diastolic pressure of less than or equal to 80 mm Hg.
A client with a blood pressure of 165/95 mmHg would be in classified as which stage of hypertension?
Stage 2 A client is diagnosed with stage 2 hypertension when their systolic blood pressure is greater than or equal to 160 or their diastolic blood pressure is greater than or equal to 100.
The nurse is administering norepinephrine intravenous (IV) to an adult client diagnosed with septic shock. The client suddenly develops redness and edema at the right forearm IV site. The client's SBP is 88 mm. Which action would the nurse implement first?
Stop the infusion and administer diluted phentolamine. Extravasation (infiltration of IV fluids outside of the vein) of the norepinephrine IV site has occurred as noted by redness and edema. The nurse's first action is to stop the infusion and immediately administer diluted phentolamine, the antidote to minimize sloughing and necrosis of the tissue. The nurse can then establish a new patent IV site and titrate the drug to keep SBP greater than 90 mm Hg. After increasing the drip, the nurse would assess the SBP again. The nurse can assess urine output and report if it is less than 30 mL/h.
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?
Hydrochlorothiazide Hydrochlorothiazide is a thiazide diuretic that promotes the loss of sodium as well as potassium from the body. Subsequently, the client is at risk for hypokalemia. Amiloride, spironolactone, and triamterene are potassium-sparing diuretics. The client using these diuretics would need to be monitored for hyperkalemia because potassium is not lost along with sodium.
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?
Hydrochlorothiazide Hydrochlorothiazide is a thiazide diuretic that promotes the loss of sodium as well as potassium from the body. Subsequently, the client is at risk for hypokalemia. Amiloride, spironolactone, and triamterene are potassium-sparing diuretics. The client using these diuretics would need to be monitored for hyperkalemia because potassium is not lost along with sodium.
The nurse is caring for a patient at risk of shock. What physiologic response would the nurse know to look for while assessing for shock? Activation of infectious response Increased blood pressure Hypoperfusion of tissues Temperature
Hypoperfusion of tissues Regardless of the initial cause of shock, certain physiologic responses are common to all types of shock. These physiologic responses include hypoperfusion of tissues, hypermetabolism, and activation of the inflammatory response
The nurse is caring for a patient at risk of shock. What physiologic response would the nurse know to look for while assessing for shock? Increased blood pressure Temperature Activation of infectious response Hypoperfusion of tissues
Hypoperfusion of tissues Regardless of the initial cause of shock, certain physiologic responses are common to all types of shock. These physiologic responses include hypoperfusion of tissues, hypermetabolism, and activation of the inflammatory response
A client taking a calcium channel blocker (nifedipine) also takes ranitidine for dyspepsia. The nurse assesses the client for which medication interactions? Bradycardia Bradypnea Tachypnea Tachycardia
Hypotensive crisis Hypotensive crisis may be seen in older patients on nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Thromboembolism, stroke, and blindness will not occur during nitroprusside therapy.
A patient, aged 78 years, is receiving nitroprusside for hypertensive emergency. For which condition should the patient be assessed? Hypotensive crisis Thromboembolism Blindness Stroke
Hypotensive crisis Hypotensive crisis may be seen in older patients on nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Thromboembolism, stroke, and blindness will not occur during nitroprusside therapy.
A patient, aged 78 years, is receiving nitroprusside for hypertensive emergency. For which condition should the patient be assessed? Stroke Blindness Thromboembolism Hypotensive crisis
Hypotensive crisis Hypotensive crisis may be seen in older patients on nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Thromboembolism, stroke, and blindness will not occur during nitroprusside therapy.
A 48-year-old client with a blood pressure of 198/112 mm Hg reports severe headache and drowsiness. The nurse notes that the client is disoriented and has begun to vomit. What is the primary nursing goal for this client experiencing a hypertensive emergency?
Implement interventions to lower blood pressure. Hypertensive emergencies require immediate blood pressure reduction with parenteral antihypertensive drugs to limit damage to target organs. While appropriate, none of the other options have priority over decreasing the blood pressure.
When preparing a plan of care for a client in hypovolemic shock, which partial nursing diagnosis might be relevant to the patient's condition?
Ineffective Tissue Perfusion Hypovolemic shock is caused by the loss of intravascular fluids, including blood. Therefore, of the four options, the only choice relevant to hypovolemic shock is Ineffective Tissue Perfusion.
When preparing a plan of care for a client in hypovolemic shock, which partial nursing diagnosis might be relevant to the patient's condition? Activity Intolerance Excess Fluid Volume Social Isolation Ineffective Tissue Perfusion
Ineffective Tissue Perfusion Hypovolemic shock is caused by the loss of intravascular fluids, including blood. Therefore, of the four options, the only choice relevant to hypovolemic shock is Ineffective Tissue Perfusion.
A male client who has been receiving verapamil for several months comes to the clinic reporting significant dizziness, light-headedness, and fatigue. He also reports frequent episodes of nausea and swelling of his ankles. Drug toxicity is suspected. Which question would be critical to ask the client? "Are you taking any over-the-counter pain relievers like ibuprofen?" "Have you been drinking any grapefruit juice lately?" "Are your splitting or crushing your pills?" "When did you take the last dose of the drug?"
"Have you been drinking any grapefruit juice lately?" Verapamil, like other calcium channel blockers, interacts with grapefruit juice, increasing the concentration of calcium channel blockers and leading to toxicity. Calcium channel blockers do not interact with ibuprofen. Splitting or crushing the pills could lead to a release of the drug all at once, but this is more common when the drug is first taken. Asking about the time the client last took the drug might be important, but it would not address the problem associated with the significant adverse effects.
Which statement made by a client prescribed hydrochloride indicates effective teaching about beta-blocker therapy?
"I'll make sure not to stop taking my propranolol suddenly." It is imperative not to stop taking beta-blockers suddenly in order to avoid severe cardiac effects. Beta-blockers do not relieve chest pain nor are they expected to increase urination. Many herbs are contraindicated with beta-blockers.
Which statement made by a client prescribed hydrochloride indicates effective teaching about beta-blocker therapy?
"I'll make sure not to stop taking my propranolol suddenly." It is imperative not to stop taking beta-blockers suddenly in order to avoid severe cardiac effects. Beta-blockers do not relieve chest pain nor are they expected to increase urination. Many herbs are contraindicated with beta-blockers.
A client, prescribed amlodipine, asks how this drug works. What is the nurse's best response?
"It dilates peripheral arteries and relaxes vascular smooth muscle." Amlodipine is a calcium channel blocker that dilates peripheral arteries and decreases peripheral vascular resistance by relaxing vascular smooth muscle. Diuretics decrease the cardiac output by diuresis of sodium and water. This medication does not increase pain or affect the heart rate. ACE inhibitors block the conversion of angiotensin I to angiotensin II.
A client, prescribed amlodipine, asks how this drug works. What is the nurse's best response? "Decreases the cardiac output by diuresis of sodium and water." "Blocks conversion of angiotensin I to angiotensin II." "It dilates peripheral arteries and relaxes vascular smooth muscle." "Increases client's perception of pain and decreases the heart rate."
"It dilates peripheral arteries and relaxes vascular smooth muscle." Amlodipine is a calcium channel blocker that dilates peripheral arteries and decreases peripheral vascular resistance by relaxing vascular smooth muscle. Diuretics decrease the cardiac output by diuresis of sodium and water. This medication does not increase pain or affect the heart rate. ACE inhibitors block the conversion of angiotensin I to angiotensin II.
A client, prescribed amlodipine, asks how this drug works. What is the nurse's best response? "Decreases the cardiac output by diuresis of sodium and water." "Increases client's perception of pain and decreases the heart rate." "It dilates peripheral arteries and relaxes vascular smooth muscle." "Blocks conversion of angiotensin I to angiotensin II."
"It dilates peripheral arteries and relaxes vascular smooth muscle." Amlodipine is a calcium channel blocker that dilates peripheral arteries and decreases peripheral vascular resistance by relaxing vascular smooth muscle. Diuretics decrease the cardiac output by diuresis of sodium and water. This medication does not increase pain or affect the heart rate. ACE inhibitors block the conversion of angiotensin I to angiotensin II.
Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension?
"When was your last menstrual period?" It would be important to know when the patient's LMP occurred and that the client is not pregnant. These drugs are category C for the first trimester and category D for the second and third trimesters of pregnancy and should not be used in pregnancy unless the benefits outweigh the risks. The other questions provide good assessment information but would provide no specific insights regarding the client who is beginning angiotensin II receptor blocker therapy.
The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response?
"With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." Hypertension causes damage to blood vessels within the body that may lead to cardiovascular and kidney damage. Hypertension may be treated with or without medications. It is not within the scope of the nurse to decide whether or not the client needs medications, but to provide the education regarding the disease process and medications.
The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response? "Maybe you do not need medication with your history." "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." "The effects of high blood pressure are different for different people." "We always treat high blood pressure with medicine to prevent further damage to your body."
"With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." Hypertension causes damage to blood vessels within the body that may lead to cardiovascular and kidney damage. Hypertension may be treated with or without medications. It is not within the scope of the nurse to decide whether or not the client needs medications, but to provide the education regarding the disease process and medications.
A client with diabetes also has hypertension. The nurse would expect that the blood pressure goal for the client would be which of the following?
130/80 mm Hg The blood pressure goal for a client with diabetes or kidney disease is 130/80 mm Hg. Values of 140/90 mm Hg and 150/100 mm Hg indicate the blood pressure is not under good control. Blood pressure of 100/70 mm Hg can increase the risk or orthostatic hypotension.
A client with diabetes also has hypertension. The nurse would expect that the blood pressure goal for the client would be which of the following? 100/70 mm Hg 130/80 mm Hg 140/90 mm Hg 150/100 mm Hg
130/80 mm Hg The blood pressure goal for a client with diabetes or kidney disease is 130/80 mm Hg. Values of 140/90 mm Hg and 150/100 mm Hg indicate the blood pressure is not under good control. Blood pressure of 100/70 mm Hg can increase the risk or orthostatic hypotension.
A nurse is providing care to a client diagnosed with stage 2 hypertension. The nurse understands that most clients with stage 2 hypertension will require how many antihypertensives to lower blood pressure to goal initially?
2 Most clients with stage 2 hypertension will require 2 medications to lower their blood pressure to goal initially.
A client with hypertension has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the health care provider concludes that losartan alone is not controlling the hypertension. What would the health care provider likely add to the regimen to better control the client's hypertension?
A diuretic When losartan therapy is started, maximal effects on blood pressure usually occur within 3 to 6 weeks. If losartan alone does not control blood pressure, a low dose of a diuretic may be added. A combination product of losartan and hydrochlorothiazide is available. The addition of an ACE inhibitor, a vasopressor or another ARB is not appropriate.
A client with hypertension has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the health care provider concludes that losartan alone is not controlling the hypertension. What would the health care provider likely add to the regimen to better control the client's hypertension? An ACE inhibitor A vasopressor Another ARB A diuretic
A diuretic When losartan therapy is started, maximal effects on blood pressure usually occur within 3 to 6 weeks. If losartan alone does not control blood pressure, a low dose of a diuretic may be added. A combination product of losartan and hydrochlorothiazide is available. The addition of an ACE inhibitor, a vasopressor or another ARB is not appropriate.
A client with hypertension has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the health care provider concludes that losartan alone is not controlling the hypertension. What would the health care provider likely add to the regimen to better control the client's hypertension?
A diuretic When losartan therapy is started, maximal effects on blood pressure usually occur within 3 to 6 weeks. If losartan alone does not control blood pressure, a low dose of a diuretic may be added. A combination product of losartan and hydrochlorothiazide is available. The addition of an ACE inhibitor, a vasopressor or another ARB is not appropriate.
What statement should underlie the nurse's response when asked if ACE inhibitor therapy can be continued during pregnancy?
ACE inhibitors are contraindicated during pregnancy because they are teratogenic. It is important to instruct women of childbearing age to take measures to prevent pregnancy while taking captopril or other ACE inhibitors because the drugs are teratogenic. This therapy must be discontinued if pregnancy occurs.
The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?
It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. Nitroprusside, which is used in hypertensive crisis, directly relaxes vascular smooth muscle, allowing the dilation of peripheral arteries and veins. Angiotensin II receptor blockers block the action of angiotensin II from all the different pathways where it is formed, not just the single substrate altered by ACE inhibitors. Selective aldosterone blockers bind selectively to the mineralocorticoid receptors, thereby blocking aldosterone from binding to these receptors, while calcium channel blockers inhibit the movement of calcium ions across cell membranes.
The nurse has admitted a client with type 1 diabetes mellitus who has been prescribed captopril for treatment of hypertension. The nurse knows this medication is used in clients with diabetes for what reason?
It reduces proteinuria. Captopril is an ACE inhibitor, and it is used to treat hypertension in clients with type 1 diabetes mellitus because it reduces proteinuria and slows progression of renal impairment.
The nurse has admitted a client with type 1 diabetes mellitus who has been prescribed captopril for treatment of hypertension. The nurse knows this medication is used in clients with diabetes for what reason? It reduces fasting blood glucose. It decreases peripheral tissue ischemia. It will prevent the development of blindness. It reduces proteinuria.
It reduces proteinuria. Captopril is an ACE inhibitor, and it is used to treat hypertension in clients with type 1 diabetes mellitus because it reduces proteinuria and slows progression of renal impairment.
After teaching a group of students about the cardiovascular system and pressures, the students demonstrate understanding of the information when they identify which area as having the highest pressure?
Left ventricle The area of highest pressure in the system is always the left ventricle during systole. This pressure propels the blood out of the aorta and into the system.
A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long? 5 years Lifelong One year Until blood pressure is 120/80 mmHg
Lifelong Once primary hypertension develops, management of the disorder becomes a lifetime task. Diet and exercise with weight loss can help to lower blood pressure, however, there are many factors even genetics that contribute to hypertension.
A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long?
Lifelong Once primary hypertension develops, management of the disorder becomes a lifetime task. Diet and exercise with weight loss can help to lower blood pressure, however, there are many factors even genetics that contribute to hypertension.
A nurse is preparing to administer an antihypertensive drug that lowers the blood pressure primarily via suppression of the renin-angiotensin-aldosterone system. Which drug might this be? Lisinopril Verapamil Diltiazem Furosemide
Lisinopril Angiotensin-converting enzyme inhibitors (ACEIs) act primarily for suppress the renin-angiotensin-aldosterone system, and lisinopril is an ACEI. Verapamil and diltiazem are calcium channel blockers and furosemide is a diuretic.
A nurse is preparing to administer an antihypertensive drug that lowers the blood pressure primarily via suppression of the renin-angiotensin-aldosterone system. Which drug might this be? Lisinopril Verapamil Diltiazem Furosemide
Lisinopril Angiotensin-converting enzyme inhibitors (ACEIs) act primarily for suppress the renin-angiotensin-aldosterone system, and lisinopril is an ACEI. Verapamil and diltiazem are calcium channel blockers and furosemide is a diuretic.
A nurse is preparing to administer an antihypertensive drug that lowers the blood pressure primarily via suppression of the renin-angiotensin-aldosterone system. Which drug might this be? Verapamil Diltiazem Lisinopril Furosemide
Lisinopril Angiotensin-converting enzyme inhibitors (ACEIs) act primarily for suppress the renin-angiotensin-aldosterone system, and lisinopril is an ACEI. Verapamil and diltiazem are calcium channel blockers and furosemide is a diuretic.
A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker?
Losartan Losartan is an example of an angiotensin II receptor blocker. Moexipril is an ACE inhibitor. Minoxidil is a vasodilator. Amlodipine is a calcium channel blocker.
Captopril therapy has a potentially adverse effect of neutropenia (low neutrophil count). When taking captopril, which patient would be at the greatest risk for developing this side effect? Hilda, who is showing symptoms of chronic cough Karl, who is showing symptoms of angioedema confined to the face and lip Angela, who is in her first trimester of pregnancy Mark, who is suffering from impaired renal function
Mark, who is suffering from impaired renal function Because the patient suffers from impaired renal function, the nurse must closely monitor Mark for neutropenia, the most common side effect in such patients. Also at risk are patients with heart failure and collagen vascular diseases. Neutropenia generally resolves quickly after captopril is discontinued. Captopril should be administered cautiously to patients who are showing symptoms of chronic cough or angioedema. If the patient becomes pregnant while taking captopril, therapy should be discontinued as soon as possible. However, such patients do not face as much of a risk of neutropenia as patients with impaired renal function.
Captopril therapy has a potentially adverse effect of neutropenia. When taking captopril, which patient would be at the greatest risk for developing this side effect? Angela, who is in her first trimester of pregnancy Mark, who is suffering from impaired renal function Hilda, who is showing symptoms of chronic cough Karl, who is showing symptoms of angioedema confined to the face and lip
Mark, who is suffering from impaired renal function Because the patient suffers from impaired renal function, the nurse must closely monitor Mark for neutropenia, the most common side effect in such patients. Also at risk are patients with heart failure and collagen vascular diseases. Neutropenia generally resolves quickly after captopril is discontinued. Captopril should be administered cautiously to patients who are showing symptoms of chronic cough or angioedema. If the patient becomes pregnant while taking captopril, therapy should be discontinued as soon as possible. However, such patients do not face as much of a risk of neutropenia as patients with impaired renal function.
The ICU nurse is caring for a patient in shock. What is one of the most important functions of the nursing role in caring for this patient? Documenting the administration of medications Monitoring for complications and side effects of treatment Reporting adverse effects of treatment Safely administering prescribed fluids
Monitoring for complications and side effects of treatment General nursing measures include ensuring safe administration of prescribed fluids and medications and documenting their administration and effects. An important function of the nursing role is monitoring for complications and side effects of treatment and reporting them promptly. The other options are correct but not more important functions of nursing care than monitoring for complications and side effects of treatment.
How can the home care nurse assist the client or the client's family members who have hypertension? (Select all that apply.)
Monitoring for drug effects Promoting compliance with the prescribed pharmacologic modifications Promoting compliance with the prescribed lifestyle modifications Whether the client or another member of the household is taking antihypertensive medications, the home care nurse may be helpful in teaching about the drugs, monitoring for drug effects, and promoting compliance with the prescribed regimen (pharmacologic and lifestyle modifications). The nurse would not provide financial assistant with daily expenses though the nurse would help the client and family discover resources that might provide what is needed.
A nurse is educating a group of nursing students on the mechanisms of action of angiotensin-converting enzyme inhibitors (ACEI). Which medication should the nurse explain as the hormone produced by the adrenal cortex?
Aldosterone The nurse should explain that aldosterone is the hormone produced by the adrenal cortex. Renin and angiotensin are hormones produced in the kidneys, and not by the adrenal cortex. Enalapril is not a hormone; it is an ACEI antihypertensive drug.
A client is receiving carvedilol to treat hypertension. The nurse identifies this drug as a(n):
Alpha- and beta-blocker Carvedilol is an alpha- and beta-blocker.
The nurse recognizes that which medication may be used to treat a hypertensive crisis? Amlodipine Hydralazine Minoxidil Nitroprusside
Nitroprusside Nitroprusside is administered during a hypertensive crisis intravenously. Hydralazine and minoxidil are used for severe hypertension, and amlodipine is also administered for hypertension.
A 42-year-old client is seen by the health care provider for follow-up for diabetic nephropathy. The provider prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to?
Angiotensin II receptor blockers Losartan is an angiotensin II receptor blocker (ARB) and is recommended for clients with diabetic renal disease because ARBs have been shown to reduce the rate of end-stage renal disease. Antihyperlipidemic drugs help to reduce cholesterol. Calcium channel blockers relax and widen blood vessels by affecting the muscle cells in the arterial walls, these are recommended with caution in pregnant women. Selective aldosterone blockers do not show reduction of end-stage renal disease but are effective in treating severe CHF.
A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely?
Potassium Aliskiren is associated with hyperkalemia. Therefore, the nurse would need to closely monitor potassium levels. Diuretics can lead to hyponatremia, hypomagnesemia, and hypokalemia.
On several occasions, the nurse checks a client's blood pressure. The readings are 130/82 mm Hg, 136/84 mm Hg, and 128/88 mm Hg. The nurse would expect this client to be classified as having which stage of hypertension? Stage 2 hypertension Stage 1 hypertension Normotensive Prehypertension
Prehypertension
On several occasions, the nurse checks a client's blood pressure. The readings are 130/82 mm Hg, 136/84 mm Hg, and 128/88 mm Hg. The nurse would expect this client to be classified as having which stage of hypertension?
Prehypertension Prehypertension is defined as a systolic pressure between 120 and 130 mm Hg or a diastolic pressure between 80 and 89 mm Hg. Stage 1 hypertension is defined as a systolic pressure between 140 and 159 mm Hg or a diastolic pressure between 90 and 99 mm Hg. Stage 2 hypertension is defined as a systolic pressure of greater than or equal to 160 mm Hg or a diastolic pressure greater than or equal to 100 mm Hg. Normotension is defined as a systolic pressure of less than or equal to 120 mm Hg or a diastolic pressure of less than or equal to 80 mm Hg.
On several occasions, the nurse checks a client's blood pressure. The readings are 130/82 mm Hg, 136/84 mm Hg, and 128/88 mm Hg. The nurse would expect this client to be classified as having which stage of hypertension? Prehypertension Stage 1 hypertension Stage 2 hypertension Normotensive
Prehypertension Prehypertension is defined as a systolic pressure between 120 and 139 mm Hg or a diastolic pressure between 80 and 89 mm Hg. Stage 1 hypertension is defined as a systolic pressure between 140 and 159 mm Hg or a diastolic pressure between 90 and 99 mm Hg. Stage 2 hypertension is defined as a systolic pressure of greater than or equal to 160 mm Hg or a diastolic pressure greater than or equal to 100 mm Hg. Normotension is defined as a systolic pressure of less than or equal to 120 mm Hg or a diastolic pressure of less than or equal to 80 mm Hg.
A client taking a calcium channel blocker (nifedipine) also takes ranitidine for dyspepsia. The nurse assesses the client for which medication interactions?
Bradycardia When combined with ranitidine, calcium channel blockers can have an enhanced effect. Calcium channel blockers relax blood vessels, increase the supply of oxygen to the heart, and reduce the workflow, which may cause the heart to slow. Neither tachycardia, tachypnea, nor bradypnea are related to combining ranitidine with calcium channel blockers.
Which dietary choice is most appropriate and should be encouraged by the nurse for a client diagnosed with hypertension? hot dog, baked beans, and coleslaw grilled hamburger, French fries, and cola ham sandwich, potato chips, and cookie grilled chicken, green salad, and apple
Bradycardia When combined with ranitidine, calcium channel blockers can have an enhanced effect. Calcium channel blockers relax blood vessels, increase the supply of oxygen to the heart, and reduce the workflow, which may cause the heart to slow. Neither tachycardia, tachypnea, nor bradypnea are related to combining ranitidine with calcium channel blockers.
A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which mode of action helps losartan to bring about its antihypertensive effect?
By blocking the angiotensin II receptors Losartan brings about an antihypertensive effect by blocking the angiotensin II receptors. Losartan is an angiotensin II receptor antagonist. By blocking the angiotensin II receptor, the renin-angiotensin system is stopped and consequently blood pressure is reduced. Drugs such as captopril prevent the conversion of angiotensin I. Losartan does not prevent renin secretion. Losartan does not block aldosterone receptors.
A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition? pulmonary edema venous ulcers chest pain palpitations
Pulmonary edema Pulmonary edema is one of the cardinal signs of left-sided heart failure. This health problem does not typically cause venous ulcers, chest pain, or palpitations.
The nurse is reviewing lab results where the client has elevated BUN and creatinine levels. The nurse would question the administration of which antihypertensive?
Quinapril Quinapril is an ACE inhibitor and is contraindicated in clients with renal failure. Nifedipine, diltiazem, and amlodipine are calcium channel blockers and are not contraindicated in renal failure.
A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply. Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation Focus on finding a different job
Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation Lifestyle management of a client diagnosed with primary hypertension should focus on aerobic exercise, improved diet, weight loss, decreased alcohol consumption, and decreased cigarette smoking. Client education should focus on stress management techniques, and finding a different job is not appropriate at this time.
A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?
Restore and maintain adequate tissue perfusion. The goal of adrenergic drug therapy in hypotension and shock is to restore and maintain adequate tissue perfusion, especially to vital organs.
A client is experiencing orthostatic hypotension that is due to antihypertensive therapy. Which nursing diagnosis would be most appropriate?
Risk for injury Risk for injury is appropriate because the changes in blood pressure with position changes increases the client's risk for falls. Ineffective airway clearance would be appropriate if the client has copious respiratory secretions or the unrelenting cough of ACE inhibitors. Impaired peripheral tissue perfusion would be appropriate if the client was experiencing changes in the color or circulation to his extremities. Fluid volume deficit would be appropriate if the client was dehydrated.
A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on captopril (Capoten). The nurse should recognize that the therapeutic effect of this drug is achieved in what way?
By inhibiting the transformation of angiotensin I to angiotensin II Captopril inhibits the ACE needed to change the inactive angiotensin I to the active form, angiotensin II. This reduction of angiotensin II decreases the secretion of aldosterone, thus preventing sodium and water retention. Captopril therefore decreases peripheral vascular resistance and lowers blood pressure. Calcium channel blockers such as verapamil block the movement of calcium ions into arterial smooth muscles and aldosterone blockers such as Eplerenone (Inspra) inhibit aldosterone from binding to mineralocorticoid receptors. ACE inhibitors do not have a direct effect on vascular smooth muscle.
A 54-year-old client with CHF is admitted to the unit. The nurse knows that what physiologic changes will affect a client's stroke volume?
Changes in heart contraction Stroke volume is the volume of blood ejected from the heart at each beat. If a heart contracts harder, more blood is ejected. If a heart cannot contract very well, then less blood is ejected and stroke volume falls. Heparin dose, walking patterns, and respiratory rate do not directly affect stroke volume.
During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment?
Secondary hypertension Secondary hypertension results as a consequence of renal impairment. In secondary hypertension there is usually a known cause for the development of hypertension. Renal disease is one of the causes of secondary hypertension. When there is no known cause of hypertension it is called essential hypertension. Rebound hypertension occurs when a patient abruptly stops taking antihypertensive medication. Hypertensive emergency is a high blood pressure state that has to be lowered immediately.
After reviewing the various antihypertensive agents, a group of students demonstrate the need for additional teaching when they identify which agent as a calcium channel blocker? Nicardipine Valsartan Verapamil Diltiazem
Valsartan Valsartan is an angiotensin II receptor blocker.
A 26-year-old white male client has been prescribed captopril for hypertension. A nurse has been assigned to the client to provide education regarding the use of this drug. The nurse will advise the client that:
a persistent, dry cough may occur; however, it is not serious. The nurse will advise the client that the captopril may produce a persistent, dry cough that is not serious. Clients may want to discontinue therapy because of the cough, but the nurse should encourage the client to continue therapy and help the client minimize the cough. However, if the cough becomes intolerable, the client should contact the prescriber. The client should be instructed to take the first dose at bedtime to minimize the possibilities of injury from first-dose hypotension. The client should be advised to notify the prescriber promptly if sore throat; fever; swollen hands or feet; irregular heartbeat; chest pain; swollen face, eyes, lips and tongue; difficulty breathing; or hoarseness occur. These effects could indicate angioedema, which can be life threatening. If the client normally uses a salt substitute containing potassium or a potassium supplement, these substances may need to be discontinued to avoid possible hyperkalemia. Hypokalemia is not a concern.
A 51-year-old client has been diagnosed with hypertension following several elevated blood pressure readings. The nurse should prepare to educate the client regarding which likely drug regimen?
a thiazide diuretic combined with a beta-blocker The JNC 7 guidelines suggest thiazide diuretics be used as first-line therapy, either alone (monotherapy) or with a beta-blocker, ACE inhibitor, ARB, or calcium channel blocker. Consequently, the other listed drug regimens are less likely to be implemented.
How does captopril contribute to a reduction of a client's blood pressure?
blocking the conversion of angiotensin I to angiotensin II ACE inhibitors such as captopril block the enzyme that normally converts angiotensin I to the potent vasoconstrictor angiotensin II. Calcium channel blockers dilate peripheral arteries and relax vascular smooth muscle. Angiotensin II receptor blockers mitigate the hypertensive effects of angiotensin II and diuretics increase water excretion.
Epinephrine typically demonstrates the potential to promote relaxation of muscles in what structure? bronchiole intestinal wall superficial blood vessel gastrointestinal sphincter
bronchiole Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic shock. The medication has no effect on the muscles suggested by the other options.
Epinephrine typically demonstrates the potential to promote relaxation of muscles in what structure? superficial blood vessel gastrointestinal sphincter intestinal wall bronchiole
bronchiole Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic shock. The medication has no effect on the muscles suggested by the other options.
Which antihypertensive medication can be administered by transdermal patch? clonidine candesartan amlodipine enalapril
clonidine
Which antihypertensive medication can be administered by transdermal patch? amlodipine candesartan enalapril clonidine
clonidine Clonidine is available as a transdermal patch. Enalapril, candesartan, and amlodipine are not available by this route.
The nurse should inform the client of the possibility of developing what common adverse effect of captopril therapy?
dry cough A persistent cough develops in a significant number of clients taking captopril, and this problem may lead to discontinuation of the drug. Photosensitivity, rhinitis, and rash are not common adverse effects of ACE inhibitors.
The nurse should inform the client of the possibility of developing what common adverse effect of captopril therapy? rhinitis photosensitivity rash to the trunk and extremities dry cough
dry cough A persistent cough develops in a significant number of clients taking captopril, and this problem may lead to discontinuation of the drug. Photosensitivity, rhinitis, and rash are not common adverse effects of ACE inhibitors.
A client has been prescribed ramipril 5 mg PO daily with the scheduled dose due at 08:00. The nurse first reviews the client's most recent blood work and should consider withholding the dose because of what laboratory finding?
elevated potassium levels ACE inhibitors like ramipril carry a risk of hyperkalemia, and an elevated potassium level may warrant withholding the drug. Elevated neutrophils or low sodium and hemoglobin levels would not likely prompt this action.
Norepinephrine should be used with caution in an elderly client because of the increased risk of which side effect?
exacerbation of chronic cardiovascular conditions Clinicians use adrenergic agents to treat asthma, hypotension, shock, cardiac arrest, and anaphylaxis in older adults. These drugs stimulate the heart to increase rate and force of contraction and blood pressure. Because older adults often have chronic cardiovascular conditions (e.g., angina, dysrhythmias, heart failure, coronary artery disease, hypertension, peripheral vascular disease) that are aggravated by adrenergic drugs, careful monitoring by the nurse is required. The actions of norepinephrine do not pose an increased risk for any of the other mentioned conditions.
Norepinephrine should be used with caution in an elderly client because of the increased risk of which side effect? exacerbation of chronic cardiovascular conditions cerebral ischemia intracranial pressure Stevens-Johnson's syndrome
exacerbation of chronic cardiovascular conditions Clinicians use adrenergic agents to treat asthma, hypotension, shock, cardiac arrest, and anaphylaxis in older adults. These drugs stimulate the heart to increase rate and force of contraction and blood pressure. Because older adults often have chronic cardiovascular conditions (e.g., angina, dysrhythmias, heart failure, coronary artery disease, hypertension, peripheral vascular disease) that are aggravated by adrenergic drugs, careful monitoring by the nurse is required. The actions of norepinephrine do not pose an increased risk for any of the other mentioned conditions.
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for: constipation. falls. xerostomia (dry mouth). depression.
falls Angiotensin II receptor blockers such as losartan are associated with a risk of dizziness and a consequent risk for falls. This risk is more pronounced among older adults. Losartan is not associated with constipation, xerostomia, or depression.
An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect? falls infection acute confusion impaired oxygenation
falls Initiation of antihypertensive therapy creates a risk of acute hypotension and consequent falls. Infection, confusion, or impaired oxygenation is much less likely.
A patient is receiving verapamil. What would be important for the nurse to stress that the patient avoid?
grapefruit juice Verapamil, like other calcium channel blockers, interacts with grapefruit juice, increasing the concentration of calcium channel blockers and leading to toxicity.
A client, being treated in the hospital for a femoral fracture, is scheduled to receive a daily dose of metoprolol that was prescribed 3 years ago. Prior to administering this drug, the nurse should assess and document which client data? Select all that apply.
heart rate blood pressure Beta-blockers reduce heart rate and blood pressure; both parameters should be assessed prior to administration. Beta-blockers do not significantly affect potassium levels, oxygen levels, or peripheral circulation.
What additional medication will best increase the effectiveness of blood pressure control in a client prescribed losartan? atorvastatin calcium hydrochlorothiazide hydralazine hydrochloride digoxin
hydrochlorothiazide If losartan alone does not control blood pressure, a low dose of diuretic may be added. Hydrochlorothiazide is a diuretic agent. Atorvastatin calcium is not a diuretic agent but rather a statin medication. Hydralazine is not a diuretic agent but rather a vasodilator. Digoxin is not a diuretic agent but rather a digitalis glycoside.
What electrolyte imbalance might a diabetic client be prone to develop when prescribed captopril? hyperkalemia hypokalemia hypernatremia hypermagnesemia
hyperkalemia By blocking production of angiotensin II, the ACE inhibitors decrease aldosterone production (thus reducing retention of sodium and water and increasing the retention of potassium). Hyperkalemia may develop in clients who have diabetes mellitus or renal impairment. Hypokalemia is not a risk in clients with diabetes mellitus. Hypernatremia is not a major risk in clients with diabetes who are taking captopril. Hypermagnesemia is not a risk in clients with diabetes who are taking captopril.
What electrolyte imbalance might a diabetic client be prone to develop when prescribed captopril? hypermagnesemia hyperkalemia hypernatremia hypokalemia
hyperkalemia By blocking production of angiotensin II, the ACE inhibitors decrease aldosterone production (thus reducing retention of sodium and water and increasing the retention of potassium). Hyperkalemia may develop in clients who have diabetes mellitus or renal impairment. Hypokalemia is not a risk in clients with diabetes mellitus. Hypernatremia is not a major risk in clients with diabetes who are taking captopril. Hypermagnesemia is not a risk in clients with diabetes who are taking captopril.
A teenage client has not responded normally to rescue inhaler therapy. When subcutaneous epinephrine is prescribed, the nurse should anticipate what reaction to occur?
instant bronchodilation For acute asthma attacks, subcutaneous administration of epinephrine usually produces bronchodilation instantly; maximal effects may occur within 20 minutes helping to eventually decrease the respiratory rate. None of the remaining options identify expected results of subcutaneous epinephrine.
A teenage client has not responded normally to rescue inhaler therapy. When subcutaneous epinephrine is prescribed, the nurse should anticipate what reaction to occur? increased level of consciousness within 2 to 5 minutes immediate reduction of anxiety instant bronchodilation an immediate increase in respiratory rate
instant bronchodilation For acute asthma attacks, subcutaneous administration of epinephrine usually produces bronchodilation instantly; maximal effects may occur within 20 minutes helping to eventually decrease the respiratory rate. None of the remaining options identify expected results of subcutaneous epinephrine.
A malnourished and hypertensive client is being treated with losartan. Considering the client's nutritional status, how should the dose of the medication be adjusted in this client?
lowered Both losartan and the metabolite are highly bound to plasma albumin, and losartan has a shorter duration of action. Due to malnutrition, a low-dose of losartan should be prescribed. The dose should not be higher than normal due to possible toxicity. The dose should not be the same as normal due to possible toxicity. The medication will not be combined with a diuretic unless the blood pressure is not controlled.
A malnourished and hypertensive client is being treated with losartan. Considering the client's nutritional status, how should the dose of the medication be adjusted in this client?
lowered Both losartan and the metabolite are highly bound to plasma albumin, and losartan has a shorter duration of action. Due to malnutrition, a low-dose of losartan should be prescribed. The dose should not be higher than normal due to possible toxicity. The dose should not be the same as normal due to possible toxicity. The medication will not be combined with a diuretic unless the blood pressure is not controlled.
When the cardiac workload is increased from secondary hypertension, the client is at risk for developing what associated condition?
myocardial hypertrophy Hypertension profoundly alters cardiovascular function by increasing the workload of the heart and causing thickening and sclerosis of arterial walls. The increased cardiac workload leads to myocardial hypertrophy as a compensatory mechanism, with eventual heart failure. Because of endothelial dysfunction and arterial changes (vascular remodeling), the arterial lumen narrows. Renal damage is associated with hypertension, while increased venous tone is a compensatory mechanism for hypotension.
A client is prescribed captopril. What adverse effect should the client be instructed on that can occur with angiotensin-converting enzyme (ACE) inhibitors?
persistent cough A persistent cough can develop with the use of ACE inhibitors like captopril. Sedation, tachycardia, and rash are not generally associated as adverse effects of ACE inhibitors.
An adult client presents with a blood pressure of 128/86 mm Hg. The client exercises regularly, is weight-appropriate for height, and indicates no use of tobacco or alcohol. How would the client's blood pressure be classified?
prehypertension Prehypertension is defined as systolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. More severe hypertension, stage 2 hypertension, is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher. Normal blood pressure is more than 120 over 80 and less than 140 over 90 (120/80-140/90).
An adult client presents with a blood pressure of 128/86 mm Hg. The client exercises regularly, is weight-appropriate for height, and indicates no use of tobacco or alcohol. How would the client's blood pressure be classified? stage 2 hypertension stage 1 hypertension prehypertension normal
prehypertension Prehypertension is defined as systolic blood pressure of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. More severe hypertension, stage 2 hypertension, is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher. Normal blood pressure is more than 120 over 80 and less than 140 over 90 (120/80-140/90).
A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition?
pulmonary edema Pulmonary edema is one of the cardinal signs of left-sided heart failure. This health problem does not typically cause venous ulcers, chest pain, or palpitations.
How is hypertension defined with regard to blood pressure readings?
systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg Hypertension is defined as a systolic pressure above 140 mm Hg or a diastolic pressure above 90 mm Hg on multiple blood pressure measurements. Blood pressure readings lower than 140 mm Hg/90 mm Hg does not meet the criteria while readings above 140 mm Hg/90 mm Hg are higher than the criteria and so reflect hypertension but do not define the criteria.
What sign/symptom would help confirm the possible diagnosis of hypovolemic shock in a client experiencing a significant loss of blood? Select all that apply.
weak pulse clammy skin nausea Signs of hypovolemic shock include weak, rapid pulse; cool, clammy skin; faintness, postural dizziness; and nausea. Neither chest pain nor fever is associated with septic shock since blood loss is the focus of the problem.
The nurse is teaching a client about hypertension. Nonpharmacologic methods to decrease blood pressure would include which? weight loss and decreased salt intake. decreased water intake and decreased potassium intake. increased exercise activity and fat intake. stress reduction techniques and high fat intake.
weight loss and decreased salt intake. Nonpharmacological methods to lower blood pressure include weight loss, stress reduction, regular aerobic exercise, smoking cessation, moderation of alcohol consumption, and dietary changes (such as a decrease in sodium intake). Water and potassium intake are not related to blood pressure. Although increased exercise and stress reduction may be helpful, increased fat intake is counterproductive to the goal of reducing weight.
