T&C I assessment & management of pt w/ hypertension
A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?
"Flex your calf muscles, avoid alcohol, and change positions slowly."
The nurse is teaching a client about recommended follow-up for a person initially diagnosed with prehypertension. What time frame will the nurse advise the client to have the blood pressure (BP) rechecked?
1 year
Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through:
Ophthalmic examination.
Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply.
Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured.
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."
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
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore blood pressure below hypertensive levels?
Decrease sodium intake
Which diuretic medication conserves potassium?
Spironolactone
When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures
differ no more than 5 mm Hg between arms.
The nurse is assessing the blood pressure for a patient who has hypertension and the nurse does not hear an auscultatory gap. What outcome may be documented in this circumstance?
A high diastolic or low systolic reading
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
Age
A nurse is providing education to a client about monitoring blood pressure readings at home. What reminders will the nurse review with the client? Select all that apply.
Avoid talking during the measurement. Sit with both feet on the ground during the measurement. Ensure at least 5 minutes of quiet rest before measurements. Be sure the forearm is well supported at heart level while taking blood pressure
The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure?
Heart and blood vessels
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
A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect?
Hyperkalemia
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
A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?
Potassium level
Which finding indicates that hypertension is progressing to target organ damage?
Retinal blood vessel damage
A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include?
nonpharmacological interventions
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?
Hypertensive emergency
The nurse is caring for a client newly diagnosed with secondary hypertension. Which condition contributes to the development of secondary hypertension?
Renal disease
Which term describes high blood pressure from an identified cause, such as renal disease?
Secondary hypertension
The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?
Sit on the edge of the chair and rise slowly.
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
The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium?
Spironolactone
A diastolic blood pressure of 92 mm Hg is classified as
Stage 2 hypertension
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?
Stroke
What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply.
family history of early cardiovascular events diabetes hypertension obesity
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.
A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?
"I chose broiled chicken with a baked potato for dinner."
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 is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specify about this client's target blood pressure?
130/80 or lower
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
A nurse is discussing with a nursing student how to accurately measure blood pressure. What statement by the student indicates an understanding of the education?
A cuff that is too small will give a false high blood pressure.
A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for?
Dizziness
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)
The nurse is caring for a client with accelerated hypertension. Which body system would the nurse assess to identify early signs of blood pressure progression?
Eyes
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 with hypertension has been able to maintain a blood pressure of 130/70 mm Hg for 1 year while reducing dietary sodium and taking hydrochlorothiazide (HCTZ) and atenolol. What treatment plan will the nurse educate the client about?
Gradual reducing the HCTZ and the atenolol and continuing to reduce sodium intake
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
A 77-year-old client presents to the local community center for a blood pressure (BP) screening; BP is recorded as 180/90 mm Hg. The client has a history of hypertension but currently is not taking the prescribed medications. Which question is most appropriate for the nurse to ask the client first?
"Can you tell me the reasons you aren't taking your medications?"
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."
