Chapter 22 "Nursing Care of Patients With Hypertension"

A client with hypertension presents to the clinic with a blood pressure reading of 218/112. Which question is most important for the nurse to ask?

"Have you been taking your blood pressure medications?"

The nurse is providing teaching regarding the DASH diet for a client diagnosed with hypertension. Which statement made by the client indicates a need for further education?

"I can eat foods high in sodium as long as I drink plenty of water."

The nurse is providing preoperative teaching to a client about to undergo cardiac surgery. Which of the following statements made by the client indicates a need for further education?

"I should avoid coughing and deep breathing so my incision does not reopen."

The nurse is teaching a postoperative client how to apply antiembolism stockings. Which statement made by the client indicates a need for further teaching?

"The top of the stocking need to be 2 inches over the kneecap."

The nurse is answering questions for a client about to undergo angiography. Which statement made by the client indicates an understanding of the procedure?

"This test will inject dye into my vessels and see if I have a clot somewhere."

The nurse is caring for a client with hypertension. Which clinical manifestations should the nurse expect the client to exhibit? Select all that apply.

-asymptomatic -headache -bloody nose -SOB

The nurse is caring for a client with suspected orthostatic hypotension. Which factors place this client at risk? Select all that apply

-diuretics -analgesics -pain

The nurse is caring for a client with suspected orthostatic hypotension. Which factors place this client at risk? Select all that apply.

-diuretics -analgesics -pain

The nurse is preparing a presentation about cardiovascular disease. Which should the nurse include in the presentation as risk factors? Select all that apply.

-smoking -poor diet -obesity -high total cholesterol

The nurse is caring for a client with hypertension. The client is at risk for which of the following? Select all that apply.

-stroke -heart failure -pulmonary edema

The nurse is providing teaching for a client being discharged home with metoprolol. Which of the following is most important for the nurse to include in the teaching? Select all that apply.

-weigh self daily -sit up slowly from a lying position -do not stop taking medication abruptly -notify HCP if dizziness occurs

The nurse is providing teaching regarding healthy food choices to a client with hypertension. Which food choice indicates that the client understood the teaching?

1 small apple with 1 cup of raw leafy vegetables and 1 ½ ounce of cheese

The nurse is assessing the pulse of a client. The pulse disappears when slight pressure is applied and returns when the pressure is removed. This describes a pulse of what quality?

1+

The nurse is assessing a client's blood pressure (BP). Which finding would the nurse document as normal?

110/70 *normal BP is considered less than 120/80*

elevated BP/"pre hypertension"

120-129/<80

Stage 1 hypertension

130-139/80-89

The nurse is administering furosemide 40 mg by mouth to a client with hypertension. Available is furosemide 20 mg tablets. How many tablets will the nurse administer? Enter the numeral only.

2 tabs

The health-care provider suspects a client has hypertension. The nurse should anticipate preparing the client for which of the following?

24-hour ambulatory blood pressure (BP) monitoring

The nurse is assessing the resting heart rate of a marathon runner. Which heart rate is an expected finding in this client?

50 beats/minute *An athletic individual typically has a slow heart rate because a well-conditioned heart pumps efficiently.*

normal BP

<120/<80

Stage 2 hypertension

>=140/>=90

The nurse is caring for a group of clients. Which client is at highest risk for developing hypertension?

A 56-year-old African-American female who is 5'4" and weighs 260 pounds.

The nurse is caring for a group of clients. Which client should the nurse see first?

A client with a blood pressure of 180/90 who reports chest pain *This client has elevated blood pressure (not as elevated as some) but is reporting chest pain, which could be caused by a myocardial infarction (MI). This client is unstable and should be seen first.*

The nurse is caring for a group of clients. Which client should the nurse see first?

A client with a manual blood pressure of 224/114

plaque

A deposit of fatty material on the lining of an artery.

cardiac output

A measure of the pumping ability of the heart; amount of blood pumped by the heart per minute.

primary hypertension

Abnormally elevated blood pressure of unknown cause. Also called essential hypertension.

hypertension

Abnormally elevated blood pressure.

The nurse is preparing a client for a cardiac catheterization. Which of the following is the most important piece of data to know prior to the procedure?

Allergies to iodine, shellfish, or contrast dye

The nurse is caring for a client taking digoxin. Which medication in the client's orders should the nurse question?

Amlodipine

hypertrophy

An increase in the size of an organ or structure, or of the body, owing to growth rather than tumor formation.

Which answer describes the role of arteries?

Carry blood from the heart to capillaries

essential hypertension

Chronic elevation of blood pressure resulting from an unknown cause

The nurse is assessing the temperature of a client's lower extremities and notes that one leg is cool to the touch. Which of these answers describes the meaning of a cool extremity?

Decreased arterial blood flow

Which internal factor may contribute to hypertension?

Decreased elasticity of blood vessels

The nurse is caring for a client with orthostatic hypotension. Which intervention should the nurse implement to promote safety?

Encourage the client to ask for assistance prior to getting out of bed

secondary hypertension

High blood pressure that is a symptom of a specific cause, such as a kidney abnormality.

The nurse is preparing to administer propranolol to a client with hypertension. The nurse obtains a blood pressure reading of 76/42. Which action should the nurse take?

Hold the medication and notify the health-care provider (HCP)

Hypertension can lead to which change in the heart?

Increase in size of left ventricle *hypertrophy*

systolic

Maximal pressure exerted on the arteries during contraction of the left ventricle of the heart. The top number of a blood pressure reading.

The nurse is caring for a client with exacerbation of asthma and hypertension. Which medication order should the nurse question?

Metoprolol

Hypertensive urgency

Occurs when blood pressure is as elevated as in a hypertensive emergency but without progression of target-organ dysfunction.

peripheral vascular resistance

Opposition to blood flow through the vessels.

The nurse is reviewing lab values for a client taking furosemide. Which of these lab values would concern the nurse the most?

Potassium 2.5 mEq/L

The first heart sound heard at the beginning of systole when the tricuspid and mitral valves close is known as which sound?

S1

The nurse obtains a blood pressure (BP) reading of 134/86. According to the blood pressure categories, this client's blood pressure is in which category?

Stage 1 hypertension

hypertensive emergency

Systolic blood pressure above 180 mm Hg and diastolic blood pressure above 120 mm Hg.

diastolic

The amount of pressure exerted on the wall of the arteries when the ventricles are at rest. The bottom number in a blood pressure reading.

Viscosity

Thickness, as of the blood.

The nurse is taking a medication history of a client about to undergo cardiovascular surgery. Which medication reported by the client would require the nurse to notify the surgeon?

Warfarin

The nurse is caring for a client who underwent a cardiac catheterization. Which of the following interventions should the nurse implement? Select all that apply.

_Monitor vital signs -Monitor peripheral pulses -Keep the client on bed rest as ordered -Monitor the puncture site

The nurse is caring for a client who reports pink and frothy sputum. The nurse suspects this client may have a diagnosis of which condition?

acute heart failure

Which of the following is a nonmodifiable risk factor for heart disease?

age

A client returns to the clinic for a follow-up after being treated for hypertension for 4 months. Which assessment data indicates that the medication has been effective?

blood pressure is 116/70

A client presents to the emergency department with chest pain. Which blood study is most important to monitor to rule out a myocardial infarction (MI)?

cardiac troponin *A cardiac troponin level is drawn to detect cardiac damage. This is more effective than a CK-MB.*

A client presents to the clinic with chest pain. For which test should the nurse prepare the client first?

electrocardiogram (ekg/ ecg)

A client with a diagnosis of hypertension who has been taking medication reports a dry cough. Which medication can the nurse expect to find in the client's medication history?

lisinopril *the side effect of an ACE inhibitor is dry cough*

The nurse is auscultating a client's heart sounds and notes a prolonged, faint swishing sound. The nurse suspects the client may be exhibiting which abnormality?

murmur

The nurse is monitoring a client's pulse and notes there are fewer radial beats than apical beats. Which action by the nurse is best?

notify the HCP *client has pulse deficit*

The nurse is assessing a client who reports chest pain along with pain in the shoulder. Which term describes this pain?

radiate

Which part of the heart pumps deoxygenated blood toward the lungs?

right ventricle

The nurse is caring for a client receiving furosemide. The nurse should provide the following education to the client:

take the medication in the morning

decreased venous blood flow cause the extremity to be

warm