Nokea
A patient in hypertensive emergency is being cared for in the ICU. The patient has become hypovolemic secondary to natriuresis. What is the nurses most appropriate action?
- A. Add sodium to the patients IV fluid, as ordered
- B. Administer a vasoconstrictor, as ordered
- C. Promptly cease antihypertensive therapy
- D. Administer normal saline IV, as ordered
Correct Answer: D
Rationale: If there is volume depletion secondary to natriuresis caused by the elevated BP, then volume replacement with normal saline can prevent large, sudden drops in BP when antihypertensive medications are administered. Sodium administration, cessation of antihypertensive therapy, and administration of vasoconstrictors are not normally indicated.
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A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group?
- A. Pacific Islanders
- B. African Americans
- C. Asian-Americans
- D. Hispanics
Correct Answer: D
Rationale: The prevalence of uncontrolled hypertension varies by ethnicity, with Hispanics and African Americans having the highest prevalence at approximately 63% and 57%, respectively.
The hospital nurse cares for many patients who have hypertension. What nursing diagnosis is most common among patients who are being treated for this health problem?
- A. Deficient knowledge regarding the lifestyle modifications for management of hypertension
- B. Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy
- C. Deficient knowledge regarding BP monitoring
- D. Noncompliance with treatment regimen related to medication costs
Correct Answer: B
Rationale: Deviation from the therapeutic program is a significant problem for people with hypertension and other chronic conditions requiring lifetime management. For many patients, this is related to adverse effects of medications. Medication cost is relevant for many patients, but adverse effects are thought to be a more significant barrier. Many patients are aware of necessary lifestyle modification, but do not adhere to them. Most patients are aware of the need to monitor their BP.
A patient comes to the walk-in clinic complaining of frequent headaches. While assessing the patients vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this patients BP be defined if a similar reading were obtained at a subsequent office visit?
- A. High normal
- B. Normal
- C. Stage 1 hypertensive
- D. Stage 2 hypertensive
Correct Answer: D
Rationale: JNC 7 defines stage 2 hypertension as a reading 160/100 mm Hg.
The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal?
- A. Less than 140/90 mm Hg
- B. Less than 130/90 mm Hg
- C. Less than 129/89 mm Hg
- D. Less than 120/80 mm Hg
Correct Answer: D
Rationale: JNC 7 defines a blood pressure of less than 120/80 mm Hg as normal, 120 to 129/80 to 89 mm Hg as prehypertension, and 140/90 mm Hg or higher as hypertension.
A patient has come to the clinic for a follow-up assessment that will include a BP reading. To ensure an accurate reading, the nurse should confirm that the patient has done which of the following?
- A. Tried to rest quietly for 5 minutes before the reading is taken
- B. Refrained from smoking for at least 8 hours
- C. Drunk adequate fluids during the day prior
- D. Avoided drinking coffee for 12 hours before the visit
Correct Answer: A
Rationale: Prior to the nurse assessing the patients BP, the patient should try to rest quietly for 5 minutes. The forearm should be positioned at heart level. Caffeine products and cigarette smoking should be avoided for at least 30 minutes prior to the visit. Recent fluid intake is not normally relevant.