Nokea
The nurse has just finished teaching a patient who is hypertensive about the newly prescribed quinapril. Which of the following patient statements indicates that more teaching is needed?
- A. The medication may not work as well if I take any Aspirin.
- B. My health care provider may order a blood potassium level occasionally.
- C. I will call my health care provider if I notice that I have a frequent cough.
- D. I won't worry if I have a little swelling around my lips and face.
Correct Answer: D
Rationale: Angioneurotic edema occurring with angiotensin-converting enzyme (ACE) inhibitor therapy is an indication that the ACE inhibitor should be discontinued. The patient should be taught that if any swelling of the face or oral mucosa occurs, the health care provider should be immediately notified because this could be life threatening. The other patient statements indicate that the patient has an accurate understanding of ACE inhibitor therapy.
You may also like to solve these questions
The nurse is caring for a patient who has just diagnosed with hypertension and has a new prescription for captopril. Which of the following information is important to include when teaching the patient?
- A. Check BP daily before taking the medication.
- B. Increase fluid intake if dryness of the mouth is a problem.
- C. Include high-potassium foods such as bananas in the diet.
- D. Change position slowly to help prevent dizziness and falls.
Correct Answer: D
Rationale: The angiotensin-converting enzyme (ACE) inhibitors frequently cause orthostatic hypotension, and patients should be taught to change position slowly to allow the vascular system time to compensate for the position change. Increasing fluid intake may counteract the effect of the medication, and the patient is taught to use gum or hard candy to relieve dry mouth. The BP does not need to be checked at home by the patient before taking the medication. Because ACE inhibitors cause potassium retention, increased intake of high-potassium foods is inappropriate.
The nurse in the emergency department received change-of-shift report on these four patients with hypertension. Which of the following patients should the nurse assess first?
- A. 52-year-old with a BP of 212/90 who has intermittent claudication
- B. 43-year-old with a BP of 190/102 who is complaining of chest pain
- C. 50-year-old with a BP of 210/110 who has a creatinine of 1.33 mcmol/L
- D. 48-year-old with a BP of 200/98 whose urine shows microalbuminuria
Correct Answer: B
Rationale: The patient with chest pain may be experiencing acute myocardial infarction and rapid assessment and intervention is needed. The symptoms of the other patients also show target organ damage, but are not indicative of acute processes.
Which of the following assessment findings for a patient who is receiving furosemide to treat stage 2 hypertension is most important to report to the health care provider?
- A. Blood glucose level of 10 mmol/L
- B. Blood potassium level of 3.0 mmol/L
- C. Early morning BP reading of 164/96 mm Hg
- D. Orthostatic systolic BP decrease of 12 mm Hg
Correct Answer: B
Rationale: Hypokalemia is a frequent adverse effect of the loop diuretics and can cause life-threatening dysrhythmias. The health care provider should be notified of the potassium level immediately and administration of potassium supplements initiated. The elevated blood glucose and BP also indicate a need for collaborative interventions but will not require action as urgently as the hypokalemia. An orthostatic drop of 12 mm Hg is common and will require intervention only if the patient is symptomatic.
The nurse is teaching a patient with stage I hypertension about diet modifications that should be implemented. Which of the following diet choices indicates that the teaching has been effective?
- A. The patient avoids eating nuts or nut butters.
- B. The patient restricts intake of dietary protein.
- C. The patient has only one cup of coffee in the morning.
- D. The patient has a glass of low-fat milk with each meal.
Correct Answer: D
Rationale: The Dietary Approaches to Stop Hypertension (DASH) recommendations for prevention of hypertension include increasing the intake of calcium-rich foods. Caffeine restriction and decreased protein intake are not included in the recommendations. Nuts are high in beneficial nutrients and 4-5 servings weekly are recommended in the DASH diet.
Which of the following actions should the nurse in the hypertension clinic take in order to obtain an accurate baseline blood pressure (BP) for a new patient?
- A. Obtain a BP reading in each arm and average the results.
- B. Deflate the BP cuff at a rate of 5-10 mm Hg/second.
- C. Have the patient sit in a chair.
- D. Assist the patient to the supine position for BP measurements.
Correct Answer: C
Rationale: The patient should be seated to assess the initial BP and pulse. The BP is obtained in both arms, but the results of the two arms are not averaged. The patient does not need to be in the supine position. The cuff should be deflated at 2-3 mm Hg/second.