Nokea
The nurse is teaching a patient about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply.
- A. Transient ischemic attacks
- B. Cerebrovascular accident
- C. Retinal hemorrhage
- D. Venous insufficiency
- E. Right ventricular hypertrophy
Correct Answer: A,B,C
Rationale: Potential complications of hypertension include the following: left ventricular hypertrophy; MI; heart failure; transient ischemic attacks (TIAs); cerebrovascular accident; renal insufficiency and failure; and retinal hemorrhage. Venous insufficiency and right ventricular hypertrophy are not potential complications of uncontrolled hypertension.
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A patient has been diagnosed as being prehypertensive. What should the nurse encourage this patient to do to aid in preventing a progression to a hypertensive state?
- A. Avoid excessive potassium intake
- B. Exercise on a regular basis
- C. Eat less protein and more vegetables
- D. Limit morning activity
Correct Answer: B
Rationale: To prevent or delay progression to hypertension and reduce risk, JNC 7 urged health care providers to encourage people with blood pressures in the prehypertension category to begin lifestyle modifications, such as nutritional changes and exercise. There is no need for patients to limit their activity in the morning or to avoid potassium and protein intake.
A patient with newly diagnosed hypertension has come to the clinic for a follow-up visit. The patient asks the nurse why she has to come in so often. What would be the nurses best response?
- A. We do this so you dont suffer a stroke
- B. We do this to determine how your blood pressure changes throughout the day
- C. We do this to see how often you should change your medication dose
- D. We do this to make sure your health is stable. Well then monitor it at routinely scheduled intervals
Correct Answer: D
Rationale: When hypertension is initially detected, nursing assessment involves carefully monitoring the BP at frequent intervals and then at routinely scheduled intervals. The reference to stroke is frightening and does not capture the overall rationale for the monitoring regimen. Changes throughout the day are not a clinical priority for most patients. The patient must not change his or her medication doses unilaterally.
The nurse is collaborating with the dietitian and a patient with hypertension to plan dietary modifications. These modifications should include which of the following?
- A. Reduced intake of protein and carbohydrates
- B. Increased intake of calcium and vitamin D
- C. Reduced intake of fat and sodium
- D. Increased intake of potassium, vitamin B12 and vitamin D
Correct Answer: C
Rationale: Lifestyle modifications usually include restricting sodium and fat intake, increasing intake of fruits and vegetables, and implementing regular physical activity. There is no need to increase calcium, potassium, and vitamin intake. Calorie restriction may be required for some patients, but a specific reduction in protein and carbohydrates is not normally indicated.
During an adult patients last two office visits, the nurse obtained BP readings of 122/84 mm Hg and 130/88 mm Hg, respectively. How would this patients BP be categorized?
- A. Normal
- B. Prehypertensive
- C. Stage 1 hypertensive
- D. Stage 2 hypertensive
Correct Answer: B
Rationale: Prehypertension is defined systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg.
A patients recently elevated BP has prompted the primary care provider to prescribe furosemide (Lasix). The nurse should closely monitor which of the following?
- A. The clients oxygen saturation level
- B. The patients red blood cells, hematocrit, and hemoglobin
- C. The patients level of consciousness
- D. The patients potassium level
Correct Answer: D
Rationale: Loop diuretics can cause potassium depletion. They do not normally affect level of consciousness, erythrocytes, or oxygen saturation.