Assessment and Management of Patients With Hypertension

Assessment and Management of Patients With Hypertension

Question 1 See full question

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that
antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a
client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?

You Selected:

• "Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups
of fluid daily."

Correct response:

• "Flex your calf muscles, avoid alcohol, and change positions slowly."

Explanation:

Measures that minimize orthostatic hypotension include flexing the calf muscles to boost blood return
to the heart, avoiding alcohol and straining at stool, changing positions slowly, eating a high-protein
snack at night, wearing elastic stockings, and holding onto a stationary object when rising. Although the
client should rest between demanding activities and consume plenty of fluids and fiber (contained in
fruits and vegetables) to maintain a balanced diet, these measures don't directly relieve orthostatic
hypotension.

Reference:

• Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th
ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 31: Assessment and
Management of Patients With Hypertension, p. 871.

Chapter 31: Assessment and Management of Patients With Hypertension - Page 871

Question 2 See full question

Which of the following terms is given to hypertension in which blood pressure that is controlled with
therapy becomes uncontrolled (abnormally high) with the discontinuation of therapy?

You Selected:

• Rebound

Correct response:

• Rebound

Explanation:

Rebound hypertension may precipitate a hypertensive crisis. Essential or primary hypertension
denotes high blood pressure from an unidentified source. Secondary hypertension denotes high blood
pressure from an identified cause, such as renal disease.

Reference:

,Assessment and Management of Patients With Hypertension

• Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th
ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 31: Assessment and
Management of Patients With Hypertension, p. 863.

Chapter 31: Assessment and Management of Patients With Hypertension - Page 863

Question 3 See full question

Of the following diuretic medications, which conserves potassium?

You Selected:

• Spironolactone (Aldactone)

Correct response:

• Spironolactone (Aldactone)

Explanation:

Aldactone is known as a potassium-sparing diuretic. Lasix causes loss of potassium from the body. Diuril
causes mild hypokalemia. Hygroton causes mild hypokalemia.

Reference:

• Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th
ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 31: Assessment and
Management of Patients With Hypertension, p. 867.

Chapter 31: Assessment and Management of Patients With Hypertension - Page 867

Question 4 See full question

A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which of
the following statements would the nurse include in the education session?

You Selected:

• Engage in aerobic activity at least 30 minutes/day most days of the week.

Correct response:

• Engage in aerobic activity at least 30 minutes/day most days of the week.

Explanation:

Recommmended lifestye modifications to prevent and manage hypertension include maintaining a
normal body mass index (about 24; greater than 25 is considered overweight), maintaining a waist
circumference of less than 40 inches for men and 35 inches for women, limiting alcohol intake to no
more than 2 drinks for men and 1 drink for women per day, and engaging in aerobic activity at least 30
minutes per day most days of the week.

Reference:

, Assessment and Management of Patients With Hypertension

• Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th
ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 31: Assessment and
Management of Patients With Hypertension, p. 865.

Chapter 31: Assessment and Management of Patients With Hypertension - Page 865

Question 5 See full question

A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed a thiazide
and an angio-converting enzyme inhibitor. About what is the nurse most concerned?

You Selected:

• Postural hypotension and resulting injury

Correct response:

• Postural hypotension and resulting injury

Explanation:

Antihypertensive medication can cause hypotension, especially postural hypotension that may result in
injury. Rebound hypertension occurs when antihypertensive medication is stopped abruptly. Sexual
dysfunction may occur, especially with beta blockers, but other medications are available should this
problem ensue. This is not immediately a priority concern. Antihypertensive medications do not usually
cause postural hypertension.

Reference:

• Smeltzer, S.C., and Bare, B. Brunner & Suddarth's Textbook of Medical Surgical-Nursing, 12th
ed. Philadelphia: Lippincott Williams & Wilkins, 2010, Chapter 32: Assessment and
Management of Patients With Hypertension, page 899.

Question 6 See full question

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed
hypertension. While discussing dietary changes, which of the following points would the nurse
emphasize?

You Selected:

• It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

Correct response:

• It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

Explanation:

It takes 2 to 3 months for the taste buds to adapt to changes in salt intake. Knowing this may help the
client adjust to reduced salt intake. The client should be advised to limit alcohol intake.

Reference: