Author Question: During his initial screening, the patient's blood pressure was noted to be elevated. Two months ... (Read 91 times)

mckennatimberlake · **on:** Jun 25, 2018

During his initial screening, the patient's blood pressure was noted to be elevated. Two months after the first assessment, he was noted to have a blood pressure of 150/92 and 166/96 at different times during the visit.

It is now a month and a half later, and the nurse is concerned because the patient's initial blood pressure on this visit was 154/94 . She is preparing to take a second blood pressure, understanding that another reading in this range could lead to a diagnosis of:
a. hypotension
b. prehypertension
c. hypertension
d. orthostatic hypotension

Question 2

Where is the pulmonic area for auscultation found?

a. Second intercostal space on the right side
b. Second intercostal space on the left side
c. Third intercostal space (Erb's point)
d. Fourth intercostal space along the sternum

nixon_s · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

C
Hypertension is defined as systolic blood pressure (SBP) of 140 mm Hg or greater, diastolic blood pressure (DBP) of 90 mm Hg or greater, or taking antihypertensive medication (NHBPEP, 2003). One blood pressure recording revealing a high SBP or DBP does not qualify as a diagnosis of hypertension. However, if you assess a high reading (e.g., 150/90 mm Hg), encourage the patient to return for another checkup within 2 months. The diagnosis of hypertension in adults requires an average of two or more readings taken at each of two or more visits after an initial screening. Hypotension occurs when the systolic blood pressure falls to 90 mm Hg or below. Prehypertension is a designation for patients at high risk for developing hypertension. In these patients, early intervention through adoption of healthy lifestyles reduces the risk of or prevents hypertension. Orthostatic hypotension, also referred to as postural hypotension, occurs when a normotensive person develops symptoms (e.g., lightheadedness, dizziness) and low blood pressure when rising to an upright position.

Answer to Question 2

B
The pulmonic area is at the second intercostal space on the left side. The aortic area is at the second intercostal space on the patient's right side. The second pulmonic area is found by moving down the left side of the sternum to the third intercostal space, also referred to as Erb's point. The tricuspid area is located at the fourth left intercostal space along the sternum.