The nurse on the intermediate care unit received change-of-shift ...

[torybrooks]

The nurse on the intermediate care unit received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?
 
  a. 43-year-old with a (blood pressure (BP) of 160/92 who is complaining of chest pain
  b. 52-year-old with a BP of 212/90 who has intermittent claudication
  c. 50-year-old with a BP of 190/104 who has a creatinine of 1.7 mg/dL
  d. 48-year-old with a BP of 172/98 whose urine shows microalbuminuria

Question 2

Which information should the nurse include when teaching a patient with newly diagnosed hypertension?
 
  a. Increasing physical activity will control blood pressure (BP) for most patients.
  b. Most patients are able to control BP through dietary changes.
  c. Annual BP checks are needed to monitor treatment effectiveness.
  d. Hypertension is usually asymptomatic until target organ damage occurs.

[kswal303]

Answer to Question 1

ANS: A
The patient with chest pain may be experiencing acute myocardial infarction, and rapid assessment and intervention are needed. The symptoms of the other patients also show target organ damage but are not indicative of acute processes.

Answer to Question 2

ANS: D
Hypertension is usually asymptomatic until target organ damage has occurred. Lifestyle changes (e.g., physical activity, dietary changes) are used to help manage blood pressure, but drugs are needed for most patients. Home BP monitoring should be taught to the patient and findings checked by the health care provider frequently when starting treatment for hypertension and then every 3 months once stable.