Author Question: A patient who does not consume alcohol or nicotine products reports a strong family history of ... (Read 118 times)

craiczarry · **on:** Jul 23, 2018

A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease.

The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse will expect to teach this patient about:
a. ACE inhibitors and calcium channel blocker medications.
b. the DASH diet, sodium restriction, and exercise.
c. increased calcium and potassium supplements.
d. thiazide diuretics and lifestyle changes.

Question 2

A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting.

The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order:
a. a beta blocker.
b. a loop diuretic and spironolactone.
c. a thiazide diuretic.
d. counseling on lifestyle changes.

juliaf · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
This patient has prehypertension without other risk factors. Lifestyle changes are indicated at this point. If blood pressure rises to hypertension levels, other measures, including drug therapy, will be initiated. Calcium and potassium supplements are not indicated.

Answer to Question 2

ANS: C
This patient has primary, or essential, hypertension as evidenced by systolic pressure greater than 140 and diastolic pressure greater than 90, along with normal tests ruling out another primary cause. Thiazide diuretics are first-line drugs for hypertension. Beta blockers are effective, but are most often used to counter reflex tachycardia associated with reduced blood pressure caused by therapeutic agents. Loop diuretics cause greater diuresis than is usually needed and so are not first-line drugs. This patient should be counseled on lifestyle changes as an adjunct to drug therapy, but should also begin drug therapy because hypertension already exists.