The patient has been admitted for hypertension. His blood ...

[jrubin]

The patient has been admitted for hypertension. His blood pressure is normally in the 160/90 range. He has been on bed rest for the past few days, and the doctor has started him on a new blood pressure medication.
 
  The nurse is assisting the patient to move from the bed to the chair for breakfast, but when the patient tries to sit up on the side of the bed, he complains of being dizzy and nauseous. The nurse lays the patient down and takes his vital signs. His pulse is 124 . His blood pressure is 130/80 . This blood pressure is indicative of what? a. A normal blood pressure for this patient
  b. Orthostatic hypotension
  c. Orthostatic hypertension
  d. Effective baroreceptor function

Question 2

When teaching about blood pressure measurement in the home, the nurse instructs the client to:
 
  A. Reduce extraneous noise
  B. Take the blood pressure measurement after exercising
  C. Assess the blood pressure at different times each day
  D. Repeat attempts at measurement several times at the same location until it is heard

[scottmt]

Answer to Question 1

B
Orthostatic hypotension is a drop in blood pressure that occurs when the patient changes from a horizontal to a vertical position. It traditionally is defined as a drop in systolic or diastolic blood pressure of 20 or 10 mm Hg, respectively. Those at higher risk are immobilized patients, those undergoing prolonged bed rest, the older adult patient, those receiving antihypertensive medications, and those with chronic illness, such as diabetes mellitus or cardiovascular disease. Signs and symptoms of orthostatic hypotension include dizziness, light-headedness, nausea, tachycardia, pallor, and even fainting. Orthostatic hypertension would be an increase in blood pressure. Physiological changes associated with aging and prolonged bed rest may reduce the effectiveness of the baroreceptors. In these patients, moving to the dangling position may cause a gravity-induced drop in blood pressure; thus, it is recommended to raise the head of the bed and allow a few minutes before dangling.

Answer to Question 2

A
A. Eliminate extraneous noise such as television and conversation if client must use stethoscope to measure BP.
B. Encourage client to avoid exercise, caffeine, and smoking for 30 minutes before assessment to avoid inaccurate reading.
C. Encourage client to perform measurements on routine schedule for long-term monitoring plan. A routine schedule allows for daily comparisons.
D. If pressure is still inaudible or difficult to obtain, try alternative methods such as using the other arm or changing to electronic equipment for measurement.

[jrubin]

TYSM

[cpetit11]

Excellent