Hypertension

The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

• Serum creatinine of 2.8 mg/dL
• Serum potassium of 4.5 mEq/L
• Serum hemoglobin of 14.7 g/dL
• Blood glucose level of 96 mg/dL

Which action should the nurse take when administering the initial dose of oral labetalol (Normodyne) to a patient with hypertension?

• Encourage the use of hard candy to prevent dry mouth.
• Instruct the patient to ask for help if heart palpitations occur.
• Ask the patient to request assistance when getting out of bed.
• Teach the patient that headaches may occur with this medication.

After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented, which diet choice indicates that the teaching has been effective?

• The patient avoids eating nuts or nut butters.
• The patient restricts intake of chicken and fish.
• The patient has two cups of coffee in the morning.
• The patient has a glass of low-fat milk with each meal.

A patient has just been diagnosed with hypertension and has been started on captopril (Capoten). Which information is important to include when teaching the patient about this medication?

• Check blood pressure (BP) in both arms before taking the medication.
• Increase fluid intake if dryness of the mouth is a problem.
• Include high-potassium foods such as bananas in the diet.
• Change position slowly to help prevent dizziness and falls.

Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this medication when the patient reveals a history of

• asthma.
• daily alcohol use
• peptic ulcer disease.
• myocardial infarction (MI).

A 56-year-old patient who has no previous history of hypertension or other health problems suddenly develops a blood pressure (BP) of 198/110 mm Hg. After reconfirming the BP, it is appropriate for the nurse to tell the patient that

• a BP recheck should be scheduled in a few weeks.
• dietary sodium and fat content should be decreased.
• there is an immediate danger of a stroke and hospitalization will be required.
• diagnosis of a possible cause, treatment, and ongoing monitoring will be needed.

During change-of-shift report, the nurse obtains the following information about a hypertensive patient who received the first dose of nadolol (Corgard) during the previous shift. Which information indicates that the patient needsimmediate intervention?

• The patient’s most recent blood pressure (BP) reading is 158/91 mm Hg.
• The patient’s pulse has dropped from 68 to 57 beats/minute.
• The patient has developed wheezes throughout the lung fields.
• The patient complains that the fingers and toes feel quite cold.

The nurse on the intermediate care unit received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?

• 43-year-old with a (blood pressure (BP) of 160/92 who is complaining of chest pain
• 52-year-old with a BP of 212/90 who has intermittent claudication
• 50-year-old with a BP of 190/104 who has a creatinine of 1.7 mg/dL
• 48-year-old with a BP of 172/98 whose urine shows microalbuminuria

A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and nausea and has a blood pressure (BP) of 238/118 mm Hg. Which question should the nurse ask first?

• “Did you take any acetaminophen (Tylenol) today?”
• “Have you been consistently taking your medications?”
• “Have there been any recent stressful events in your life?”
• “Have you recently taken any antihistamine medications?”

The nurse is assessing a patient who has been admitted to the intensive care unit (ICU) with a hypertensive emergency. Which finding is most important to report to the health care provider?

• Urine output over 8 hours is 250 mL less than the fluid intake.
• The patient cannot move the left arm and leg when asked to do so.
• Tremors are noted in the fingers when the patient extends the arms.
• The patient complains of a headache with pain at level 8/10 (0 to 10 scale).