Chapter 34: Hypertension PT2

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Which cause is considered the leading cause of death for individuals with hypertension?

Cardiovascular disease

Which information about how diuretics guides the nurse's response when a patient asks how this medication can help lower blood pressure?

Decreases circulatory volume and dilating peripheral arterioles

Which adverse effect of ACE inhibitors is more common in women than men?

Cough

Which electrolyte imbalance may occur when a patient with a history of diabetes mellitus is prescribed aliskiren (Tekturna) for the treatment of hypertension?

Hyperkalemia

Which kind of juice should be avoided by a patient prescribed eplerenone (Inspra) for the treatment of hypertension?

Grapefruit

Which assessment does the nurse include in a care plan of a patient starting an angiotensin-converting (ACE) inhibitor?

Close observation after the initial dose until blood pressure stabilizes in 2 to 3 hours

Which advantage is accurated related to the use of a beta-adrenergic blocking agent over other antihypertensive medications?

Cause minimal orthostatic or exercise hypotension.

Which antihypertensive medication is more effective in African Americans and older adult patients?

Calcium channel blockers

Which medication is contraindicated for a patient that has been prescribed amlodipine (Norvasc) for the treatment of hypertension?

Digoxin (Lanoxin)

Which agent does the nurse anticipate will be ordered by the healthcare provider for a patient with hypertension that has suffered a heart attack?

Beta-adrenergic blocker

Which route will the nurse use to administer nitroprusside sodium (Nitropress) to a patient who is in hypertensive crisis?

Intravenous

Which drug categories are the preferred to treat hypertension? (Select all that apply.)

Diuretics, Beta-adrenergic blockers

Which antihypertensive agents fall into the adjunctive category? (Select all that apply.)

Peripheral-acting adrenergic antagonists, Central-acting alpha-2 agonists, Direct vasodilators

Which behavior modifications are appropriate for a patient to implement to help control hypertension? (Select all that apply.)

Increased exercise, Stress reduction, Weight reduction diet, Smoking cessation

A nurse assesses a clients electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?

Ventricular and atrial depolarizations are initiated from different sites.

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?

"Avoid straining while having a bowel movement."

A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?

A 50-year-old who is post coronary artery bypass graft surgery

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?

Speech alterations

A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this clients medication administration record to prevent a common complication of this condition?

Warfarin (Coumadin)

A nurse administers prescribed adenosine (Adenocard) to a client. Which response should the nurse assess for as the expected therapeutic response?

Short period of asystole

A telemetry nurse assesses a client with third-degree heart block who has wide QRS complexes and a heart rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete next?

level of consciousness

A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the clients electrocardiogram. Which action should the nurse take next?

Assess vital signs and level of consciousness.

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client?

Ensure that everyone is clear of contact with the client and the bed.

After teaching a client who has an implantable cardioverter-defibrillator (ICD), a nurse assesses the clients understanding. Which statement by the client indicates a correct understanding of the teaching?

"I will avoid sources of strong electromagnetic fields."

A nurse cares for a client with atrial fibrillation who reports fatigue when completing activities of daily living. What interventions should the nurse implement to address this clients concerns?

Schedule periods of exercise and rest during the day.

A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. Which action should the nurse take prior to the initiation of cardioversion?

Turn off oxygen therapy.

A nurse prepares to discharge a client with cardiac dysrhythmia who is prescribed home health care services. Which priority information should be communicated to the home health nurse upon discharge?

medication reconciliation

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

Midsternal chest pain

A nurse teaches a client who experiences occasional premature atrial contractions (PACs) accompanied by palpitations that resolve spontaneously without treatment. Which statement should the nurse include in this clients teaching?

"Minimize or abstain from caffeine."

The nurse asks a client who has experienced ventricular dysrhythmias about substance abuse. The client asks, Why do you want to know if I use cocaine? How should the nurse respond?

"Clients who use cocaine are at risk for fatal dysrhythmias."

A nurse supervises an unlicensed assistive personnel (UAP) applying electrocardiographic monitoring. Which statement should the nurse provide to the UAP related to this procedure?

"Clean the skin and clip hairs if needed."

A nurse assesses a clients electrocardiogram (ECG) and observes the reading shown below:

Sinus rhythm with premature ventricular contractions (PVCs)

A nurse cares for a client who is on a cardiac monitor. The monitor displayed the rhythm shown below:

Assess airway, breathing, and level of consciousness.

A nurse performs an admission assessment on a 75-year-old client with multiple chronic diseases. The clients blood pressure is 135/75 mm Hg and oxygen saturation is 94% on 2 liters per nasal cannula. The nurse assesses the clients rhythm on the cardiac monitor and observes the reading shown below:

Ask the client what medications he or she takes.

The nurse is caring for a client on the medical-surgical unit who suddenly becomes unresponsive and has no pulse. The cardiac monitor shows the rhythm below:

Initiate cardiopulmonary resuscitation (CPR).

A nurse cares for a client with congestive heart failure who has a regular cardiac rhythm of 128 beats/min. For which physiologic alterations should the nurse assess? (Select all that apply.)

Decrease in cardiac output, Increase in blood pressure, Decrease in urine output

A nurse teaches a client with a new permanent pacemaker. Which instructions should the nurse include in this clients teaching? (Select all that apply.)

"Until your incision is healed, do not submerge your pacemaker. Only take showers.", "Report any pulse rates lower than your pacemaker settings.", "Do not lift your left arm above the level of your shoulder for 8 weeks."

A nurse is teaching a client with premature ectopic beats. Which education should the nurse include in this clients teaching? (Select all that apply.)

Smoking cessation, Stress reduction and management, Adverse effects of medications

A nurse volunteers to do blood pressure screenings at a local community hospital's annual health fair. As the nurse prepares to take a person's blood pressure, what observation indicates that the current aneroid sphygmomanometer will not measure the blood pressure accurately?

The needle is above zero on the gauge.

What nursing modification is most appropriate when taking the blood pressure of a client who weighs 250 pounds?

Use an extra-large blood pressure cuff.

When the nurse teaches a client's spouse how to take a blood pressure measurement, when is the correct time to note the diastolic blood pressure reading?

When the last loud knocking sound is heard

While an African American has his blood pressure checked, he asks the nurse why it is important to control hypertension. What response by the nurse is most accurate?

Sustained hypertension compromises blood flow to many vital organs.

When obtaining a health history from a person at the clinic, what finding strongly suggests that the person is hypertensive? Select all that apply.

Throbbing headaches, Flushed skin color, Blurred vision

The nurse advises a person at the clinic to seek medical attention immediately following blood pressure readings of 206/110 mm Hg and 198/104 mm Hg. When a person with hypertension is assessed, what finding is the best indication that the client's heart has been affected by sustained high blood pressure?

The client's heart is moderately enlarged

A low-sodium diet is recommended for a client with hypertension. The best evidence that the client understands the nurse's instructions regarding dietary restrictions is if the client says he or she should avoid which item?

Soy sauce