Hesi Hypertension

Topics: Hypertension, Blood pressure, Abdominal aortic aneurysm Pages: 23 (5252 words) Published: March 17, 2014
Assessment

Mr. Dunn's blood pressure reading is 189/110. His LDL cholesterol reading is 200 mg/dl. He asks the student nurse if he should be concerned about his blood pressure.

1.
How should the student respond?
A) "Your blood pressure is very high. You need to see your healthcare provider today." INCORRECT
Mr. Dunn's blood pressure is high. The student nurse needs to assess for other symptoms before making the determination that the healthcare provider must see him that day.

B) "You have hypertension. You need to start making some lifestyle changes." INCORRECT
The diagnosis of hypertension is not made until the client has an elevated blood pressure on two different occasions.

C) "Please sit here quietly for a few minutes. I need to recheck your blood pressure." CORRECT
Mr. Dunn's blood pressure is high, but may be temporarily elevated due to activity or stress. The blood pressure should be rechecked after the client rests for a few minutes.

D) "I need you to remain seated. I am going to call for the emergency squad." INCORRECT
Based on the information currently available to the student nurse, there is no need to call the EMS.

The student nurse asks Mr. Dunn about his health history. He is 6 feet tall and his weight is 190 lbs. Mr. Dunn states that he has lost a lot of weight recently. He also reports experiencing a lot of stress at work and that he often goes out with the crew after work to have several beers. He reports that his mother, who had diabetes mellitus, has passed away. He believes that she also had hypertension. He smokes 1½ packs of cigarettes a day and drinks 4 to 5 cups of coffee a day.

2.
What significant risk factor for hypertension does the student nurse identify for Mr. Dunn according to this health history? A) Family history of diabetes.
INCORRECT
If Mr. Dunn had diabetes, this would be a significant risk factor but the presence of diabetes in his family is not.

B) Recent weight loss.
INCORRECT
Weight loss is not a risk factor for hypertension.

C) Caffeine intake.
INCORRECT
There is no current indication that caffeine intake is a risk factor for hypertension.

D) Alcohol consumption.
CORRECT
Excessive alcohol intake is strongly associated with hypertension.

Client Teaching
The student nurse rechecks Mr. Dunn's blood pressure now that he has been sitting quietly for a few minutes. His blood pressure is 180/106.   

3.
According to the assessment of this client, what recommendation is most important for the student nurse to provide Mr. Dunn? A) See his healthcare provider within the next week for a BP recheck. CORRECT

His blood pressure is significantly elevated. Since these BP readings were obtained on the same day, Mr. Dunn needs to see his healthcare provider soon for a second BP measurement so that a diagnosis can be determined and treatment initiated.  

B) Limit his salt intake and start a weight loss program.
INCORRECT
Both of these actions may help decrease the client's blood pressure, but another intervention is more important at this time.

C) Attend a stress reduction seminar offered in his community. INCORRECT
While this may be useful, another intervention is more important at this time.

D) Learn about high fiber foods and add more fiber to his diet. INCORRECT
Increasing fiber in the diet promotes over-all health by helping cholesterol levels, but it does not affect blood pressure.

The student nurse continues to talk with Mr. Dunn about hypertension. Mr. Dunn states he feels great physically and does not see why he needs to see his healthcare provider.

4.
How should the student nurse respond?
A) "Your blood pressure is dangerously elevated. You could have a heart attack or stroke at any time."  INCORRECT
Threatening the client with a major problem is not the best way to motivate a client to get care.

B) "While often there are no symptoms, high blood pressure does cause damage to many organs." CORRECT
Often...
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