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Chapter 18: Care of Patients with Hypertension and Peripheral Vascular Disease deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd EditionMULTIPLE CHOICE1. Which blood pressure findings constitute a diagnosis of hypertension? a. 120/80 2, 2 weeks apartb. 140/90 2, 2 weeks apartc. 120/80 on 3 consecutive daysd. 140/90 every day for a weekANS: B A diagnosis of hypertension is made if the systolic pressure is equal to or greater than 140 mm Hg and the diastolic pressure is equal to or greater than 90 mm Hg at least twice on two different occasions 2 weeks apart.PTS: 1 DIF: Cognitive Level: Comprehension REF: 396 OBJ: 10 (theory) TOP: Hypertension: Diagnosis KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance2. The nurse is educating an older adult patient who is taking antihypertensives with diuretics. Which information regarding safety precautions is most important for the nurse to include? Age-related changes (reduced baroreceptor sensitivity) and risk for fluid shifts related to diuretics predispose the older adult patient to orthostatic hypotension. In order to prevent falls, the patient should change positions slowly and cautiously, like taking time to sit on the edge of the bed before standing. While purchasing a home blood pressure monitor, limiting sodium in the diet, and keeping an updated list of medications may assist with management of hypertension, fall prevention and safety are most important for the older adult patient.PTS: 1 DIF: Cognitive Level: Analysis REF: 398, Older Adult Care Points OBJ: 5 (clinical) TOP: Orthostatic Hypotension KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control3. The home health nurse is caring for a patient with a blood pressure reading of 200/160. The patient denies any discomfort. The nurse should immediately contact the health care provider to report that the patient is experiencing which problem?
The diastolic pressure rising to readings between 140 and 170 and the patient being asymptomatic indicates hypertensive crisis.PTS: 1 DIF: Cognitive Level: Comprehension REF: 402 OBJ: 3 (theory) TOP: Malignant Hypertension KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation