Fresh fruits and vegetables and whole grains in the

fresh fruits and vegetables, and whole grains
in the daily diet
fat-free or low-fat dairy products.
meats lower in cholesterol (eg, fish, poultry)
and alternate protein sources (eg, legumes)
instead of red meats
Q: The nurse is reviewing a client's health
history during a primary care visit. Which of
the following findings should the nurse
identify as risk factors for developing
hypertension? Select all that apply.
African American ethnicity
DM Type 2
Freq Stress at work
LDL of 94 mg/dL (2.43 mmol/L)
Smoking of 1 pack of cigarettes daily
Nonmodifiable
Increase age
Positive family hx
African American ethnicity
DM Type 1
Modifiable
Excess alcohol intake
Smoking
Obesity
Excessive sodium intake
Sedentary lifestyle
Increased stress
For clients with a newly implanted permanent
pacemaker, the nurse should assess for
electrical capture of heart rhythm (eg, ECG)
and mechanical capture of heart rate (eg,
pulse). A central pulse (eg, auscultation of
apical, palpation of femoral) should be
assessed to determine mechanical captur
The nurse is caring for a client who had a
large anterior wall myocardial infarction (MI)
24 hours ago. Which finding
is most important to report to the health care
provider (HCP)?
Nausea and Vomiting
New S3 heart sound
Occasional unifocal PVCs
Temperature of 100.4 F (38C)
The new development of pulmonary
congestion on x-ray, auscultation of a new
S
3
heart sound, crackles on auscultation of
breath sounds, or jugular venous
distension can signal heart failure and should
be reported immediately to the HCP since they
Q: The nurse cares for a client with flash
pulmonary edema secondary to acute heart
failure. Furosemide 40 mg IVP and morphine
2 mg IVP are administered. Which
finding best indicates that treatment has been
effective?
BP 110/72
Reduced anxiety
RR decrease from 26/min to 18/min
Urine output of 1L in past 2 hours
Pulmonary edema , a potentially life-
threatening condition, is commonly associated

Limiting intake of sweets, foods high in
sodium (eg, potato chips, frozen meals,
canned foods), and sugary beverages to the
occasional treat
36. client dx 6 months ago hypertension and
had a recent emergency department visit for a
transient ischemic attack (TIA). BP today is
170/88 mm Hg. What teaching topic is
a priority for the nurse to discuss with this
client?
Taking BP medication as prescribed
A major problem with long-term management
of hypertension is poor adherence to the
treatment plan. Blood pressure medications
can have unpleasant side effects , including
fatigue, dizziness, and erectile dysfunction.
Client may stop taking the medications when
they believe their blood pressure has returned
to normal range or if medications are
expensive.
Hyperlipidemia
DM Type 2
Untreated hypertension increases client risk
for coronary artery disease, stroke, heart
failure, and renal failure.
Q: The nurse is caring for a client who just
had a permanent ventricular pacemaker
inserted. The nurse observes the cardiac
monitor and sees a pacing spike followed by a
QRS complex for each heartbeat. How should
the nurse assess for mechanical capture of the
pacemaker?
Auscultate the apical pulse rate
A 12-lead ECG does not assess mechanical
capture of cardiac activity via the client's
pacemaker.
indicate HF or Cardiogenic shock
#keyword: hypertension prescribed
hydrochlorothiazide, lisinopril, and clonidine,
current BP 190/102 mm Hg, reports a HA
lasted several days. question most to
ask next ?
How are you currently taking your BP
medications?
A major problem in the long-term
management of hypertension is poor
adherence to the treatment plan, often due to
unpleasant side effects (eg, fatigue, dizziness,
reduced libido, erectile dysfunction) and
medication cost.
Determining whether a client is taking
medications as prescribed is a priority, as
sudden or abrupt discontinuation of
antihypertensive medications can
cause rebound hypertension and
possibly hypertensive crisis (eg, blurred
vision, dizziness, severe headache, shortness
of breath).
with left-sided heart failure, in which fluid
leaks across the capillary membranes into the
alveoli, causing impaired gas exchange.
IV diuretics (eg, furosemide)
and morphine help reduce
preload and decrease pulmonary
congestion , which improves gas
exchange and respiratory quality (eg, relief
of dyspnea/tachypnea
#The client is embarrassed to talk to the health