Lewis Chapter 32 Hypertension Medical-Surgical Nursing 10th Edition
1. The nurse teaches a 28-year-old man newly diagnosed with
hypertension about lifestyle modifications to reduce his blood pressure.
Which statement by the patient requires an intervention by the nurse?
A "I will avoid adding salt to my food during or after cooking."
B "If I lose weight, I might not need to continue taking medications."
C "I can lower my blood pressure by switching to smokeless tobacco."
D "Diet changes can be as effective as taking blood pressure
medications."-
: C "I can lower my blood pressure by switching to smokeless tobacco."
Nicotine contained in tobacco products (smoking and chew) cause
vasoconstric- tion and increase blood pressure. Persons with
hypertension should restrict sodium to 1500 mg/day by avoiding foods
high in sodium and not adding salt in preparation of food or at meals.
Weight loss can decrease blood pressure between 5 to
20 mm Hg. Following dietary recommendations (such as the DASH
diet) lowers blood pressure, and these decreases compare with those
achieved with blood pressure-lowering medication.
,2. The nurse supervises an unlicensed assistant personnel (UAP) who is
taking the blood pressure of 58-year-old female patient admitted with heart
failure. The patient is obese. The nurse should intervene if what is
observed?
A The UAP waits 2 minutes after position changes to take orthostatic pres-
sures.
B The UAP deflates the blood pressure cuff at a rate of 8 to 10 mm Hg per
second.
C The UAP takes the blood pressure with the patient's arm at the level of
the heart.
D The UAP takes a forearm blood pressure because the largest cuff will not
fit the patient's upper arm.: B The UAP deflates the blood pressure cuff
at a rate of 8 to 10 mm Hg per second.
The cuff should be deflated at a rate of 2 to 3 mm Hg per second. The
arm should be supported at the level of the heart for accurate blood
pressure measurements. If the maximum size blood pressure cuff does
not fit the upper arm, the forearm may be used. Orthostatic blood
pressures should be taken within 1 to 2 minutes of repositioning the
,patient.
3. A 44-year-old man is diagnosed with hypertension and receives a
prescrip- tion for benazepril (Lotensin). After the nurse teaches him about
the medica- tion, which statement by the patient indicates his correct
understanding?
, A "If I take this medication, I will not need to follow a special diet."
B "It is normal to have some swelling in my face while taking this
medica- tion."
C "I will need to eat foods such as bananas and potatoes that are high
in potassium."
D "If I develop a dry cough while taking this medication, I should notify
my doctor.": D "If I develop a dry cough while taking this medication, I
should notify my doctor."
Benazepril is an angiotensin-converting enzyme inhibitor. The
medication inhibits breakdown of bradykinin, which may cause a dry,
hacking cough. Other adverse effects include hyperkalemia. Swelling
in the face could indicate angioedema and should be reported
immediately to the prescriber. Patients taking drug therapy for
hypertension should also attempt lifestyle modifications to lower blood
pressure such as a reduced-sodium diet.
4. A 67-year-old woman with a history of coronary artery disease and
prior myocardial infarction is admitted to the emergency department with a
blood pressure of 234/148 mm Hg and started on IV nitroprusside
(Nitropress). What should the nurse determine as an appropriate goal for
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