Hypertension Case Study
Section 1
AssessmentThe client's blood pressure is 189/110 mmHg. The LDL cholesterol
reading is 200 mg/dL. The client asks the student nurse if concern is needed
about the blood pressure reading.
How should the student nurse respond?
"Your blood pressure is very high. You need to see your healthcare provider
(HCP) today."
"You have hypertension. You need to start making some lifestyle changes."
"Please sit here quietly for a few minutes. I need to recheck your blood pressure."
"I need you to remain seated. I am going to call for the emergency medical
system."
Please sit here quietly for a few minutes. I need to recheck your blood pressure.
The student nurse asks the client about health history. The client is 6 foot (182.88
cm) tall and weighs 190 pounds (86.18 kg). The client 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. The client reports that
his mother, who had diabetes mellitus, has passed away. He believes that she
also had hypertension. The client smokes 1.5 packs of cigarettes and drinks 4 to
5 cups of coffee each day.
Based on the client's health history, what significant risk factor for hypertension
does the student nurse identify? (Select all that apply.)
Select all that apply
Family history of diabetes.
Alcohol consumption.
Smoking.
Stress.
Caffeine intake.
Alcohol consumption
Smoking
Stress
Section 2
Client TeachingThe student nurse rechecks the client's blood pressure now that
he has been sitting quietly for a few minutes. His blood pressure is 180/106
mmHg.
According to the assessment of this client, which recommendation
is most important for the student nurse to provide?
See the HCP as soon as possible within the next week for a BP recheck.
Limit salt intake and start a weight loss program.
Attend a stress reduction seminar offered in his community.
Learn about high fiber foods and add more fiber to his diet.
See their HCP as soon as possible within the next week for a BP recheck.
, The student nurse continues to talk with the client about the blood pressure
results. The client states that he feels great physically and doesn't see why he
needs to see his HCP.
Which is the best response the student nurse can give to the client about the
urgent need to see the HCP?
Reiterate how dangerously high the blood pressure is and that it could lead to a
heart attack or stroke at any time.
Tell the client while often there are no symptoms, high blood pressure does
cause damage to many organs.
Explain how hypertension is called the silent killer and that the client could die at
a young age.
Inform the client that it is always better to treat high blood pressure before you
start having symptoms.
Tell the client while often there are no symptoms, high blood pressure does cause
damage to many organs.
A week later the client has an appointment with the HCP. After the exam, the HCP
explains to the client that he has stage 2 primary (essential) hypertension.
Which information obtained during the assessment supports this diagnosis?
Blood pressure of 184/98 mm Hg.
Family history of hypertension.
Irregular pulse rate of 110 beats/min.
An auscultated heart murmur.
Blood pressure of 184/98 mm Hg.
The HCP informs the client that he need to be on a low-salt diet, stop smoking,
limit alcohol intake, decrease stress level, and start taking hydrochlorothiazide 25
mg by mouth (PO) daily and atenolol 25mg PO daily. The client asks the nurse if
the HCP should find out the reason for the hypertension.
How should the nurse respond to the client's concern?
Explain that the HCP does not think determining the cause is important now.
Further tests may be done once the blood pressure is in the normal range.
Most cases of hypertension are without an identified cause and effected by
multiple risk factors, so unless there is a health history indicator, the HCP does
not look for one.
The cause for the hypertension will become evident and ongoing appointments
with HCP are necessary until the cause is determined.
Tell the client not to worry because stress causes blood pressure to go up even
more.
Most cases of hypertension are without an identified cause and effected by multiple risk
factors, so unless there is a health history indicator, the HCP does not look for one.
The client asks the nurse about the medications, hydrochlorothiazide 25 mg PO
daily and atenolol 25 mg PO daily. The nurse reviews the medications, the side
effects, and the importance of taking the medications every day.
Which statement indicates that the client understands the nurse's instructions
about the medications? (Select all that apply.)
Select all that apply
The client states they will need to take the hydrochlorothiazide in the morning.
Section 1
AssessmentThe client's blood pressure is 189/110 mmHg. The LDL cholesterol
reading is 200 mg/dL. The client asks the student nurse if concern is needed
about the blood pressure reading.
How should the student nurse respond?
"Your blood pressure is very high. You need to see your healthcare provider
(HCP) today."
"You have hypertension. You need to start making some lifestyle changes."
"Please sit here quietly for a few minutes. I need to recheck your blood pressure."
"I need you to remain seated. I am going to call for the emergency medical
system."
Please sit here quietly for a few minutes. I need to recheck your blood pressure.
The student nurse asks the client about health history. The client is 6 foot (182.88
cm) tall and weighs 190 pounds (86.18 kg). The client 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. The client reports that
his mother, who had diabetes mellitus, has passed away. He believes that she
also had hypertension. The client smokes 1.5 packs of cigarettes and drinks 4 to
5 cups of coffee each day.
Based on the client's health history, what significant risk factor for hypertension
does the student nurse identify? (Select all that apply.)
Select all that apply
Family history of diabetes.
Alcohol consumption.
Smoking.
Stress.
Caffeine intake.
Alcohol consumption
Smoking
Stress
Section 2
Client TeachingThe student nurse rechecks the client's blood pressure now that
he has been sitting quietly for a few minutes. His blood pressure is 180/106
mmHg.
According to the assessment of this client, which recommendation
is most important for the student nurse to provide?
See the HCP as soon as possible within the next week for a BP recheck.
Limit salt intake and start a weight loss program.
Attend a stress reduction seminar offered in his community.
Learn about high fiber foods and add more fiber to his diet.
See their HCP as soon as possible within the next week for a BP recheck.
, The student nurse continues to talk with the client about the blood pressure
results. The client states that he feels great physically and doesn't see why he
needs to see his HCP.
Which is the best response the student nurse can give to the client about the
urgent need to see the HCP?
Reiterate how dangerously high the blood pressure is and that it could lead to a
heart attack or stroke at any time.
Tell the client while often there are no symptoms, high blood pressure does
cause damage to many organs.
Explain how hypertension is called the silent killer and that the client could die at
a young age.
Inform the client that it is always better to treat high blood pressure before you
start having symptoms.
Tell the client while often there are no symptoms, high blood pressure does cause
damage to many organs.
A week later the client has an appointment with the HCP. After the exam, the HCP
explains to the client that he has stage 2 primary (essential) hypertension.
Which information obtained during the assessment supports this diagnosis?
Blood pressure of 184/98 mm Hg.
Family history of hypertension.
Irregular pulse rate of 110 beats/min.
An auscultated heart murmur.
Blood pressure of 184/98 mm Hg.
The HCP informs the client that he need to be on a low-salt diet, stop smoking,
limit alcohol intake, decrease stress level, and start taking hydrochlorothiazide 25
mg by mouth (PO) daily and atenolol 25mg PO daily. The client asks the nurse if
the HCP should find out the reason for the hypertension.
How should the nurse respond to the client's concern?
Explain that the HCP does not think determining the cause is important now.
Further tests may be done once the blood pressure is in the normal range.
Most cases of hypertension are without an identified cause and effected by
multiple risk factors, so unless there is a health history indicator, the HCP does
not look for one.
The cause for the hypertension will become evident and ongoing appointments
with HCP are necessary until the cause is determined.
Tell the client not to worry because stress causes blood pressure to go up even
more.
Most cases of hypertension are without an identified cause and effected by multiple risk
factors, so unless there is a health history indicator, the HCP does not look for one.
The client asks the nurse about the medications, hydrochlorothiazide 25 mg PO
daily and atenolol 25 mg PO daily. The nurse reviews the medications, the side
effects, and the importance of taking the medications every day.
Which statement indicates that the client understands the nurse's instructions
about the medications? (Select all that apply.)
Select all that apply
The client states they will need to take the hydrochlorothiazide in the morning.
