A client's most recent vital signs include heart rate 80 beats/minute and blood pressure 119/70 mm Hg. When the client reports dizziness after rising quickly, which finding should the nurse expect on reassessment?

Heart rate 100 beats/minute.

Blood pressure 125/65 mm Hg.

Heart rate 70 beats/minute.

Blood pressure 115/70 mm Hg.

Answer and Explanation

The Correct Answer is A

A. Heart rate 100 beats/minute: A compensatory increase in heart rate (tachycardia) is expected in orthostatic hypotension. It helps maintain cerebral perfusion when blood pools in the lower extremities after standing quickly.

B. Blood pressure 125/65 mm Hg: This BP shows a slight systolic increase, which is not typical after orthostatic stress. A decrease in BP, not an increase, would be expected if symptoms like dizziness are present.

C. Heart rate 70 beats/minute: A decreased heart rate is not physiologically expected when someone experiences postural hypotension. Bradycardia would worsen cerebral perfusion and is inconsistent with dizziness.

D. Blood pressure 115/70 mm Hg: This change is too minor to explain dizziness. In orthostatic hypotension, we usually expect a drop of ≥20 mm Hg systolic or ≥10 mm Hg diastolic after position change.

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Correct Answer is C

Explanation

A. Encourage the client's family to visit more often: The client is withdrawn, increased visits may feel overwhelming. This approach assumes the client is ready for interaction, which may not be the case, and does not directly address communication barriers.

B. Encourage the client to participate in group activities: This may be premature for a client who is severely withdrawn. Pushing participation too soon may increase distress or resistance, making rapport-building through simpler interactions more effective initially.

C. Engage the client in non-threatening conversations: Starting with gentle, non-intrusive conversations helps build trust and re-establish communication. It meets the client where they are emotionally and lays a foundation for further therapeutic engagement without increasing anxiety or pressure.

D. Schedule a daily conference with the social worker: Daily meetings may not be feasible or welcomed by a withdrawn client. Interventions should first aim to re-establish connection through nurse-client interaction.

A. Chicken, yams, pinto beans and pecans. B. Steak and baked potato with butter and cheese topping. C. Canned ham and green beans. D. Pasta with fish and an orange.

Correct Answer is D

Explanation

A. Chicken, yams, pinto beans, and pecans: This meal is not ideal for a client with CKD because pinto beans and pecans are high in potassium and phosphorus, which can be problematic for clients with CKD. Yams are also high in potassium.

B. Steak and baked potato with butter and cheese topping: Steak is high in protein and phosphorus, which can overload the kidneys. Baked potato, especially with cheese, can be high in potassium, which should be monitored in CKD.

C. Canned ham and green beans: Canned ham is often high in sodium, which is not recommended for clients with CKD, as it can exacerbate fluid retention and high blood pressure. Green beans are a good choice, but the sodium content in the ham is a concern.

D. Pasta with fish and an orange: Pasta is low in potassium and phosphorus, and fish provides a good source of protein that is generally easier on the kidneys compared to red meat. This meal is lower in sodium, phosphorus, and potassium, making it a better choice for CKD.

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A client's most recent vital signs include heart rate 80 beats/minute and blood pressure 119/70 mm Hg. When the client reports dizziness after rising quickly, which finding should the nurse expect on reassessment?

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