A nurse is creating a teaching plan for a community group about preventing atherosclerosis. Which preventative strategies will the nurse include in the plan? Select All That Apply

A. Changes in peristalsis: Changes in peristalsis, which refers to the rhythmic contraction and relaxation of the gastrointestinal tract muscles, are not typically associated with target organ damage in hypertension. While hypertension can indirectly affect gastrointestinal function through its impact on other organ systems, such as the kidneys and cardiovascular system, alterations in peristalsis are more commonly attributed to gastrointestinal disorders or neurological conditions rather than hypertension-induced target organ damage.

B. Decreased urine output: In a patient diagnosed with hypertension, decreased urine output may indicate the development of target organ damage, particularly renal damage. Hypertension can lead to chronic kidney disease (CKD) over time, which is characterized by a gradual decline in kidney function. Decreased urine output may be a sign of impaired renal function, reduced glomerular filtration rate (GFR), or the presence of proteinuria. These changes indicate that the kidneys are no longer effectively filtering waste products and regulating fluid balance, suggesting the onset of renal damage as a consequence of long-standing hypertension.

C. Decreased insulin resistance: Hypertension is not directly linked to changes in insulin resistance. However, hypertension and insulin resistance are often comorbid conditions that share common risk factors, such as obesity, sedentary lifestyle, and unhealthy diet. While poorly controlled hypertension and insulin resistance can contribute to the development of cardiovascular disease and other complications, a decrease in insulin resistance would not typically be considered an indicator of target organ damage in hypertension.

D. Hypercholesterolemia: Hypercholesterolemia, or high levels of cholesterol in the blood, is a risk factor for cardiovascular disease, including atherosclerosis and coronary artery disease. While hypertension and hypercholesterolemia frequently coexist and contribute to the progression of vascular damage, the presence of hypercholesterolemia alone does not necessarily indicate target organ damage specific to hypertension. However, elevated cholesterol levels can exacerbate vascular changes and increase the risk of cardiovascular events in individuals with hypertension.

A. Administer post-exposure prophylaxis medication: While post-exposure prophylaxis (PEP) medication may be necessary in certain cases of needlestick injuries involving potential exposure to HIV, it is not the first step to perform. The initial priority is to ensure the safety of the healthcare provider and prevent potential transmission of the virus.

B. Determine the HIV status of the patient: Determining the HIV status of the patient is essential for risk assessment and guiding subsequent management. However, this step may take some time, and immediate action to protect the healthcare provider should not be delayed while waiting for the patient's HIV status to be confirmed.

C. Advise exposed healthcare providers to use precautions: This is the first step to perform after a needlestick injury. Healthcare providers should be immediately advised to use standard precautions, including hand hygiene and the use of personal protective equipment, to minimize the risk of transmission of bloodborne pathogens.

D. Undergo early reevaluation after exposure: Early reevaluation after exposure is important to assess the risk of transmission and determine the need for further interventions, including PEP medication. However, advising exposed healthcare providers to use precautions should take precedence as an immediate response to the injury.