During a health education session, a participant asked the nurse about the hepatitis B virus. What measure will the nurse recommend for preventing infection with this virus?

Answer: D

Rationale:

A) A renal ultrasound: A renal ultrasound is not typically used to confirm a diagnosis of hypertension. While renal artery stenosis can contribute to hypertension in some cases, it is not the primary diagnostic test for hypertension.

B) A cardiac stress test: A cardiac stress test is not used to confirm a diagnosis of hypertension. It is primarily used to assess cardiovascular function and detect coronary artery disease or cardiac arrhythmias.

C) A manual blood pressure cuff: While manual blood pressure measurements can provide accurate readings, they are subject to potential inaccuracies due to factors such as observer bias and white coat syndrome. Therefore, they may not be the most reliable method for confirming a diagnosis of hypertension.

D) Ambulatory blood pressure measurement: Ambulatory blood pressure measurement involves obtaining multiple blood pressure readings over a 24-hour period using a portable monitor. It is considered the gold standard for diagnosing hypertension, as it provides a more comprehensive assessment of blood pressure variability and reduces the impact of white coat syndrome. Therefore, it is the preferred diagnostic test in this scenario to confirm whether the patient has hypertension outside of the clinical setting.

A. The partial thromboplastin time is 30 seconds:

The partial thromboplastin time (PTT) measures the clotting time of blood and is typically used to monitor patients on heparin therapy, not warfarin. A PTT of 30 seconds is within the normal range and does not directly relate to warfarin therapy. Therefore, it does not require immediate follow-up in the context of warfarin administration.

B. The International normalized ratio is 6.0:

The International Normalized Ratio (INR) is a standard measure used to monitor the effectiveness of warfarin therapy. For most indications, the therapeutic range for INR is typically between 2.0 and 3.0. A value of 6.0 indicates that the patient's blood is taking six times longer to clot than normal, suggesting a significantly increased risk of bleeding. Therefore, this result requires immediate follow-up by the nurse to assess the patient's condition and potentially adjust warfarin dosage to reduce the risk of bleeding.

C. Creatinine is 12:

Creatinine is a waste product generated by muscle metabolism and is filtered out of the blood by the kidneys. Elevated levels of creatinine may indicate impaired kidney function, but this result does not directly relate to warfarin therapy. While an elevated creatinine level may require follow-up for other reasons, it does not necessitate immediate action related to warfarin therapy.

D. The patient's hematocrit level is 43%:

Hematocrit is a measure of the proportion of red blood cells in the blood. A hematocrit level of 43% is within the normal range for both men and women and does not directly relate to warfarin therapy. While changes in hematocrit may occur in some patients taking warfarin, this result alone does not require immediate follow-up in the context of warfarin administration.