The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

Changes in peristalsis

Decreased urine output

Decreased insulin resistance

Hypercholesteremia

Answer and Explanation

The Correct Answer is B

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "Weigh yourself after breakfast every morning": Hydrochlorothiazide, a diuretic, can lead to fluid and electrolyte imbalances, including hyponatremia and hypokalemia. Monitoring weight daily, particularly after breakfast, helps detect any sudden weight changes that could indicate fluid retention or loss, allowing for timely intervention.

B. "Check your blood pressure anytime during the day": While monitoring blood pressure regularly is important for patients with hypertension, it is not a specific safety precaution related to taking hydrochlorothiazide. Blood pressure monitoring may be recommended, but it is not the primary safety precaution associated with this medication.

C. "Call the primary care provider if you experience any seizures": Seizures are not a common side effect of hydrochlorothiazide. Therefore, while it is important for patients to report any unusual symptoms to their healthcare provider, seizures are not specifically associated with this medication.

D. "Exercise at least twice a week": While regular exercise is beneficial for overall health, it is not a specific safety precaution related to taking hydrochlorothiazide. However, lifestyle modifications such as diet and exercise may complement medication therapy in managing hypertension.

A. Systolic BP between 120 and 160 mmHg B. Diastolic BP between 70- and 99-mm Hg C. Diastolic BP between 60- and 79-mm Hg D. Systolic blood pressure between 90 to 120 mm Hg

Correct Answer is D

Explanation

A. Systolic BP between 120 and 160 mmHg:
While this range represents a moderate level of blood pressure control, it may not be optimal for preventing organ damage in individuals with primary hypertension. Systolic blood pressure (SBP) between 120 and 160 mmHg is considered elevated and may still increase the risk of cardiovascular complications over time. While it's not dangerously high, it's not within the recommended range for preventing organ damage associated with hypertension.

B. Diastolic BP between 70- and 99-mm Hg:
This range for diastolic blood pressure (DBP) is relatively broad and encompasses normal to elevated levels. While DBP between 70 and 99 mmHg is generally considered within the normal to prehypertensive range, it may not fully reflect the target range recommended for preventing organ damage in individuals with hypertension. The upper limit of 99 mmHg is higher than the optimal target range for preventing hypertension-related complications.

C. Diastolic BP between 60- and 79-mm Hg:
This range represents the optimal target for diastolic blood pressure (DBP) in individuals with hypertension. Keeping DBP between 60 and 79 mmHg is associated with reduced risk of cardiovascular events and end-organ damage. It aligns with current guidelines for blood pressure management and reflects successful teaching regarding the recommended range needed to prevent organ damage in patients with primary hypertension.

D. Systolic blood pressure between 90 to 120 mm Hg:
This range represents the optimal target for systolic blood pressure (SBP) in individuals with hypertension. Maintaining SBP between 90 and 120 mmHg is associated with the lowest risk of cardiovascular events and complications. It aligns with current guidelines for blood pressure management and reflects successful teaching regarding the recommended range needed to prevent organ damage in patients with primary hypertension.

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The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching an older adult with a new prescription for hydrochlorothiazide as a second anti-hypertensive drug. What safety precaution will the nurse include in the teaching?

Correct Answer is A

Explanation

The nurse is teaching a patient, newly diagnosed with primary hypertension, about the recommended blood pressure range needed to prevent organ damage. Which range, chosen by patient, indicates that the teaching was successful?

Correct Answer is D

Explanation

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