The nurse is caring for a client with hypertension who is being assessed for possible target organ damage.
The nurse should monitor the results of which of the following diagnostic tests?

Choice A rationale

Restricting sodium intake is essential as high sodium levels can increase fluid retention, leading to elevated blood pressure. A low-sodium diet reduces the workload on blood vessels and decreases the risk of cardiovascular complications associated with hypertension. The recommended sodium intake for adults should be less than 2,300 mg per day, and ideally closer to 1,500 mg daily for optimal blood pressure control.

Choice B rationale

Hypertension can lead to damage to the small blood vessels in the retina, resulting in hypertensive retinopathy. Stressing ophthalmic care ensures early detection and management of vision changes that may be indicative of ongoing vascular damage. Regular ophthalmologic evaluation aids in preventing irreversible vision loss and allows better management of systemic hypertension's effects on ocular health.

Choice C rationale

Increasing the intake of fruits and vegetables provides essential nutrients such as potassium, magnesium, and dietary fiber. Potassium helps counteract the effects of sodium and relaxes blood vessel walls, lowering blood pressure. The DASH diet, rich in fruits and vegetables, is widely recommended for individuals with hypertension to promote cardiovascular health and regulate blood pressure.

Choice D rationale

Taking prescribed medications as ordered ensures consistent management of blood pressure and prevention of complications such as stroke, heart attack, and kidney damage. Antihypertensive medications, including ACE inhibitors, beta-blockers, or diuretics, work through various mechanisms to lower blood pressure. Adherence prevents fluctuations and maintains target levels of less than 140/90 mmHg.

Choice E rationale

Not taking medication when blood pressure is less than 140/90 mmHg is incorrect because hypertension management requires consistent medication to maintain target levels and prevent rebound hypertension. Abrupt discontinuation can lead to complications such as severe hypertensive episodes and organ damage. Regular monitoring is crucial to guide therapy adjustments safely.

Choice A rationale

Asking about medication use may provide helpful information but does not address the primary concern. The symptoms of visual changes and headaches can indicate serious conditions such as increased intracranial pressure or hypertensive crisis. Immediate assessment is necessary to determine severity and prevent complications. Identifying a potential trigger does not replace the need for prompt diagnostic evaluation.

Choice B rationale

Referring the client to an eye specialist might be appropriate in cases of persistent vision issues without urgent symptoms. However, when combined with headaches, these symptoms could indicate systemic or neurological issues, such as hypertension or a brain lesion. Immediate action is required, as delayed assessment might allow for worsening of an acute condition.

Choice C rationale

Obtaining a full history and physical would provide valuable data for diagnosis. However, this approach is time-intensive and may not address the urgency of the situation. Rapid assessment, such as blood pressure measurement, takes precedence to identify conditions that could be immediately life-threatening, such as hypertensive emergencies.

Choice D rationale

Measuring blood pressure promptly assesses for hypertensive crises, a common cause of vision changes and headaches. Hypertensive crises require immediate treatment to prevent end-organ damage. Normal blood pressure ranges are typically 120/80 mmHg, and values exceeding 180/120 mmHg indicate a crisis. This action provides quick, actionable information critical for patient safety.