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

Assessing for hypotension is not indicative of fluid overload. Hypotension is more likely associated with hypovolemia or hemorrhage, whereas fluid overload manifests as signs of hypervolemia, including elevated blood pressure and pulmonary edema.

Choice B rationale

Assessing for distention above the pubis area identifies bladder retention or obstruction but is not directly related to monitoring fluid overload. Fluid overload affects systemic circulation and organ function rather than localized distention.

Choice C rationale

Monitoring laboratory values for hypernatremia is not an effective strategy for detecting fluid overload. Hypernatremia occurs due to inadequate water intake rather than excessive fluid administration. Fluid overload is typically identified by signs such as pulmonary congestion and generalized edema.

Choice D rationale

Maintaining strict intake and output records is crucial in detecting fluid overload. It helps identify disproportionate fluid retention compared to urinary output, signaling hypervolemia. Continuous monitoring ensures timely adjustments in fluid administration and prevents complications. .

Choice A rationale

Magnesium levels and bilateral lower extremity ultrasounds are not specific for assessing target organ damage in hypertension. While magnesium may influence cardiovascular health, it is not a primary indicator of organ damage. Ultrasounds evaluate arterial or venous abnormalities, not hypertension’s systemic effects.

Choice B rationale

Urinalysis, blood chemistry, and a 12-lead electrocardiogram assess renal, metabolic, and cardiac effects of hypertension. Proteinuria in urinalysis indicates kidney damage. Electrolyte imbalances or creatinine elevations suggest renal impairment. An ECG reveals left ventricular hypertrophy or ischemia. These tests comprehensively evaluate hypertension-related complications.

Choice C rationale

A complete blood count evaluates blood cell counts but does not directly assess target organ damage from hypertension. An electroencephalogram assesses brain activity, not hypertension-induced injury. These tests are inappropriate for this diagnostic goal.

Choice D rationale

Troponin, calcium, and partial thromboplastin time evaluate myocardial infarction, bone health, and coagulation, respectively. They do not provide information about hypertension’s systemic organ effects. Accurate test selection ensures appropriate diagnostic focus.