The nurse is teaching a patient about a thiazide-like diuretic. Which statement made by the patient indicates an understanding of the teaching?

Condition the Patient is Most Likely Experiencing:

Intracerebral Haemorrhage (ICH) : The patient presents with a severe headache, lethargy, decreased level of consciousness, and slurred, incomprehensible speech, which are common signs of a stroke or intracerebral haemorrhage. A history of hypertension and atrial fibrillation increases the risk for both ischemic and hemorrhagic strokes. The use of apixaban, an anticoagulant, suggests the patient is at risk for bleeding complications, including intracerebral haemorrhage.

Interventions to Perform/Anticipate:

1. Perform a CT Scan of the Head:
   • Rationale: A CT scan will help determine if there is bleeding or an ischemic event in the brain. It is crucial for differentiating between ischemic and hemorrhagic stroke, guiding subsequent treatment.
2. Administer Intravenous Antihypertensives:
   • Rationale: Controlling blood pressure is critical to reduce the risk of further bleeding in the brain. Immediate BP management is essential in the acute setting of suspected stroke.

Parameters to Monitor:

1. Neurological Status:
   • Rationale: Monitoring changes in the patient’s level of consciousness, pupil reactions, and motor response will help assess the progression of the neurological deficit and effectiveness of interventions.
2. Blood Pressure:
   • Rationale: Maintaining blood pressure within a safe range is essential to prevent exacerbation of the hemorrhage. Hypertension management is key to avoid further complications.

A. "It is caused by a tumor of the adrenal gland.": This statement is incorrect as a tumor of the adrenal gland (like a pheochromocytoma) would cause secondary hypertension, not primary hypertension, which has no identifiable cause.
B. "The cause can be identified with magnetic resonance imaging.": Primary hypertension does not have a specific identifiable cause, and imaging like MRI cannot pinpoint a cause for it. This statement indicates a misunderstanding.
C. "The cause is unknown.": This statement is correct for primary hypertension, as it is characterized by having no identifiable underlying cause.
D. "There are no tests to identify the cause.": This is correct for primary hypertension since it has no specific identifiable cause. The diagnosis is based on excluding other potential causes of secondary hypertension.
E. "An arteriogram will show why hypertension is occurring.": An arteriogram might identify blockages or other issues in the arteries, but it will not show the cause of primary hypertension. This indicates a need for further teaching.