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?

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.

A. Following proper handwashing and use of masks: While handwashing and wearing masks are important infection control measures, they are not specific to preventing hepatitis B virus (HBV) infection. While HBV can be present in blood and certain body fluids, such as semen and vaginal fluids, the primary modes of transmission are through activities that involve percutaneous or mucosal exposure to infected blood or body fluids, such as unprotected sex, sharing needles, or accidental needlesticks. While hand hygiene and mask use are crucial in healthcare settings to prevent the transmission of various infections, including HBV, they may not offer sufficient protection against HBV transmission in all situations.

B. Avoiding chemicals that are toxic and polluted air: While avoiding toxic chemicals and polluted air is important for overall health and may support liver health indirectly, it is not directly related to preventing HBV infection. HBV is primarily transmitted through exposure to infected blood or body fluids rather than environmental factors such as air pollution or exposure to toxic chemicals.

C. Public health education and vaccination: This is the most appropriate measure for preventing HBV infection. Public health education plays a crucial role in raising awareness about the risks of HBV transmission and promoting behaviors that reduce the risk of exposure, such as safe sex practices, avoiding sharing needles, and seeking medical care for potential exposures. Additionally, vaccination against HBV is highly effective in preventing infection and is recommended for all individuals, particularly those at increased risk of exposure, such as healthcare workers, people with multiple sexual partners, and individuals who inject drugs. Vaccination not only protects vaccinated individuals but also contributes to herd immunity, reducing the overall prevalence of HBV in the population.

D. Limiting alcohol intake of red and white wine: While limiting alcohol intake is important for liver health, particularly in individuals with liver disease, it is not specifically aimed at preventing HBV infection. Excessive alcohol consumption can contribute to liver damage and may exacerbate liver disease in individuals infected with HBV. However, it does not directly address the risk of HBV transmission.