Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 48-year-old patient with newly diagnosed hypertension?

128/76 mm Hg

148/78 mm Hg

98/56 mm Hg

128/92 mm Hg

Answer and Explanation

The Correct Answer is A

Choice A reason: A blood pressure of 128/76 mm Hg is within the target range for a patient with hypertension, indicating that the current therapy is effectively managing the condition. This reading is below the generally accepted threshold for hypertension, which is 140/90 mm Hg.

Choice B reason: A blood pressure of 148/78 mm Hg is above the target range for hypertension management. This reading suggests that the patient may need an adjustment in their therapy to better control their blood pressure and reduce the risk of cardiovascular complications.

Choice C reason: A blood pressure of 98/56 mm Hg is too low and may indicate hypotension, which can be a concern, especially if the patient experiences symptoms like dizziness or fainting. This reading suggests that the patient's therapy may need to be adjusted to avoid excessively lowering blood pressure.

Choice D reason: A blood pressure of 128/92 mm Hg shows an elevated diastolic pressure, which is above the target range. This indicates that the patient's hypertension is not fully controlled, and adjustments in therapy may be needed to bring both systolic and diastolic pressures within the desired range.

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Correct Answer is B

Explanation

Choice A reason: 0.45% sodium chloride is a hypotonic solution, which is not ideal for rapidly replacing fluid volume in patients with low blood pressure due to severe diarrhea. Hypotonic solutions can cause fluid to move into cells rather than staying in the vascular space, potentially worsening hypotension.

Choice B reason: 0.9% sodium chloride, also known as normal saline, is an isotonic solution. It is the best choice for rapidly replacing fluid volume in patients with low blood pressure. Isotonic solutions stay in the vascular space and help restore circulating blood volume and blood pressure without causing fluid shifts that can lead to cellular edema or dehydration.

Choice C reason: 5% dextrose in 0.9% sodium chloride is a hypertonic solution, which might not be the most appropriate for initial rapid fluid resuscitation. Hypertonic solutions can draw fluid into the vascular space from the interstitial and intracellular spaces, potentially leading to rapid changes in fluid balance and electrolyte shifts.

Choice D reason: 5% dextrose in 0.45% sodium chloride is also a hypertonic solution but with a hypotonic component (0.45% sodium chloride). This combination is not typically used for rapid fluid resuscitation because it can cause fluid shifts that are less predictable and may complicate the patient's electrolyte balance and hydration status.

A. Prevents skin maceration B. Reduces restenosis C. Reduces the risk of infection D. Increases perfusion to the legs

Correct Answer is D

Explanation

Choice A reason: Preventing skin maceration is not the primary purpose of the reverse Trendelenburg position. Skin maceration typically occurs due to excessive moisture on the skin, and the bed position does not directly address this issue.

Choice B reason: Reducing restenosis, which is the re-narrowing of a blood vessel after it has been treated, is not directly affected by the patient's bed position. Restenosis is more related to the procedure performed and the patient's overall condition rather than positioning.

Choice C reason: Reducing the risk of infection is also not a direct benefit of the reverse Trendelenburg position. Infection prevention involves maintaining sterile techniques, proper wound care, and monitoring for signs of infection.

Choice D reason: Increasing perfusion to the legs is the correct rationale for placing the bed in the reverse Trendelenburg position for a patient with critical limb ischemia. This position helps to improve blood flow to the lower extremities by utilizing gravity to aid in circulation, thus enhancing oxygen and nutrient delivery to the affected tissues.

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Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 48-year-old patient with newly diagnosed hypertension?

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Explanation

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Correct Answer is D

Explanation

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