Medical Surgical Hypertension #1

Question

A client with stage 2 hypertension returns to the clinic for follow-up. The client states that prescribed antihypertensives are taken if the client remembers. The client also states that lunch on the job consists of fast food and does not have time to fix a lunch in the mornings. After assessment and analysis, the nurse has identified a nursing diagnosis of risk for ineffective health maintenance related to nonadherence to therapeutic regimen. Which type of teaching/education would benefit the client most?

Answers

  1. Ask the client if there is a death wish because of the noncompliance then proceed to ask why the client does not want to live to see grandchildren.
    • Rationale:

      This answer is not correct because shaming the client and trying to make them feel guilty about not following the medical advice and medication regimen is not therapeutic. The nurse should help the client understand best by providing written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.

  2. Give the client free movie tickets for blood pressure less than 150/80 with the next visit and increase the incentive for the next three visits.
    • Rationale:

      This answer is not correct because coercion with awards and gifts may not help the client reach lifestyle changes for long-term. The nurse should help the client understand best by providing written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.

  3. Provide written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.
    • Rationale:

      This answer is correct because if a client is non-compliant or struggling with diet and medications, nursing instruction is needed. The type of teaching/education that would benefit a client with the risk for ineffective health maintenance most is providing written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.

  4. Provide medical journal articles on recent research in early death, mortality, and comorbidities with hypertension and heart disease.
    • Rationale:

      This answer is not correct because providing medical journal articles on recent research in early death, mortality, and comorbidities with hypertension and heart disease is not appropriate since it will likely be too complex to understand. Information should be an easy-to-understand level of reading.

Overview

The type of teaching/education that would benefit a client with the risk for ineffective health maintenance most is providing written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.

Explanation

Learning Outcomes

Uncontrolled hypertension can lead to many poor outcomes, including heart disease, stroke, and kidney disease. Client’s should follow the prescribed medication regimen to help prevent these conditions and complications associated with these. If a client is non-compliant or struggling with diet and medications, nursing instruction is needed. The type of teaching/education that would benefit a client with the risk for ineffective health maintenance most is providing written education materials, teach-back, med-minder log, and a list of foods that are low salt and low fat that can be ordered in restaurants near work.

Test Taking Tip

Written educational material is good since it allows the client to reread information and reference it when there are questions. Often clients are very overwhelmed and do not “get it” the first time hearing or reading, so the written material helps remind them of the teaching.

Video Rationale