Medical Surgical Hypertension #5

Question

The emergency department (ED) nurse assessed a client with a complaint of headache for the past two days. Blood pressure on admission to the ED was 196/114 and second blood pressure was 188/100. The ED nurse administered hydrochlorothiazide followed by losartan. Five hours later, the blood pressure was reduced by 10% and complaints of headache lessened. The ED nurse provided instructions based on follow-up for which type of hypertension?

Answers

  1. Prehypertension
    • Rationale:

      This answer is not correct because prehypertension is when a blood pressure reading is between 120/80 and 139/89. Lifestyle changes will be considered first if a client has prehypertension.

  2. Stage 1 hypertension
    • Rationale:

      This answer is not correct because the client presents with Stage 2 hypertension. Stage 2 systolic is 140 or higher and diastolic is 90 or higher. Stage 1 presents with systolic between 130-139 and diastolic between 80-90.

  3. Stage 2 hypertension
    • Rationale:

      This answer is correct because the client presents with Stage 2 hypertension. Stage 2 systolic is 140 or higher and diastolic is 90 or higher. Stage 1 presents with systolic between 130-139 and diastolic between 80-90. There is no stage 3 hypertension; however, there is a hypertensive crisis which occurs with systolic higher than 180 and diastolic higher than 120.

  4. Stage 3 hypertension
    • Rationale:

      This answer is not correct because there is no stage 3 hypertension; however, there is a hypertensive crisis which occurs with systolic higher than 180 and diastolic higher than 120. The client presents with Stage 2 hypertension. Stage 2 systolic is 140 or higher and diastolic is 90 or higher. Stage 1 presents with systolic between 130-139 and diastolic between 80-90.

Overview

Uncontrolled hypertension can lead to many poor outcomes, including heart disease, stroke, and kidney disease. Stage 2 hypertension is when systolic is 140 or higher and diastolic is 90 or higher.

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. In stage 2 hypertension, systolic blood pressure is 140 or higher and diastolic blood pressure is 90 or higher. Stage 1 presents with systolic between 130-139 and diastolic between 80-90. Prehypertension is when a blood pressure reading is between 120/80 and 139/89. There is no stage 3 hypertension; however, there is a hypertensive crisis which occurs with systolic higher than 180 and diastolic higher than 120.

Test Taking Tip

Remember that stage 2 in hypertension is the worst unless it is hypertensive crisis, which is extreme. Think “2” is the second chance before there is a crisis.

Video Rationale