A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 130/82 mm Hg places him in which of the following categories?
Within the expected reference range
Elevated
Stage 2 hypertension
Stage 1 hypertension
The Correct Answer is B
A. Within the expected reference range: While a blood pressure of 130/82 mm Hg is close to normal, it is not considered fully within the expected reference range. The normal range is typically defined as less than 120/80 mm Hg.
B. Elevated: The reading of 130/82 mm Hg falls into the "elevated" category, which is defined as systolic blood pressure between 120-129 mm Hg and diastolic pressure less than 80 mm Hg. This indicates that while the client is not hypertensive, they are at increased risk for developing hypertension in the future.
C. Stage 2 hypertension: This category is defined by a systolic reading of 140 mm Hg or higher, or a diastolic reading of 90 mm Hg or higher. The client’s reading does not meet these criteria, so this option is not applicable.
D. Stage 1 hypertension: Stage 1 hypertension is characterized by systolic readings between 130-139 mm Hg and diastolic readings between 80-89 mm Hg. Although the systolic reading is in the Stage 1 range, the diastolic reading of 82 mm Hg places the overall reading in the "elevated" category, rather than Stage 1 hypertension.
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Correct Answer is ["B","C","E","G"]
Explanation
A) Family history: Family history is a significant non-modifiable risk factor for atherosclerosis. While individuals cannot change their genetic predisposition, awareness of family history can inform lifestyle choices and risk assessments. Those with a family history should be particularly vigilant about managing other risk factors.
B) High blood pressure: High blood pressure is a modifiable risk factor that can be controlled through lifestyle changes such as diet, exercise, and medication if necessary. Effective management of hypertension can significantly reduce the risk of atherosclerosis and related cardiovascular diseases.
C) Obesity: Obesity is another modifiable risk factor. Individuals can manage their weight through healthy eating, physical activity, and lifestyle modifications. Reducing obesity can improve overall cardiovascular health and decrease the risk of developing atherosclerosis.
D) Age: Age is a non-modifiable risk factor. As people age, the risk for atherosclerosis naturally increases due to various biological changes. While aging itself cannot be altered, awareness of age-related risks can prompt individuals to adopt healthier lifestyles.
E) Lack of physical activity: This is a modifiable risk factor. Increasing physical activity can improve cardiovascular health and reduce the likelihood of developing atherosclerosis. Regular exercise can help maintain a healthy weight and improve blood pressure and cholesterol levels, contributing to overall heart health.
F) Gender: Gender is also a non-modifiable risk factor. While certain genders may have different risks at various life stages (e.g., men often have a higher risk at a younger age), this characteristic cannot be changed. Understanding gender-related risks can aid in tailoring preventive strategies but does not offer a means of modification.
G) Smoking: Smoking is a critical modifiable risk factor for atherosclerosis. Quitting smoking can significantly lower the risk of cardiovascular diseases and improve overall health. Smoking cessation should be a priority for individuals looking to prevent or manage atherosclerosis effectively.
Correct Answer is C
Explanation
A) Apply cold therapy to the affected leg: Cold therapy may be used for certain conditions to reduce swelling and pain, but in the case of suspected deep vein thrombosis (DVT) indicated by redness, warmth, tenderness, and pain in the calf, cold therapy is not appropriate. Instead, the focus should be on confirming the diagnosis before applying any treatment.
B) Monitor Homan's sign: Homan's sign involves dorsiflexion of the foot to assess for pain in the calf, which can suggest DVT. However, it is no longer considered a reliable diagnostic tool. Instead, confirmation through imaging or other diagnostic measures is preferred, so simply monitoring this sign would not be sufficient in this situation.
C) Obtain a venous duplex ultrasound: A venous duplex ultrasound is the gold standard for
diagnosing DVT. Given the client’s symptoms—redness, warmth, tenderness, and pain in the calf—the appropriate order is to obtain this ultrasound to confirm the presence of a thrombus. This imaging study provides critical information for diagnosis and subsequent management.
D) Obtain impedance plethysmography: While impedance plethysmography can assess venous flow and help diagnose DVT, it is less commonly used than venous duplex ultrasound. The more direct and widely accepted method for diagnosing DVT in this scenario is the ultrasound, making this option less suitable as the initial order.