A nurse is teaching a client just diagnosed with mild hypertension. Which of the following information should the nurse include in the teaching?
"Diuretics are the first line therapy to control hypertension."
"Reaching your goal blood pressure will occur within 2 months."
"Plan to add saturated fats to 10 percent of your daily calorie intake."
"Limit your alcohol consumption to three drinks a day."
The Correct Answer is A
A. "Diuretics are the first line therapy to control hypertension.": This statement is accurate. Thiazide diuretics are commonly recommended as first-line treatment for mild hypertension, as they help reduce blood volume and lower blood pressure effectively.
B. "Reaching your goal blood pressure will occur within 2 months.": While treatment can lead to improvements in blood pressure, the timeline for reaching target levels can vary significantly among individuals based on adherence to lifestyle changes and medication. It's important to communicate that achieving the goal may take longer than two months.
C. "Plan to add saturated fats to 10 percent of your daily calorie intake.": This recommendation is misleading. Guidelines generally suggest limiting saturated fats to less than 10 percent of total daily calories to promote heart health, not adding them.
D. "Limit your alcohol consumption to three drinks a day.": This statement is also inaccurate. For most adults, the recommendation is to limit alcohol to no more than two drinks per day for men and one drink per day for women to help manage blood pressure effectively.
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Correct Answer is D
Explanation
A) Tachycardia: Propranolol is often used to manage tachycardia by reducing heart rate and controlling excessive adrenergic activity. Therefore, this diagnosis would not warrant clarification of the order; it is an appropriate use of the medication.
B) End-stage kidney failure: While caution is necessary when administering medications in clients with renal impairment, propranolol is primarily metabolized by the liver, and its use is not contraindicated in end-stage kidney failure. However, renal function can affect dosing, so monitoring would be important, but this diagnosis alone wouldn't require clarification.
C) Hypertension: Propranolol is commonly prescribed to manage hypertension, making this diagnosis a valid reason for the medication order. The use of propranolol in this context would not need clarification.
D) Asthma: Propranolol is a non-selective beta-blocker, which can cause bronchoconstriction and exacerbate asthma symptoms. This diagnosis would require the nurse to clarify the order, as beta-blockers are generally contraindicated in clients with asthma due to the risk of respiratory complications. If the client has reactive airway disease, an alternative medication should be considered.
Correct Answer is C
Explanation
A) Ventricular tachycardia: Ventricular tachycardia is characterized by a rapid heart rate exceeding 100 bpm, typically arising from abnormal ventricular activity. In this case, the heart rate is 59 bpm, which does not support this interpretation. Additionally, ventricular tachycardia usually presents with wide QRS complexes and no discernible P waves, neither of which is true in this scenario.
B) Sinus tachycardia: Sinus tachycardia is defined by a heart rate exceeding 100 bpm originating from the sinoatrial (SA) node, with a regular rhythm and normal P waves. The heart rate of 59 bpm in this client is too low for a diagnosis of sinus tachycardia, making this option incorrect.
C) Sinus bradycardia: Sinus bradycardia occurs when the heart rate is less than 60 bpm, with a regular rhythm and a normal PR interval and QRS duration. The provided data shows a heart rate of 59 bpm, a regular rhythm, one P wave for every QRS complex, a PR interval of 0.20 seconds, and a QRS duration of 0.10 seconds, which aligns perfectly with the criteria for sinus bradycardia.
D) Normal sinus rhythm: Normal sinus rhythm typically presents with a heart rate of 60-100 bpm, a regular rhythm, and appropriate P waves for each QRS complex. Given the heart rate of 59 bpm, this does not meet the criteria for normal sinus rhythm, as it falls below the acceptable range.