Which of the following describes a situation in which the blood pressure is severely elevated and there is evidence of actual target organ damage?
Secondary hypertension
Hypertensive urgency
Hypertensive emergency
Primary hypertension
The Correct Answer is C
Rationale:
A. Secondary hypertension is high blood pressure due to an identifiable cause, such as renal disease, but it does not describe an acute situation with target organ damage.
B. Hypertensive urgency is a situation where the blood pressure is severely elevated but without evidence of target organ damage.
C. Hypertensive emergency is characterized by severely elevated blood pressure with evidence of acute target organ damage, such as encephalopathy, myocardial infarction, or renal failure, requiring immediate medical intervention.
D. Primary hypertension, also known as essential hypertension, is high blood pressure without a known secondary cause and does not describe an acute emergency.
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Correct Answer is B
Explanation
Rationale:
A. While lowering BP to 120/80 may be an ultimate goal, it is not the initial target in a hypertensive emergency.
B. Rapid reduction in blood pressure can cause hypoperfusion of vital organs such as the brain, heart, and kidneys, leading to ischemic injury. The aim is to reduce the BP gradually to prevent these complications.
C. IV antihypertensive medications generally have a rapid onset, not a slow one.
D. While gradual reduction is important, it is not done to allow rest but to protect organ perfusion.
Correct Answer is B
Explanation
Rationale:
A. Obtaining a stat chest x-ray is important if catheter misplacement is suspected, but in this situation, ensuring the accuracy of the pressure reading through proper leveling and zeroing is the priority.
B. Zero referencing and leveling the catheter at the phlebostatic axis is essential to ensure accurate readings of the pulmonary artery pressure, which is critical for patient assessment and management.
C. Increasing supplemental oxygen is unnecessary given the patient’s stable oxygen saturation and normal respiratory status.
D. While notifying the provider is important, ensuring the accuracy of the pressure reading by leveling and zeroing the catheter should be done first.