A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize?

Increasing fluids to maintain BP

Taking medication first thing in the morning

Stopping medication if dizziness persists

Rising slowly from a lying or sitting position

Answer and Explanation

The Correct Answer is D

A. Increasing fluids to maintain BP: While staying well-hydrated is generally beneficial for overall health and blood pressure management, increasing fluids is not the primary intervention for dizziness associated with alpha-adrenergic blockers. Alpha-blockers can cause orthostatic hypotension, which may lead to dizziness upon standing, especially if rising quickly.

B. Taking medication first thing in the morning: Taking medication in the morning is a common recommendation for many medications, including some antihypertensive drugs. However, for alpha-adrenergic blockers that can cause orthostatic hypotension, timing of medication administration is not the primary concern in addressing dizziness.

C. Stopping medication if dizziness persists: Abruptly stopping medication without consulting a healthcare provider is not recommended, especially for antihypertensive medications. It's important for clients to follow their prescribed treatment plan and communicate any side effects or concerns to their healthcare provider for appropriate management.

D. Rising slowly from a lying or sitting position: This is the correct emphasis for the nurse. Alpha-adrenergic blockers can cause orthostatic hypotension, a drop in blood pressure upon standing, which can lead to dizziness or lightheadedness. To minimize this risk, the client should be advised to rise slowly from lying down or sitting to standing positions. This gradual movement helps the body adjust to changes in blood pressure more effectively.

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Correct Answer is D

Explanation

A. "Hypertension is the leading cause of death in people your age.": While hypertension is a significant risk factor for cardiovascular events and mortality, stating it as the leading cause of death without specific context or statistical data may not provide the most informative response to the client's question.

B. "Hypertension puts you at increased risk of type 1 diabetes and cancer in your age group.": Hypertension is primarily associated with cardiovascular risks such as stroke, heart disease, and kidney disease. While it can contribute to overall health risks, it is not typically linked directly to type 1 diabetes or cancer in the context of this client's question.

C. "Hypertension can cause you to develop dangerous blood clots in your legs that can migrate to your lungs.": While hypertension can contribute to cardiovascular complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE), these are not the primary risks that are typically emphasized when discussing the importance of treating hypertension.

D. "Hypertension greatly increases your risk of stroke and heart disease.": This response is the most relevant and specific to the client's question. Hypertension is a major risk factor for stroke, heart disease (including heart attack and heart failure), and other cardiovascular complications. By treating hypertension and controlling blood pressure within recommended targets, the client can significantly reduce the risk of these serious and potentially life-threatening conditions.

A. Ascending edema B. The client has no desire to eat. C. The client sleeps on three pillows at night. D. The client has a five pound weight gain.

Correct Answer is C

Explanation

A. Ascending edema:

Ascending edema, also known as dependent edema, is typically associated with right-sided heart failure rather than left-sided heart failure. In right-sided heart failure, the heart's ability to pump blood to the lungs for oxygenation is compromised, leading to fluid backup in the systemic circulation. This fluid accumulates in the dependent areas of the body, such as the lower extremities (legs and ankles), causing swelling that can ascend upwards if left untreated. However, ascending edema is not a characteristic finding in left-sided heart failure, where pulmonary congestion and orthopnea are more common manifestations.

B. The client has no desire to eat:

While decreased appetite can occur in heart failure due to various factors such as fluid retention, abdominal bloating, or medication side effects, it is not a specific hallmark of left-sided heart failure. Symptoms such as fatigue, dyspnea (shortness of breath), orthopnea (difficulty breathing while lying flat), and paroxysmal nocturnal dyspnea (PND) are more commonly associated with left-sided heart failure. These symptoms result from the impaired function of the left ventricle, leading to pulmonary congestion and inadequate oxygenation.

C. The client sleeps on three pillows at night:

This choice is the correct answer. Sleeping on three pillows at night is a classic manifestation of orthopnea, a condition commonly seen in left-sided heart failure. Orthopnea refers to difficulty breathing while lying flat, which is alleviated by elevating the head and upper body with multiple pillows or sleeping in a semi-upright position. Orthopnea occurs due to the redistribution of fluid from the legs and lower body to the lungs when lying down, resulting in pulmonary congestion and respiratory distress.

D. The client has a five-pound weight gain:

Weight gain is a common symptom of fluid retention in heart failure; however, a specific weight gain of five pounds alone may not be indicative of left-sided heart failure without considering other clinical signs and symptoms. In heart failure, weight gain is often associated with fluid overload, which can lead to edema, dyspnea, orthopnea, and other signs of congestion. It's important to assess the client comprehensively for fluid status, including evaluating for edema, respiratory symptoms, and changes in weight over time, to determine the underlying cause of weight gain.

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A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is assessing a client with left-sided heart failure. What would the nurse expect to find?

Correct Answer is C

Explanation

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