A nurse is educating a client about bariatric surgery. Which of the following statements by the client indicate a need for further teaching?

Choice A reason: Tachycardia is a physiological response to fear and anxiety. Tachycardia is a condition where the heart rate is faster than normal, usually above 100 beats per minute. Fear and anxiety can trigger the release of stress hormones, such as adrenaline and cortisol, that stimulate the sympathetic nervous system. This causes the heart to beat faster and stronger, increasing the blood flow and oxygen delivery to the muscles and organs. This prepares the body for the fight-or-flight response, which is a survival mechanism that helps the person to cope with a perceived threat or danger.

Choice B reason: Bronchial constriction is not a physiological response to fear and anxiety. Bronchial constriction is a condition where the airways in the lungs become narrow and inflamed, reducing the airflow and causing difficulty breathing. Bronchial constriction can be caused by various factors, such as asthma, allergies, infections, or irritants. Fear and anxiety can worsen the symptoms of bronchial constriction, but they are not the primary cause of it.

Choice C reason: Bradypnea is not a physiological response to fear and anxiety. Bradypnea is a condition where the breathing rate is slower than normal, usually below 12 breaths per minute. Bradypnea can be caused by various factors, such as brain injury, drug overdose, sleep apnea, or metabolic disorders. Fear and anxiety can increase the breathing rate, not decrease it, as the body needs more oxygen to cope with the stress.

Choice D reason: Pupillary constriction is not a physiological response to fear and anxiety. Pupillary constriction is a condition where the pupils in the eyes become smaller and less responsive to light. Pupillary constriction can be caused by various factors, such as eye injury, medication, aging, or neurological disorders. Fear and anxiety can cause pupillary dilation, not constriction, as the pupils widen to allow more light and improve the vision. This helps the person to see better and react faster to the situation.

Choice A reason: Assessment is the first and most important phase of the nursing process, as it involves collecting and analyzing data about the patient's health status, needs, and preferences. The nurse should have assessed the patient's blood pressure before administering the antihypertensive medication, as it could have been contraindicated or required a dosage adjustment. By failing to do so, the nurse put the patient at risk of hypotension and its complications.

Choice B reason: Planning is the second phase of the nursing process, in which the nurse sets goals and outcomes for the patient's care and selects appropriate interventions. The nurse did not make an error in this phase, as the administration of the antihypertensive medication was part of the plan of care for the patient with hypertension.

Choice C reason: Diagnosis is the third phase of the nursing process, in which the nurse identifies the patient's actual or potential health problems based on the assessment data. The nurse did not make an error in this phase, as the diagnosis of hypertension was accurate and supported by the patient's history and vital signs.

Choice D reason: Evaluation is the fourth and final phase of the nursing process, in which the nurse measures the patient's progress and outcomes and modifies the plan of care as needed. The nurse did not make an error in this phase, as the re-checking of the blood pressure and the recognition of the patient's symptoms were part of the evaluation process. However, the nurse should have also notified the provider and implemented interventions to treat the hypotension.