(Select all that apply).
A nurse is providing discharge teaching to a client with gestational hypertension who delivered a healthy baby two days ago.
Which of the following statements by the client would indicate a need for further teaching?
I should continue to take my blood pressure medication as prescribed until my next check-up
I should report any signs of headache, blurred vision, or abdominal pain to my provider
I should avoid breastfeeding my baby until my blood pressure returns to normal.
I should limit my salt intake and drink plenty of fluids.
I should weigh myself daily and report any sudden weight gain to my provider
Correct Answer : A,B,D,E
The correct answer is choice C. Choice C is wrong because breastfeeding is not contraindicated for women with gestational hypertension. Breastfeeding has many benefits for both the mother and the baby, and it does not affect blood pressure.
Choice A is correct because blood pressure medication should be continued as prescribed until the next check-up. Stopping medication abruptly can cause a rebound increase in blood pressure and increase the risk of complications.
Choice B is correct because headache, blurred vision, or abdominal pain are signs of severe preeclampsia, a serious complication of gestational hypertension that can affect the brain, liver, and kidneys. These symptoms should be reported to the provider immediately.
Choice D is correct because limiting salt intake and drinking plenty of fluids can help lower blood pressure and prevent fluid retention.
Salt can cause the body to hold on to excess water, which increases blood volume and blood pressure. Fluids can help flush out excess salt and keep the body hydrated.
Choice E is correct because weighing oneself daily and reporting any sudden weight gain to the provider can help monitor fluid balance and detect signs of preeclampsia. A weight gain of more than 2 pounds in a week or 5 pounds in a month may indicate fluid accumulation and increased blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
The correct answer is choice A and B. Hydralazine is a drug that lowers blood pressure by relaxing the blood vessels.It can cause some side effects such astachycardia(fast heart rate) andheadache.
These are common and may go away during treatment.
However, if they are severe or persistent, the nurse should monitor the client and report to the doctor.
Choice C is wrong because nausea is not a common side effect of hydralazine.
It may be caused by other factors such as pregnancy or infection.
Choice D is wrong because hyperkalemia (high potassium level in the blood) is not a side effect of hydralazine.
It may be caused by other drugs such as angiotensin-converting enzyme inhibitors or potassium-sparing diuretics.
Choice E is wrong because oliguria (low urine output) is not a side effect of hydralazine.
It may be a sign of kidney damage or dehydration.
The nurse should monitor the client’s fluid intake and output and report any changes to the doctor.
Correct Answer is B
Explanation
The correct answer is choice B. Monitor fetal heart rate continuously.This is because hydralazine is a vasodilator that lowers blood pressure and may cause tachycardia.Tachycardia can affect the fetal heart rate and oxygenation, so continuous monitoring is essential to detect any signs of fetal distress.
Choice A is wrong because hydralazine does not cause orthostatic hypotension, but rather a reflex increase in heart rate and cardiac output.
Orthostatic hypotension is more likely to occur with other antihypertensive drugs such as alpha-blockers or diuretics.
Choice C is wrong because encouraging oral fluid intake may worsen the fluid retention and edema that are common in preeclampsia.Fluid intake should be restricted to avoid pulmonary edema and cerebral edema.
Choice D is wrong because administering oxygen via nasal cannula is not a priority intervention for a woman with severe preeclampsia who is receiving hydralazine IV.Oxygen therapy may be indicated if the woman develops signs of hypoxia, such as dyspnea, cyanosis, or low oxygen saturation.However, oxygen therapy should be used with caution as it may increase oxidative stress and placental vasoconstriction.
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