The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

Changes in peristalsis

Decreased urine output

Decreased insulin resistance

Hypercholesteremia

Answer and Explanation

The Correct Answer is B

A. Changes in peristalsis: Changes in peristalsis, which refers to the rhythmic contraction and relaxation of the gastrointestinal tract muscles, are not typically associated with target organ damage in hypertension. While hypertension can indirectly affect gastrointestinal function through its impact on other organ systems, such as the kidneys and cardiovascular system, alterations in peristalsis are more commonly attributed to gastrointestinal disorders or neurological conditions rather than hypertension-induced target organ damage.

B. Decreased urine output: In a patient diagnosed with hypertension, decreased urine output may indicate the development of target organ damage, particularly renal damage. Hypertension can lead to chronic kidney disease (CKD) over time, which is characterized by a gradual decline in kidney function. Decreased urine output may be a sign of impaired renal function, reduced glomerular filtration rate (GFR), or the presence of proteinuria. These changes indicate that the kidneys are no longer effectively filtering waste products and regulating fluid balance, suggesting the onset of renal damage as a consequence of long-standing hypertension.

C. Decreased insulin resistance: Hypertension is not directly linked to changes in insulin resistance. However, hypertension and insulin resistance are often comorbid conditions that share common risk factors, such as obesity, sedentary lifestyle, and unhealthy diet. While poorly controlled hypertension and insulin resistance can contribute to the development of cardiovascular disease and other complications, a decrease in insulin resistance would not typically be considered an indicator of target organ damage in hypertension.

D. Hypercholesterolemia: Hypercholesterolemia, or high levels of cholesterol in the blood, is a risk factor for cardiovascular disease, including atherosclerosis and coronary artery disease. While hypertension and hypercholesterolemia frequently coexist and contribute to the progression of vascular damage, the presence of hypercholesterolemia alone does not necessarily indicate target organ damage specific to hypertension. However, elevated cholesterol levels can exacerbate vascular changes and increase the risk of cardiovascular events in individuals with hypertension.

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Correct Answer is D

Explanation

A. "Has anyone in your family ever experienced symptoms similar to yours?":
This question aims to gather information about potential familial illnesses or infections but does not specifically address the possible etiology of human immunodeficiency virus (HIV). While HIV can be transmitted vertically from mother to child, asking about family members' symptoms is less directly relevant to the assessment of HIV exposure.

B. "How many alcoholic drinks do you typically consume in a week?":
This question assesses the patient's alcohol consumption habits and is important for evaluating overall health and potential risk factors for various conditions. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Alcohol consumption may affect immune function but is not a primary indicator of HIV exposure.

C. "To the best of your knowledge, are your immunizations up to date?":
This question is aimed at assessing the patient's immunization status and is essential for preventive healthcare. However, it does not directly address the possible etiology of human immunodeficiency virus (HIV). Immunizations primarily protect against infectious diseases caused by bacteria or viruses other than HIV.

D. "Have you recently had unprotected intercourse with a new partner?":
This question directly addresses behaviors that could lead to HIV transmission. Unprotected sexual intercourse with a new partner is a significant risk factor for acquiring HIV, as the virus can be transmitted through sexual contact with an infected individual. Asking about recent sexual activity helps identify potential exposure to HIV and informs appropriate testing and counseling.

A. Avoid alcohol for the first 3 weeks B. Avoid handling patient's leftover foods C. Have family members get an injection of immunoglobin D. Follow a low-protein, low carbohydrate diet

Correct Answer is B

Explanation

A. Avoid alcohol for the first 3 weeks: Avoiding alcohol may be advisable for patients with hepatitis A to prevent additional strain on the liver. However, it is not specifically related to preventing transmission of the infection to others. Therefore, it is not a transmission measure typically included in discharge instructions for the patient's family.

B. Avoid handling patient's leftover foods: Hepatitis A is primarily transmitted through the fecal-oral route, often via contaminated food or water. By avoiding handling the patient's leftover foods, the risk of transmitting the virus to family members through contaminated food is minimized. This measure helps prevent the spread of infection within the household.

C. Have family members get an injection of immunoglobulin: Immunoglobulin may be administered to individuals who have been exposed to hepatitis A to provide passive immunity and reduce the severity of the illness. However, this measure is typically recommended for individuals who have not been previously vaccinated against hepatitis A and have been in close contact with an infected person, rather than as a general preventive measure for all family members.

D. Follow a low-protein, low carbohydrate diet: While maintaining a healthy diet is important for overall health, there is no specific dietary recommendation related to protein or carbohydrate intake for patients with hepatitis A. Therefore, this measure is not directly related to preventing transmission of the infection to others and would not typically be included in discharge instructions for the patient's family.

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The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

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