TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 30: Hypotension Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A young adult patient is being treated for hypertension and is noted to have a resting blood
pressure of 135/88 mm Hg just after finishing a meal. After standing, the patient has a blood pressure of 115/70 mm Hg. What is the likely cause of this change in blood pressure? a. A hyperglycemic episode b. Antihypertensive medications c. Neurogenic orthostatic hypotension d. Postprandial hypotension ANS: B
Medications to treat hypertension may cause orthostatic hypotension. Hypoglycemia may cause hypotension. Neurogenic orthostatic hypotension is less likely since there is no direct connection to the neurological system. Postprandial hypotension occurs in elderly patients. 2. An elderly patient who experiences orthostatic hypotension secondary to antihypertensive
medications is noted to have a drop in systolic blood pressure of 25 mm Hg. Which intervention is important for this patient? a. Administration of intravenous fluids b. Close monitoring cardiorespiratory status c. Initiation of a fall risk protocol d. Withholding antihypertensive medications ANS: C
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A reduction of systolic blood pressure >20 mm Hg is a risk factor for falls in the elderly, so a fall risk protocol should be initiated. Unless the patient is dehydrated, IV fluids are not recommended. Close monitoring of CR status will not prevent falls. Withholding antihypertensive medications often worsens orthostatic hypotension. 3. An older patient develops orthostatic hypotension secondary to an antihypertensive
medication and asks what measures can be taken to minimize this condition. What will the provider recommend? a. Changing from sitting to standing slowly b. Decreasing the medication dosage c. Decreasing physical activity d. Performing the Valsalva maneuver ANS: A
Changing positions slowly will assist in minimizing the effects of this condition. Decreasing activity will not help and will have a negative effect on general health. Decreasing or discontinuation of the medication should not be done without first contracting the prescribing health care provider. Performing the Valsalva maneuver will increase intrathoracic pressure and should be avoided.
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