What recommendation a nurse should give to 55 yr old patient with blood pressure of 150/90 mmHg?

JIPMER Nursing Officer-2017

Medical Surgical Nursing

Medium

Appeared in: JIPMER Nursing Officer-2017

Explanation

A blood pressure of 150/90 mmHg is classified as Stage 2 Hypertension according to the 2017 ACC/AHA guidelines.
An initial elevated reading requires confirmation to formally diagnose hypertension, as blood pressure can fluctuate.
Guidelines recommend a follow-up evaluation within one month for an initial finding of Stage 2 Hypertension.
Rechecking in 2 weeks is a prudent and common clinical practice that aligns with this recommendation, allowing for timely confirmation and potential initiation of treatment.

Option A: A blood pressure of 150/90 mmHg is not considered normal for any adult age. The normal range is less than 120/80 mmHg.
Option C: A 6-month follow-up is too long for a Stage 2 hypertensive reading. This delay risks progression of the condition and potential target organ damage.
Option D: A 1-year follow-up is dangerously long for a hypertensive reading. This interval is reserved for individuals with normal blood pressure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Hypertension diagnosis and follow-up management to guide bedside assessment, documentation, and the next nursing action.
Nurses are at the forefront of hypertension screening. Accurate classification and advising appropriate follow-up are critical nursing responsibilities to prevent serious complications like stroke, heart attack, and kidney disease.
Patient education is a key nursing role. The nurse should explain what the numbers mean, the importance of follow-up, and introduce initial lifestyle modifications (e.g., diet, exercise) even before a formal diagnosis is made.
What if? If the patient's BP was 125/78 mmHg (Elevated), the recommendation would change to advising lifestyle changes and scheduling a recheck in 3-6 months, not 2 weeks.

How to Approach the Question

First, identify the key clinical data provided in the question: the patient's age (55 years) and blood pressure reading (150/90 mmHg).
Next, classify this blood pressure reading according to standard clinical guidelines (e.g., ACC/AHA). Recognize that 150/90 mmHg falls into the Stage 2 Hypertension category.
Recall the recommended action for an initial finding in this category. A single reading is not a diagnosis; it requires confirmation.
Remember the recommended follow-up timeframe for Stage 2 Hypertension, which is evaluation within one month.
Finally, compare this guideline to the given options. 'Recheck your BP 2 weeks later' is the only option that fits safely and appropriately within the 'one month' window.

Concept Tested & Keywords

Concept Tested: Hypertension diagnosis and follow-up management
Stem keywords: 55 yr old, blood pressure, 150/90 mmHg
Lead-in keywords: recommendation
Clinical cues: A BP of 150/90 mmHg is a key clinical value indicating Stage 2 Hypertension.

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