Based on annual physical assessments, an older adult female’s blood pressure readings have changed from 120/82 to 155/86 mm Hg over the past two years.
The practical nurse (PN) should recognize which factors in the client’s history are likely to be associated with this finding? (Select all that apply.)
A.
Leads an aerobics class.
B.
Increase in age.
C.
Body mass index of 22
D.
History of diabetes mellitus.
E.
Hyperlipidemia
The correct answer and Explanation is :
The correct answers are:
B. Increase in age.
D. History of diabetes mellitus.
E. Hyperlipidemia.
Explanation:
B. Increase in age:
Blood pressure naturally tends to rise with age due to changes in the elasticity of blood vessels and the cumulative impact of various risk factors over time. As people age, their arteries stiffen, which increases resistance to blood flow and leads to higher systolic blood pressure (the first number in a blood pressure reading). The increased systolic pressure, as seen in the client (from 120 to 155 mm Hg), reflects this process. Aging also affects the baroreceptor response, making it less effective at regulating blood pressure.
D. History of diabetes mellitus:
Diabetes is a significant risk factor for hypertension. High blood glucose levels associated with diabetes can cause damage to the blood vessels over time, leading to the thickening of arterial walls, which contributes to increased blood pressure. Diabetics are also at higher risk for atherosclerosis (plaque buildup in arteries), which further raises blood pressure. The presence of diabetes in this client likely plays a role in the observed increase in her blood pressure.
E. Hyperlipidemia:
Hyperlipidemia, or high cholesterol levels, is another key risk factor for the development of hypertension. High cholesterol leads to plaque formation in the arteries (atherosclerosis), causing them to narrow and harden, which in turn increases blood pressure. This condition contributes to the cardiovascular strain that leads to elevated systolic and diastolic readings, as seen in this client’s assessment.
Why A and C are incorrect:
A. Leads an aerobics class:
Regular physical activity, like leading an aerobics class, typically lowers blood pressure by improving heart health and reducing arterial stiffness. It is unlikely that an individual who regularly engages in aerobic exercise would experience a rise in blood pressure as a result of their physical activity alone.
C. Body mass index of 22:
A BMI of 22 falls within the normal weight range, and maintaining a healthy weight is associated with better blood pressure control. Obesity is a risk factor for hypertension, but since this client has a normal BMI, it is unlikely that her weight contributed to the increase in blood pressure.