A nurse is screening a community group for hypertension. Which person should be referred for immediate treatment?
A.
A 20-year-old client who has a blood pressure of 125/60 mm Hg.
B.
A 40-year-old client who has a blood pressure of 138/98 mm Hg.
C.
A 55-year-old client who has a blood pressure of 142/68 mm Hg.
D.
A 70-year-old client who has a blood pressure of 150/78 mm Hg.
The Correct answer and Explanation is:
The correct answer is B. A 40-year-old client who has a blood pressure of 138/98 mm Hg.
Explanation:
Blood pressure is an important vital sign used to assess cardiovascular health. It is typically measured in millimeters of mercury (mm Hg) and reported as two numbers: systolic pressure (the top number) and diastolic pressure (the bottom number). The systolic pressure represents the force of blood against the artery walls when the heart beats, while diastolic pressure represents the pressure when the heart is at rest between beats.
Normal Blood Pressure:
The American Heart Association (AHA) defines normal blood pressure as below 120/80 mm Hg.
- A 20-year-old client with a blood pressure of 125/60 mm Hg (option A) has a reading that is near normal but slightly elevated in systolic pressure. However, it is not a cause for immediate concern.
Hypertension Classification:
- Stage 1 hypertension: Systolic 130-139 mm Hg or Diastolic 80-89 mm Hg.
- Stage 2 hypertension: Systolic 140 mm Hg or higher or Diastolic 90 mm Hg or higher.
- Hypertensive crisis: Systolic over 180 mm Hg and/or diastolic over 120 mm Hg, which requires immediate intervention.
Analysis of Options:
- B. 40-year-old with a BP of 138/98 mm Hg falls into stage 2 hypertension based on the diastolic pressure of 98 mm Hg. Diastolic pressure over 90 mm Hg, particularly in a middle-aged adult, significantly increases the risk for heart disease, stroke, and kidney damage. Immediate treatment is recommended to avoid complications.
- C. 55-year-old with a BP of 142/68 mm Hg has elevated systolic pressure, indicating stage 1 hypertension. This requires monitoring but not immediate emergency treatment.
- D. 70-year-old with a BP of 150/78 mm Hg has elevated systolic pressure, which is common in older adults due to stiffened arteries. It warrants further monitoring but not immediate intervention.
Thus, option B requires immediate attention to prevent severe health complications.