A middle-aged male patient with usually well-controlled hypertension and diabetes visits the clinic. Today he has a blood pressure of 174/94 and a blood glucose level of 190 mg/dL

Question

What additional patient information may indicate that an intervention by the nurse is needed?
a. The patient indicates that he usually does blood glucose monitoring several times each day.
b. The patient states that he usually takes his prescribed antihypertensive medications on a daily basis.
c. The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son.
d. The patient states that the results are related to his family history because both of his parents have high blood pressure and diabetes.

Answer 1

ANS: C
The increase in blood pressure and glucose levels possibly suggests that stress caused by his divorce and custody battle may be adversely affecting his health. The nurse should assess this further and develop an appropriate plan to assist the patient in decreasing his stress. Although he has been very compliant with his treatment plan in the past, the nurse should assess whether the stress in his life is interfering with his management of his health problems. The family history will not necessarily explain why he has had changes in his blood pressure and glucose levels.