A client's visit to the health care clinic reveals a blood pressure of 142/90. The nurse's next step would be to:
1. Check the client's record for the past several blood pressure readings.
2. Discuss the diagnosis of hypertension with the client.
3. Notify the physician or primary health care provider immediately.
4. Identify medications the client has been taking.
Check the client's record for the past several blood pressure readings.
Rationale: This client's blood pressure meets the criteria for stage 1 hypertension (systolic 140−159 or diastolic 80−99), according to the JNC 7 report. It is important for the nurse to first compare this blood pressure reading with previous blood pressure readings since the actual diagnosis of hypertension requires multiple readings that are high. Discussing the diagnosis of hypertension may be needed, but not until it is established that the client meets the criteria for stage 1 hypertension of multiple readings between systolic 140−159 or diastolic 80−99. The physician or primary health care provider does not need to be notified immediately, but will need to be ultimately involved in this client's therapeutic plan. The nurse will identify the client's medications, which may impact the blood pressure reading. However, this would follow establishing whether the high blood pressure reading is a pattern or a new event.
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