A 75-year-old client has a baseline blood pressure of 140/90 mm Hg. The nurse obtains a sitting blood pressure reading in the client's left arm, which is 160/100 mm Hg. What action should the nurse take next?

The nurse should take a series of actions following the initial reading of 160/100 mm Hg to ensure accurate assessment and appropriate management:

1. Confirm the reading: The nurse should first make sure the blood pressure cuff is the correct size for the client's arm and that it was applied correctly. If uncertain about the initial reading, the nurse should wait a few minutes and then recheck the blood pressure in the same arm.

2. Check blood pressure in both arms: Differences in blood pressure readings between arms can be significant. Usually, a small difference of 10 mm Hg or less in systolic blood pressure between arms is considered normal, but larger differences may indicate an underlying problem. The nurse should assess the blood pressure in the other arm for comparison purposes.

3. Ensure proper technique and conditions: The client should be seated comfortably, with their back supported, feet flat on the floor, and arm supported at heart level. The client should not have smoked or consumed caffeine within 30 minutes before the measurement. The nurse should make sure the client has been resting for at least five minutes before taking the reading.

4. Record and report: If high readings are confirmed, the nurse should document the readings accurately in the client’s chart and report the findings to the attending healthcare provider for further evaluation and management.

5. Continue to monitor: Ongoing monitoring of the client's blood pressure should be done as advised by the healthcare provider, as isolated readings may not represent the client's usual blood pressure.

6. Educate the client: The nurse should educate the client on lifestyle changes that can help manage high blood pressure, such as reducing salt intake, eating a healthy diet, engaging in regular physical activity, managing stress, and adhering to any prescribed medication regimen.

• Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps. It is measured in millimeters of mercury (mm Hg) and recorded with two numbers: systolic pressure (the higher number, measured when the heart beats) over diastolic pressure (the lower number, measured when the heart is at rest between beats). A normal blood pressure reading is typically below 120/80 mm Hg. The reading of 140/90 mm Hg in the elderly client is considered hypertension or high blood pressure.
• Elevated blood pressure can be influenced by several factors, including stress, activity level, medication, and underlying health conditions. It is important for healthcare providers to ensure the accuracy of blood pressure readings to avoid overtreatment or undertreatment. Persistent hypertension requires medical attention because if left uncontrolled, it can increase the risk of heart attack, stroke, kidney disease, and other serious health issues. Patient education is a key component of managing high blood pressure, helping individuals understand the importance of lifestyle modifications and medication adherence in maintaining their cardiovascular health.