A 12-year-old child whose body mass index (BMI) is greater than the 95th percentile has a blood pressure at the 98th percentile for age, sex, and height. After lifestyle changes that include diet and exercise, the child's BMI drops to the 90th percentile, but the blood pressure remains the same. What is the primary care pediatric nurse practitioner's next step in treating this child?

Question

Quizplus · Accepted Answer

The child's persistently elevated blood pressure despite lifestyle modifications necessitates a referral to a specialist (nephrologist or cardiologist) for further evaluation and management. Medication such as an ACE inhibitor may be considered, but this should be initiated and monitored by a specialist. An echocardiogram may be ordered by the specialist, but it is not the first next step in management. Continued close monitoring of blood pressure is important, but referral to a specialist is necessary in this case.

A 12-Year-Old Child Whose Body Mass Index (BMI) Is Greater