A Person Is Recovering Following a Carotid Endarterectomy

A person is recovering following a carotid endarterectomy. The person's blood pressure has risen this morning to 168/60. What should the nurse do?

A) Recheck the blood pressure every 30 minutes and report this change to the doctor when they make rounds the next time.
B) Record the blood pressure and find out who took this reading. Have that staff member demonstrate their blood pressure procedure and offer tips to obtain more accurate readings.
C) Check the standing orders and see if there is a medication ordered PRN for lowering blood pressure. If so, administer it and document the action.
D) Recheck the blood pressure and ensure the correct size cuff was used. Compare the trend of blood pressure readings and call the doctor now.