Which complication should a nurse monitor for in a patient with poorly controlled hypertension?

Poorly controlled hypertension causes sustained elevated systemic vascular pressure, leading to progressive endothelial injury, arteriolar thickening (arteriolosclerosis), and reduced renal perfusion. Over time, this results in nephrosclerosis, glomerular damage, and eventual progression to chronic kidney disease due to irreversible nephron loss. Rationale: A. Hyperglycemia leading to diabetes is not a direct complication of hypertension. Although both conditions share metabolic risk factors, hypertension does not directly cause insulin resistance or pancreatic beta-cell dysfunction. B. Electrolyte imbalances due to sweating are not a primary complication of chronic hypertension. Electrolyte disturbances are more commonly associated with diuretics or endocrine disorders rather than elevated blood pressure itself. C. Dehydration from reduced fluid intake is unrelated to the pathophysiology of hypertension complications. Hypertension does not inherently cause reduced fluid consumption or dehydration as a complication. D. Chronic hypertension causes renal microvascular damage, leading to chronic kidney disease through progressive ischemic injury, glomerulosclerosis, and reduced filtration capacity. This is a major and well-established long-term complication requiring ongoing monitoring.