Chapter 18 - Disorders of blood flow and blood pressure

Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease?

C-reactive protein

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the client's following statements indicates a need for further health promotion teaching?

"I'm resolving to eat organic foods from now on and to drink a lot more water."

A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status?

"We don't really understand why some women get high blood pressure when they're pregnant."

An elderly client newly diagnosed with systolic hypertension asks her health care provider why this happens. The most accurate response would be:

"With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer."

A client with persistent, primary hypertension remains apathetic about his high blood pressure, stating "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could the nurse best respond to this client's statement?

"You may not sense any problems, but it really increases your risk of heart disease and stroke."

A client asks, "Why do I have clogged arteries but my neighbor has higher 'bad cholesterol' levels and yet he is just fine?" The health care provider bases the reply on which of the following physiological principles about lipoprotein?

"You more than likely have small, dense type of 'bad cholesterol' (LDL)."

A health care provider was asked by a client, "Why do my hands turn blue when I drive my car in the winter without gloves?" Which of the following is the best response?

"Your arteries in your hands/fingers are going into spasm, which decreases blood flow and circulating oxygen."

Because of its location, the presence of an abdominal aortic aneurysm may first be manifested as:

A pulsating mass

Which of the following clients would be at high risk for developing primary varicose veins? Select all that apply.

A) A 47-year-old waitress who works 12-hour shifts three or four times/week B) A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week

Which of the following children may be considered high risk for developing hypertension? Select all that apply.

A) Diagnosed with coarctation of the aorta as an infant B) Recent scan showing a pheochromocytoma D) Takes cyclosporine daily since a kidney transplant

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the client's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

Which of the following is a nonmodifiable risk factor for the development of primary hypertension?

African American race

Which of the following clients should most likely be assessed for orthostatic hypotension?

An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom

A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this client?

Anticoagulation therapy and elevation of the leg

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is:

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is:

A client's primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this agent achieve its therapeutic effect?

By decreasing vascular volume by increasing sodium and water excretion

A client is receiving home care for the treatment of a wound on the inside of her lower leg that is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the client's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this client's most likely diagnosis?

Chronic venous insufficiency

A client consistently has an elevated systolic BP greater than 150 mm Hg but a diastolic pressure in the 80s. The health care provider should be assessing for which of the following complications?

Crackles in bilateral lung bases caused by left-sided heart failure

The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the midcalf area. He has many of the manifestations of:

Deep vein thrombosis

Which of the following would be considered a major cause of secondary hyperlipoproteinemia since it increases the production of VLDL and conversion to LDL?

High-calorie diet

n addition to direct invasion of the vascular wall by an infectious agent, this pathogenic mechanism is a common cause of vasculitis?

Immune-mediated inflammation

A client with a history of disabling claudication now is in the emergency department with a lower limb that is turning dark purple to black associated with faint Doppler pedal pulses. The client will more than likely undergo:

Percutaneous transluminal angioplasty and stent placement

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes?

Peripheral vascular resistance

A client asks why his blood pressure pills seem to make him go to the bathroom to urinate frequently when they are not water pills (diuretics). Which of the following physiologic processes explains the long-term regulation of blood pressure most accurately?

Renal monitoring and adjustment of extracellular fluid volume

The most important complication of atherosclerosis that may cause occlusion of small heart vessels is:

Thrombosis