Chp 26: Disorders of Blood Flow

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

The client must protect the entire body from cold, not just the extremities. Explanation: Treatment measures are directed toward eliminating factors that cause vasospasm. Abstinence from smoking and protection from cold are priorities.

The physician understands that which client is at risk for developing primary hyperlipoproteinemia?

A client with familial hypercholesterolemia

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition?

A pulsating mass in the abdomen Explanation: Most abdominal aortic aneurysms are asymptomatic. Because an aneurysm is of arterial origin, a pulsating mass in the abdomen may provide the first evidence of the disorder.

Which intervention will the nurse prioritize for the medical management of a client with a dissecting aortic aneurysm?

Administration of vasodilators and beta-adrenergic blocking medications (beta-blockers) Administration of medications to lower blood pressure such as vasodilators and and beta-adrenergic blocking medications which slow heart rate are the expected treatment. Lowering blood pressure will lessen the force of systolic blood ejection from the heart.

The nurse knows that the renin-angiotensin-aldosterone system (RAAS) is an important mechanism in blood pressure control. Which physiologic events will activate this system? Select all that apply.

Adrenergic (sympathetic) stimulation Decreased blood sodium Fall in blood pressure Decreased blood volume

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Explanation: Preeclampsia-eclampsia is defined as an elevation in blood pressure (systolic >140 mm Hg or diastolic >90 mm Hg) and proteinuria (300 or greater in 24 hours) developing after 20 weeks of gestation.

The nurse knows that coarctation of the aorta can be a secondary cause of hypertension. Which blood pressure finding can be characteristic of this condition?

Blood pressure in arms 20 mm Hg higher than in the legs Explanation: In coarctation of the aorta, blood flow to the lower body is reduced. Blood pressure in the arms is typically at least 20 mm Hg higher than in the legs. Pulse pressure is narrowed, and femoral pulses are weak.

A client's initial blood pressure on admission to the outpatient clinic is 190/120 mm Hg. Which action by the clinic staff is most appropriate at this time?

Calling an ambulance to take the client to the emergency department Explanation: Hypertensive emergency is characterized by sudden, marked elevations of blood pressure (>180/120 mm Hg) complicated by evidence of acute or worsening target organ damage.

A client is brought to the emergency department diagnosed with malignant hypertension. The nurse knows which clinical manifestations are associated with this disorder? Select all that apply.

Diastolic pressure above 120 mm Hg Confusion Cerebral edema Papilledema Malignant hypertension is a sudden extreme rise in blood pressure with diastolic readings above 120 mm Hg. As elevated pressure forces fluid out of the cerebral capillaries, cerebral edema will develop. Papilledema, swelling of the optic nerve, is the result of elevated pressure in the capillaries in the eye.

Which antihypertensive medications might the health care provider select to use as alternatives to treat the client's hypertension? Select all that apply

Direct-acting vasodilators Alpha-adrenergic blockers Centrally acting adrenergic agonists

The client has symptoms of a focal inflammatory condition of medium-sized and large arteries which includes diplopia. Which condition does the client have?

Giant cell temporal arteritis Explanation: Giant cell temporal arteritis is a focal inflammatory condition of medium-sized and large arteries. Symptoms include blurred vision or diplopia.

The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which lipoprotein is the main carrier of cholesterol?

LDL Explanation: LDL is the main carrier of cholesterol. HDL is 50 percent protein; VLDL carries a large amount of triglycerides.

The nurse knows that peripheral vascular resistance is an important factor in blood pressure regulation. Which statements regarding peripheral vascular resistance are correct? Select all that apply.

Mean arterial pressure is determined by cardiac output and peripheral vascular resistance. Peripheral resistance is influenced by blood viscosity. Blood pressure can be maintained despite changes in cardiac output and resistance. Peripheral resistance is influenced by arteriolar constriction.

A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which intervention?

Sclerotherapy or surgery Explanation: Sclerotherapy, which often is used in the treatment of small residual varicosities, involves the injection of a sclerosing agent into the collapsed superficial veins to produce fibrosis of the vessel lumen.

Which one of the following organs are the two primary sites of lipoprotein synthesis?

Small intestine and liver

A 28-year-old client who is a heavy smoker tells the practitioner that he has been experiencing pain in his feet and lower legs for several months. The practitioner notes that pulses in the feet are diminished and believes the client may have:

Thromboangiitis obliterans Explanation: Thromboangiitis obliterans, or Buerger disease, is an inflammatory arterial disorder that affects medium-sized arteries, usually the plantar and digital vessels in the foot and lower leg. Usually the disease is seen in people less than 35 years of age who are heavy smokers. Pain is the predominant symptom and peripheral pulses are diminished or absent.

The nurse is providing education for a client diagnosed with essential hypertension. The nurse will state that the cause of this disorder is:

Unknown Explanation: Essential or primary hypertension has no identifiable cause, although there are many risk factors. The other options are causes of secondary hypertension, for which a cause can be identified and often treated.