PrepU Patho Ch 18

The nurse knows that systolic hypertension is characterized by systolic pressure of ____mm Hg or higher.

140 Systolic hypertension is a consistent systolic pressure of 140 mm Hg or higher with near normal diastolic pressure.

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below:

140/90 The main objective of hypertension management is to achieve a pressure of 140/90, although persons with renal disease or diabetes are advised to aim for 130/80 or lower. Persons with blood pressure between 140/90 and 120/80 are considered to be prehypertensive and should be monitored at regular intervals to detect any rise in pressure.

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be:

Apply sequential pneumatic compression devices to lower extremities The application of sequential pneumatic compression devices augments blood flow and reduces stasis. Early ambulation is encouraged. Ice applications would not be recommended due to venous constriction.

Which individual is at greatest risk for developing a venous thrombosis resulting from venous stasis?

Client on bed rest

A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have on the body to consequently decrease blood pressure?

Decrease vascular volume Diuretics, such as the thiazides, loop diuretics, and the aldosterone antagonist (potassium-sparing) diuretics, lower blood pressure initially by decreasing vascular volume (by suppressing renal reabsorption of sodium and increasing salt and water excretion) and cardiac output.

A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring?

HDL HDL is known as the "good" cholesterol because it transports cholesterol back to the liver for metabolism. LDL, VLDL, and IDL transport cholesterol to the tissues.

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:

Hypertension The major risk factors that can be modified by a change in health care behaviors include cigarette smoking, obesity, hypertension, hyperlipidemia and elevated LDL cholesterol, and diabetes mellitus, all of which are traditional cardiovascular risk factors. The other options are nonmodifiable risk factors for atherosclerosis.

When will the nurse plan to assess a client's blood pressure to confirm the possible diagnosis of orthostatic hypotension?

In the morning before arising from bed To confirm orthostatic hypotension, blood pressure should be assessed while the client is supine and then after standing for 1 minute and 3 minutes. A fall of 20 mm Hg or more in systolic pressure, or 10 mm Hg or more in diastolic pressure, are considered orthostasis.

The nurse practitioner's examination of a client reveals xanthomas along the client's tendons. Which test will the practitioner order?

LDL level Xanthomas along the tendons are seen in clients with elevated LDL levels, not HDL levels. CRP is a serum marker for systemic inflammation. Homocysteine is derived from the metabolism of dietary methionine and is associated with endothelial damage.

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

Tearing or ripping-type pain in the chest or back A major symptom of a dissecting aneurysm is the abrupt presence of excruciating pain, described as tearing or ripping. Pain associated with dissection of the ascending aorta frequently is located in the anterior chest, and pain associated with dissection of the descending aorta often is located in the back. In the early stages, blood pressure typically is moderately or markedly elevated.