Chapter 26: Disorders of Blood Flow and Blood Pressure Regulation

A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head?

Temporal

The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?

The client just smoked a cigarette.

A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his physician. The client's physician would anticipate that which phenomenon is most likely occurring?

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Will prevent the conversion of angiotensin I to angiotensin II

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

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."

According to the latest guidelines by the American Heart Association, which blood pressure reading would be classified as stage 1 hypertension?

137/85 mm Hg

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

140

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

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

When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate?

Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.

A client reports recent weight loss, fever, fatigue, paresthesia/pain, and weakness of the lower extremities. Assessment findings reveal reddish-blue, mottled areas of discoloration on the lower extremities. Which laboratory/diagnostic test will the health care provider prescribe for this client to correlate vasculitis with disease activity?

Antineutrophil cytoplasmic antibodies (ANCAs)

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 nurse recognizes that there are many factors that influence blood flow within the systemic circulation. In the circulatory system, which of the following are called resistance vessels?

Arterioles

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as:

Berry aneurysm

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

A client who is taking a diuretic asks the nurse to explain how a drug that makes her urinate more frequently can help her hypertension. The nurse will explain that diuretics exert their antihypertensive action in which ways? Select all that apply.

By decreasing vascular volume through the process of increasing sodium and water excretion By reducing peripheral vascular resistance

A client is receiving home care for the treatment of a wound on the inside of the lower leg described as 3 cm in diameter with a yellow wound bed draining clear exudate. Assessment of the client's legs reveals edema and a irregularly darkened pigmentation on the ankles and shins of both legs. How would the home care nurse document these findings?

Chronic venous insufficiency

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply.

Consume a diet rich in fruits, vegetables, and low-fat dairy products. Reduce dietary sodium intake. Stop smoking. Limit alcohol consumption.

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

An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?

Decreased aorta and large artery elasticity

A client is immobilized following a hip injury. The client has developed lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings?

Deep vein thrombosis

A client has a narrowed pulse pressure with a BP of 89/68. The nurse knows that which major factors influence pulse pressure? Select all that apply.

Distensibility of the arteries Stroke volume

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the the knowledge is understood when the client correctly matches which drug category to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion?

Diuretics

The nurse knows that which group of antihypertensive drugs is usually the least expensive and are well tolerated?

Diuretics

The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia?

Elevated total cholesterol

A client has been diagnosed with diabetes mellitus. Which lab result would the practitioner expect?

Elevation of triglycerides

An older adult client's blood pressure (BP) is 120/80 mm Hg when in a lying position. When the nurse retakes the client's BP in a sitting position, the BP is 92/60 mm Hg. Which intervention is appropriate for the nurse to implement?

Encouraging the client to maintain hydration throughout the day

Raynaud disease or phenonemon is a functional disorder caused by intense vasospasm of the arteries and arterioles in the:

Fingers

The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?

Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

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

Which intervention by the client will decrease overall cardiovascular risk?

Higher levels of fitness and exercise

The nurse recognizes that insulin resistance and compensatory hyperinsulinemia may be related to development of which of the following? Select all that apply.

Hypertension Type 2 diabetes Hyperlipidemia Glucose intolerance

An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug?

Hypotension

The renin-angiotensin-aldosterone system is a negative feedback system that plays a central role in blood pressure regulation. How does the end result of this feedback loop regulate blood pressure in the body?

Increases salt and water retention by the kidney

The student attends a health fair and has his serum cholestrol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol?

It is believed to play an active role in the pathogenesis of the atherosclerotic lesion.

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

The nurse's brother is not convinced that he should quit smoking. He asks his sister (the nurse) to demonstrate for him the more immediate effects of smoking on his health. Which of the following could be used to help convince the brother to stop smoking?

Measure his blood pressure and show him how much higher it is when he is smoking.

The nurse is preparing to determine the blood pressure in an older adult. Which steps in the procedure should be utilized? Select all that apply.

Measurements are taken on several different occasions. Measurements are taken in supine and standing positions. Preliminary determination is made by palpation.

A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.

Obesity High salt consumption Inactive lifestyle

At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit indicates that the client's mean arterial pressure is at the low end of the normal range; at 6 AM, the client's MAP has fallen definitively below normal. The client is at risk for:

Organ damage and hypovolemic shock

A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit?

Periodic severe headache and marked variability in blood pressure

The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control?

Promotes retention of water

The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent:

Pulmonary embolism

A nurse is evaluating hypertension risk factors with a black male who is a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. His paternal grandfather had a stroke. The lawyer drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 lb (6.8 kg) in the past year. Which risk factors or hypertension are nonmodifiable? Select all that apply.

Race Family history

A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?

Raynaud disease

A female client tells the health care provider that she has recently been experiencing episodes of changes occuring in the color of her fingertips, especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing:

Raynaud phenomenon

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for hypertension. The nurse knows that ACE inhibitors are contraindicated by which clinical condition?

Renal artery stenosis

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

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply.

Smoking cessation Dietary measures to reduce LDL levels Weight reduction if overweight

Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include:

Stasis of blood, hypercoagulability, vessel wall injury

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

Unknown

At 4 AM the hemodynamic monitoring for a critically ill client in the intensive care unit indicates that the client's mean arterial pressure (MAP) is at the low end of the normal range; at 5 AM the client's MAP has fallen definitively below normal. The nurses should prioritize assessments for:

organ damage and hypovolemic shock.

A client's blood pressure is persistently in the range of 130 to 135 mm Hg systolic and 85 to 88 mm Hg diastolic. The nurse knows that the client's blood pressure would be classified as ________ according to American Heart Association guidelines?

stage 1 hypertension

A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which has lead to a diagnosis of deep vein thrombosis (DVT). What treatment option will be of greatest benefit to prevent further thrombus formation?

Anticoagulation therapy and elevation of the leg

Which lipoprotein is the main carrier of cholesterol?

Low-density lipoprotein (LDL)

The nurse knows that which food is excluded from the Dietary Approaches to Stop Hypertension (DASH) diet?

Steak

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 client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?

Headache and confusion