Chapter 26: Disorders of Blood Flow and Blood Pressure Regulation
The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state:
it is the most common cardiovascular disorder The incidence increases with age the systolic pressure is greater than 140 mm Hg page 655
the nurse knows that which statements regarding sodium and hypertension are correct? Select all that apply
- Sodium may increase the responsiveness of the cardiovascular system to adrenergic (sympathetic stimulation) - reduction in sodium intake often produces a reduction in blood pressure - in the INTERSALT study, urinary sodium excretion and systolic blood pressure are closely correlated page 635
The nurse suspects a client has stage 2 systolic hypertension. What systolic pressure would confirm the nurse's suspicion?
140 mm Hg or Higher page 633
The nurse knows that which client is at GREATEST risk for malignant hypertension
A 25-year-old black man page 655
Which client is at greatest risk for orthostatic hypotension?
A 66-year-old postoperative client on bed rest page 659
In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities?
A client is helped out of bed and stands up page 659
A client with chronic renal failure secondary to diabetes has just been diagnosed with secondary hypertension. This increase in blood pressure is likely caused by which physiological factor?
Activation of the renin-angiotensin-aldosterone mechanism page 659
Which client would the nurse recognize as needing to be assessed for orthostatic hypotension?
An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom page 659
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 page 658
Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process?
Decreased elasticity in arterial connective tissue page 659
An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?
Decreased elasticity of the aorta and large arteries page 646
From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate?
Deep vein thrombophlebitis of the leg page 652
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 page 638
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 page 641
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 page 655
A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is:
Hypertension page 641
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The MOST appropriate information to provide would be:
Hypertension page 641
an older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an adult taking this class of drug?
Hypotension page 659
a client with hypercholesterolemia is being treated with diet and exercise. Which assessment finding is a positive outcome of this regimen?
Increased high-density lipoproteins page 639
A nurse is teaching a client with a newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?
Inhibits the conversion of angiotensin I to angiotensin II, decreasing levels and reducing its effect on vasoconstriction page 635
The nurse knows that which of the following would put a client at risk of developing hypertension, if everything else in the body remained unchanged? select all that apply.
Intravascular fluid retention elevated renin levels systemic vasoconstriction page 637
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 page 642
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?
Limit alcohol consumption consume a diet rich in fruits, vegetables, and low-fat dairy products, stop smoking Reduce dietary sodium intake page 655
Which lipoprotein is the main carries of cholesterol?
Low-density lipoprotein (LDL) page 638
At 4am, the hemodynamic monitor for a critically ill client in the ICU indicated that the client's mean arterial pressure is at the low end of the normal range; mat 6AM, the client's MAP has fallen definitely below normal. The client is at risk for:
Organ damage and hypovolemic shock page 633
What are characteristic signs of acute arterial embolism?
Pallor, pulselessness, and pain page 646
Person with hypertension secondary to hyperaldosteronism may be treated with which medication
Potassium-sparing diuretics page 656
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 page 653
The nurse knows that which food is excluded from the dietary approaches to stop hypertension (DASH) diet?
Steak page 640
The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system?
Sympathetic page 634
A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head
Temporal page 646
Which blood vessel layer is composed primarily of smooth muscle cells?
Tunica Media page 631
The nurse is providing education for a client diagnosed with essential hypertension. The nurse will state that the cause of this disorder is:
Unknown page 658
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 pulsation mass in the abdomen page 649
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.
inactive lifestyle high sale consumption obesity page 640
During a prenatal education class, an expectant mother tells the group about a friend whose blood pressure became so high during pregnancy that she has to be admitted to the hospital. Which statement should the nurse include in the response to this expectant mother?
Essentially, experts don't really know why so many pregnant women develop high blood pressure page 655
What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise?
Exercise can increase blood vessel growth and help to decrease symptoms. page 656
A nurse is evaluating hypertension risk factors with a client. Of the risk factors in the client's history notes, which risk factor(s) for hypertension is nonmodifiable? Select all that apply
race family history page 655
An adult's documented blood pressure (BP) readings over the past 2 years include: 140/82 mm Hg, 144/82 mm Hg, 150/82 mm Hg, and 162/82 mm Hg. Which interpretation(s) of these BP trend will the provider discuss with this client? Select all that apply.
-Client's systolic BP is hypertensive - Client has increased risk for future cardiovascular events. page 637
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 page 638
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 and or how should the nurse document these clinical findings?
Deep vein thrombosis page 652
The nurse practitioner's examination of a client reveals xanthomas along the client's tendons. Which test will the practitioner order?
LCL level page 640
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 page 647
which type of blood vessel cells in the tunica media layer produce vasocontraction and/or dilation of blood vessels?
Vascular smooth muscle cells (SMCs) page 631
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 page 641
The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement?
Apply sequential pneumatic compression devices to lower extremities. page 654
A client presents to the emergency department with a sudden onset of acute pain in his left lower leg. The practitioner is unable to palpate pedal pulses and finds the client to be in atrial fibrillation. Which test will the practitioner order to find the source of the emboli??
Echocardiogram page 649
A client has been diagnosed with diabetes mellitus. Which lab results would the practitioner expect?
Elevation of triglycerides page 638