nearpod questions patho exam 2

clinical manifestations of dvt explanation

Although DVT can be silent, clinical manifestations characteristic of a lower-extremity DVT include unilateral edema, calf pain or tenderness to touch, warmth and erythema, and low-grade temperature.

The nurse is caring for a client who has been admitted to the hospital for an acute exacerbation of heart failure. Blood pressure is 104/62 mm Hg, pulse is 96/min, respirations are 22/min, and oxygen saturation is 91%. Which of these findings supports the diagnosis of heart failure?

A. *B-type natriuretic peptide (BNP) 1382 pg/mL (1382 pmol/L)* B. Flat jugular veins when seated at a 45-degree angle C. Sodium 150 mEq/L (150 mmol/L) D. Urine output greater than 100 mL/hr

An elderly client tells the nurse "I have experienced leg pain for several weeks when I walk to the mailbox each afternoon, but it goes away once I stop walking." What is most likely happening with this client?

A. *Intermittent claudication* B. Lymphedema C. Venous Thrombosis D. Atherosclerosis

A client is diagnosed with Buerger's disease (thromboangiitis obliterans). The nurse anticipates teaching the client about which treatment option?

A. Avoidance of warm temperatures B. Initiation of statin C. Initiation of warfarin D. *Smoking cessation*

A client is diagnosed with lower-extremity deep venous thrombosis (DVT) after a cross-country road trip. Which clinical manifestations most characteristic of a DVT does the nurse expect to assess? Select all that apply.

A. Blue, cyanotic toes B. *Calf pain* C. Dry, shiny, hairless skin D. *Edema* E. *Warmth and erythema*

When the nurse is obtaining the health history for a client with mitral valve stenosis, which question will be most relevant to ask?

A. Do you frequently get urinary tract infections? B. Have you had a recent episode of pneumonia? C. *Did you ever have strep throat during childhood?* D. Do you have a family history of heart attack or angina?

The nurse reviews laboratory data for a client admitted to the emergency department with chest pain. Which serum value requires the most immediate action by the nurse?

A. Glucose 200 mg/dL (11.1 mmol/L) B. Hematocrit 38% (0.38) C. Potassium 3.4 mEq/L (3.4 mmol/L) D. *Troponin 0.7 ng/mL (0.7 mcg/L)*

A client with pericarditis is admitted to the cardiac unit. What assessment finding does the nurse expect in this client?

A. Heart rate that speeds up and slows down B. *Friction rub at the left lower sternal border* C. Presence of a regularly gallop rhythm D. Coarse crackles in bilateral lung bases

Which value may be protective in the development of atherosclerosis?

A. High total cholesterol B. High total triglycerides C. *High levels of LDL* D. Low levels of HDL

A patient reports with shortness of breath and is diagnosed with a pericardial effusion. The nurse knows that what serious complication can manifest if not treated?

A. Hypovolemia B. Myocardial infarct C. *Cardiac tamponade* D. Cor pulmonale

Hypertension with a specific identifiable cause is known as ____________?

A. Primary B. *Secondary* C. Tertiary D. Malignant

Which assessment finding will the nurse expect when caring for a client with right ventricular failure?

A. Pulmonary congestion B. *Lower leg edema* C. Paroxysmal nocturnal dyspnea D. Crackles in the lungs

aortic stenosis results in the incomplete emptying of the:

A. Right atrium B. *Left ventricle* C. Left atrium D. Right ventricle

reasoning for initial s/s of MI

Diaphoresis, nausea and vomiting, fever, pain radiating to neck and shoulders and hypertension Decreased heart rate is not seen initially- the heart rate and blood pressure are elevated, in an attempt to compensate for what is happening. Then the blood pressure will drop, secondary to a drop in the cardiac output.

BNP explanation

Remember what the hallmark diagnostic marker is for heart failure- BNP! BNP is secreted in response to ventricular stretch and wall tension when cardiac filling pressures are elevated. The BNP level is used to differentiate dyspnea of heart failure from dyspnea of noncardiac etiology. The level of circulating BNP correlates with both severity of left ventricular filling pressure elevation and mortality. A normal BNP level is <100 pg/mL [<100 pmol/L]. The nurse would expect a high BNP in a client exhibiting symptoms of heart failure.

explanation of secondary hypertension

Secondary hypertension has a specific identifiable cause such as a specific pathology or condition that results in hypertension. Primary hypertension does not have a clearly identifiable etiology and is therefore an idiopathic disorder. Positional changes do not generally result in hypertension. Malignant hypertension is a hypertensive crisis.

sounds heart with pericarditis explanation

The client with pericarditis may present with a pericardial friction rub at the left lower sternal border. This sound is the result of friction from inflamed pericardial layers when they rub together. The other assessments are not related.

cardiac tamponade explanation

When a pericardial effusion is not treated, the pressure that is put on the heart from the buildup of fluid is known as a cardiac tamponade.

Which of the following are considered initial signs and symptoms of an MI? Select All That Apply

A. *Diaphoresis* B. *Nausea and Vomiting* C. *Fever* D. *Pain radiating to the neck and shoulders* E. Decrease heart rate F. *Hypertension*

After having an MI, the nurse notes the patient has jugular venous distention, gained weight, developed peripheral edema, and has a heart rate of 108/minute. What should the nurse suspect is happening?

A. Acute decompensated heart failure (ADHF) B. Chronic heart failure C. Left-sided heart failure D. *Right-sided heart failure*

When caring for a client who presents to the emergency department with an ST-segment-elevation myocardial infarction (STEMI), which laboratory result will the nurse expect?

A. Decreased white blood cell count B. Elevated serum troponins I and T C. Decreased creatinine kinase-MB (CK-MB) D. Decreased B-type natriuretic peptide (BNP)

Buerger's Disease Explanation

Buerger's Disease produces varying degrees of inflammation and obstruction in the arteries and veins. Smoking cessation is essential to effective treatment. If patients do not abstain from smoking, the disease is progressive, and amputation may be necessary.

elevated laboratory results with a STEMI explanation

Elevations of troponin I and T levels are indicative and specific for cardiac muscle damage as would occur with a STEMI. White blood cell count would increase in the first days after an MI because of the inflammatory response associated with myocardial death. CK-MB is found in cardiac muscle and levels increase with myocardial cell death. BNP levels are not directly reflective of MI, but might increase if the client develops heart failure as a complication of myocardial infarction.

intermittent claudication explanation

Intermittent claudication is pain with activity in the affected limb that improves with rest. This is due to peripheral artery disease, which impairs circulation to the extremities. Poor circulation can place the cliet at increase risk for the development of arterial ulcers and infection.

right sided heart failure

Keep in mind the symptoms associated with the types of heart failure. Jugular venous distention, weight gain, peripheral edema, and increased heart rate are manifestations of right-sided heart failure. Issues around pulmonary congestion, fluid backing up into the lungs, paroxysmal nocturnal dyspnea- those are all left-sided symptoms. Remember L for LUNG and LEFT

HDL explanation

Recall that HDL is the good cholesterol. HDL functions to bring LDL to the liver to be processed. The more HDL there is in the body, the more LDL that it can remove. Increased LDL is a risk factor for atherosclerosis. It is active in the formation of foam cells, which contribute to the plaque formation characteristic of atherosclorosis. Cholesterol and triglycerides should be low to be protective

Right sided heart failure explanation

Right-sided heart failure causes increased pressure in the systemic venous system, which leads to a fluid shift in the interstitial spaces. Because of gravity, the edema is seen in the lower extremities. Crackles, paroxysmal nocturnal dyspnea and pulmonary congestion are seen in left-sided heart failure because of increased pressure in the pulmonary capillaries and movement of fluid into the alveoli.

explanation for troponin levels

Serum cardiac markers are proteins released into the bloodstream from necrotic heart tissue after a myocardial infarction (MI). Troponin is a highly specific cardiac marker for the detection of MI. A troponin value of 0.7 ng/mL (0.7 mcg/L) indicates cardiac muscle damage and should be the priority and immediate focus of the nurse. Normal value is <0.5 ng/mL.

streptococcal infections role in cardiac explanation

Streptococcal infections occuring during childhood may result in damage to heart valves. Group A streptococcal antigens bind to receptors on heart cells, where an autoimmune response is triggered, damaging the heart. The nurse may obtain information about other infections, but urinary tract infection is not associated with risk for mitral valve stenosis. Mitral stenosis does not increase pneumonia risk and is not caused by recent pneumonia. The nurse may ask about family history of heart disease, but history of coronary artery disease or MI does not increase risk for valve disease.