porth chapter 18

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall. Chemoreceptors Cardiovascular centers Baroreceptors Neural pathways

Baroreceptors

Autonomic nervous system control of blood pressure is mediated through which physiologic process? Select all that apply. Baroreceptors in blood vessels Hepatic secretions Carotid artery chemoreceptors Pain and strong emotion Aortic chemoreceptors

Baroreceptors in blood vessels Carotid artery chemoreceptors Pain and strong emotion Aortic chemoreceptors

A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups? Aboriginal and South Asian people Native American/First Nation and white people Black and South Asian people East Asian and black people

Black and South Asian people

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 Decrease heart rate Decrease renin release Increase vasoconstriction

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 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? Papilledema and lethargy Headache and confusion Restlessness and nervousness Stupor and hyperreflexia

Headache and confusion Cerebral vasoconstriction probably is an exaggerated homeostatic response designed to protect the brain from excesses of blood pressure and flow. The regulatory mechanisms often are insufficient to protect the capillaries, and cerebral edema frequently develops. As it advances, papilledema (i.e., swelling of the optic nerve at its point of entrance into the eye) ensues, giving evidence of the effects of pressure on the optic nerve and retinal vessels. The client may have headache, restlessness, confusion, stupor, motor and sensory deficits, and visual disturbances. In severe cases, convulsions and coma follow. Lethargy, nervousness, and hyperreflexia are not signs or symptoms of cerebral edema in malignant hypertension.

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 HDL VLDL IDL

LDL LDL is the main carrier of cholesterol. HDL is 50 percent protein; VLDL carries a large amount of triglycerides. IDLs are fragments of VLDLs after the triglycerides are removed and can be recycled to form VLDLs or converted to LDLs.

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 temperature and show him how much higher it is when he is smoking. Measure his blood pressure and show him how much higher it is when he is smoking. Measure his pulse and show him how much lower it is when he is smoking. Have him listen to his heart for the obvious murmur that presents when smoking.

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

A nursing instructor is explaining the role of vascular smooth muscle cells in relation to increases in systemic circulation. During discussion, which neurotransmitter is primarily responsible for contraction of the entire muscle cell layer, thus resulting in decreased vessel lumen radius? Nitric Oxide Adrenal glands Fibroblast growth factor Norepinephrine

Norepinephrine Nerve cells and circulating hormones are responsible for vasoconstriction of the vessel walls. Because they do not enter the tunica media of the blood vessel, the nerves do not synapse directly on the smooth muscle cells. Instead, they release the neurotransmitter norepinephrine, which diffuses into the media and acts on the nearby smooth muscle cells; this results in contraction of the entire muscle cell layer and thus reduces the radius of the vessel lumen. This increases the systemic circulation.

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? Deep vein thrombosis Raynaud disease Atherosclerotic occlusive disease Frostbite related to hypothermia

Raynaud disease

An older adult client has been diagnosed with orthostatic hypotension. When planning the client's subsequent care, the nurse should prioritize which diagnosis? Risk for falls Impaired physical mobility Risk for trauma Impaired walking

Risk for falls

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 Tonic-clonic seizures Chest pain radiating to the right arm Late hypertensive crisis

Tearing or ripping-type pain in the chest or back

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 ate a hamburger 45 minutes prior to the reading. The client took her antihypertensive medication 2 hours ago. The client just smoked a cigarette. The client left work 1 hour ago.

The client just smoked a cigarette.

The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system? a Hormonal activity Humoral influence The kidneys Neural mechanisms

The kidneys The kidneys exert long-term control of blood pressure by modulating sodium content and extracellular fluid volume. An increase in extracellular fluid will yield an increase in blood volume and an increase in cardiac output. If this results in too great an increase in blood pressure, the kidneys will excrete sodium and water. Neural (autonomic nervous system) and humoral mechanisms (renin-angiotensin-aldosterone system and vasopressin) exert short-term control of blood pressure. Hormonal influence involves release of epinephrine (which works through the sympathetic nervous system) from the adrenal glands.

The nurse knows that systolic hypertension carries risk for which cardiovascular events? Select all that apply. Thrombosis Right ventricular hypertrophy Damage to elastic elements of blood vessel walls Atherosclerosis Risk for aneurysm

Thrombosis Damage to elastic elements of blood vessel walls Atherosclerosis Risk for aneurysm

A client is pregnant for the first time and is considered to be at high risk for preeclampsia. The care team should prioritize which intervention? Vigilant blood pressure monitoring Oral administration of beta-adrenergic blockers Restriction of dietary sodium Cautious use of over-the-counter diuretics

Vigilant blood pressure monitoring

A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is: History of myocardial infarction Elevated HDL cholesterol Heart failure Hypertension

hypertension

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: dependent edema and decreased cognition. ischemic stroke and ischemic heart disease. organ damage and hypovolemic shock. orthostatic hypotension and cerebral aneurysm.

organ damage and hypovolemic shock. The mean arterial pressure, which represents the average blood pressure in the systemic circulation, is a good indicator of tissue perfusion. The fact that this client's MAP is falling at a time when it should be at its daily peak is cause for grave concern; blood volume is likely low, and vital organs, which depend on adequate perfusion, are at risk. Low blood pressure does not normally result in aneurysms, edema, or ischemic stroke.

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? normal blood pressure stage 1 hypertension elevated stage 2 hypertension

stage 1 hypertension