Med Surg Chapter Thirty Six

c

A client is prescribed enalapril for control of hypertension. Which health teaching will the nurse provide before the client begins therapy? A. you may develop a higher pulse rate B. you may notice some swelling in your feet C. you may develop a nagging cough D. your diet should include foods high in sodium

1

A client with a diagnosis of varicose veins is scheduled for treatment by sclerotherapy and asks the nurse to describe the procedure. Which response should the nurse make? 1. "It involves tying off the veins so that circulation is redirected in another area." 2. "It involves surgically removing the varicosity, so anesthesia will be required." 3. "It involves tying off the veins to prevent sluggishness of blood from occurring." 4. "It involves injecting an agent into the vein to damage the vein wall and close it off."

a

A client with atherosclerosis has been prescribed lovastatin. Which statement by the client indicates a need for further teaching? A. I won't need to change my diet because now I'm taking a pill B. I'll follow up with my nurse practitioner on a regular basis C. I need to quit smoking as soon as I possibly can D. I shouldn't drink grapefruit juice while on this drug

3

A home care nurse is visiting a client to provide follow-up evaluation and care of a leg ulcer. On removing the dressing from the leg ulcer, the nurse notes that the ulcer is pale and deep and that the surrounding tissue is cool to the touch. The nurse should document that these findings identify which type of ulcer? 1. A stage 1 ulcer 2. A vascular ulcer 3. An arterial ulcer 4. A venous stasis ulcer

3

A hospitalized client has been diagnosed with heart failure as a complication of hypertension. In explaining the disease process to the client, the nurse identifies which chamber of the heart as primarily responsible for the symptoms? 1. Left atrium 2. Right atrium 3. Left ventricle 4. Right ventricle

d

A patient with cardiovascular disease is prescribed a potassium-wasting diuretic. The nurse will recommend that the patient consume which food to help prevent hypokalemia? A. Dried figs B. Red apples C. Raw avocados D. Baked potatoes

hypertensive crisis

A severe elevation in blood pressure greater than 180/120 which can cause organ damage in the kidneys or heart

intermittent claudication

A term derived from a word meaning "to limp"; classic leg pain

arteriosclerosis

A thickening, or hardening, of the arterial wall that is often associated with aging

bruit

A turbulent, swishing sound, which can be soft or loud in pitch; heard as a result of blood trying to pass through a narrowed artery

atherosclerosis

A type of arteriosclerosis that involves the formation of plaque within the arterial wall and is the leading risk factor for cardiovascular disease

venous

Arterial Ulcer or Venous Ulcer? Brown pigmentation, pink ulcer bed, superficial with uneven beds, and granulation tissue present

venous

Arterial Ulcer or Venous Ulcer? Chronic non healing ulcer, no claudication, moderate ulcer discomfort, and ankle and leg swelling

arterial

Arterial Ulcer or Venous Ulcer? Cool or cold feet, decreased or absent pulses, atrophy of skin, hair loss, pallor with elevation, dependent rubor, possible gangrene, and neurologic deficits noticed

arterial

Arterial Ulcer or Venous Ulcer? Location end of the toes, between the toes, deep, pale ulcer bed with even edges, and little granulation tissue

venous

Arterial Ulcer or Venous Ulcer? ankle discoloration and edema, full veins when slightly dependent, no neurologic deficits, pulses present, and scarring may be present from previous ulcers

arterial

Arterial Ulcer or Venous Ulcer? claudication after walking 1-2 blocks, rest pain usually present, pain at ulcer site

venous

Arterial Ulcer or Venous Ulcer? long term wound care (Unna boot, damp to dry dressings), elevate extremity, patient education, and preventing infection

arterial

Arterial Ulcer or Venous Ulcer? treatment involves treating underlying cause, preventing trauma and infection, and patient education(stressing foot care)

varicose veins

Distended, protruding veins that appear darkened and tortuous frequently seen in patients with systemic problems, obesity, high estrogen states, and a family history

b, c, e

In 2013, the ACA/AHA developed guidelines to reduce cardiovascular risk and decrease blood pressure. Which interventions relate to these guidelines? (Select all that apply.) A. Use only sugar in beverages. B. Engage in aerobic exercise 3 to 4 times per week. C. Develop a dietary plan that includes fish, legumes, and nuts. D. Include at least 3000 mg of sodium per day in the dietary plan. E. Encourage a dietary pattern of vegetables, fruits, and whole grains.

peripheral vascular disease

Includes disorders that change the natural flow of blood through the arteries and veins of the peripheral circulation, causing decreased perfusion to body tissues

outflow disease

Patients with ______ describe burning or cramping in the calves, ankles, feet, and toes

inflow disease

Patients with _______ have discomfort in the lower back, buttocks, or thighs

collateral circulation

Provides blood to the affected area through smaller vessels that develop and compensate or the occluded vessels

stasis dermatitis

Reddish brow discoloration along the ankles, extending up the calf resulting from venous insufficiency

telangiectasis

Spider veins; dilated intradermal veins less than 1 to 3 mm in diameter that are visible on the skin surface

4

The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home care management and self-care management. Which statement, if made by the client, indicates a need for further instruction? 1. "I need to be sure not to go barefoot around the house." 2. "If I cut my toenails, I need to be sure that I cut them straight across." 3. "It is all right to apply lanolin to my feet, but I shouldn't place it between my toes." 4. "I need to be sure that I elevate my leg above my heart level for at least an hour every day."

1

The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly interpret the client's neurovascular status? 1. The neurovascular status is normal because of increased blood flow through the leg. 2. The neurovascular status is moderately impaired, and the surgeon should be called. 3. The neurovascular status is slightly deteriorating and should be monitored for another hour. 4. The neurovascular status is adequate from an arterial approach, but venous complications are arising.

a

The nurse is caring for a client with chronic venous stasis ulcers. Which statement by the client indicates a need for further health teaching? A. I'll wear compression stockings at night B. I'll keep my affected leg above my heart C. I'll eat protein and vitamin C foods to help heal the ulcer D. I'll change my dressing every 3 to 5 days as needed

b

The nurse is caring for a client with lower extremity peripheral arterial disease. Which statement made by the client regarding self-management requires further health teaching? A. I need to quit smoking as soon as I can B. I will elevate my legs above the level of my heart C. I will use a heating pad to promote circulation D. I will avoid crossing my legs at all times

2

The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse should plan to provide which instruction to the client? 1. Use nail polish to protect the nail beds from injury. 2. Stop smoking because it causes cutaneous vasospasm. 3. Wear gloves for all activities involving use of both hands. 4. Always wear warm clothing even in warm climates to prevent vasoconstriction.

d

The nurse is providing care to a client who has started warfarin after being diagnosed with a deep vein thrombosis. What health teaching will the nurse provide to the client related to self-management of warfarin therapy? A. You must have your partial thromboplastin time checked every 2 weeks B. massage the injection site after the warfarin is inject C. Eat plenty of dark green leafy vegetables while taking warfarin D. report any signs of bleeding to your primary care provider

heparin-induced thrombocytopenia

The provider discontinues heparin administration if every ________ (platelet count <150,000 or "white clot syndrome") occurs

arterial revascularization

The surgical procedure used to increase arterial blood flow in a affected limb

d

What is the most common symptom associated with hypertension? A. Headache B. Slurred speech C. Fainting and dizziness D. Hypertension is often asymptomatic