Prep U: CH 26 (Porth), CH 30 & 31 (Hinkle) -Perfusion Module

When advising a morbidly obese client about the benefits of weight reduction, which statement would be most accurate to share

"A 10-pound loss of weight can produce a decrease in blood pressure."

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." What is the best response by the nurse?

"Hypertension often causes no symptoms."

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?

"I chose broiled chicken with a baked potato for dinner."

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

Which is a characteristic of arterial insufficiency?

Diminished or absent pulses

A nurse is reviewing self-care measures for a client with peripheral vascular disease. Which statement indicates proper self-care measures?

"I have my wife look at the soles of my feet each day."

A community health nurse teaches a group of older adults about modifiable risk factors that contribute to the development of peripheral arterial disease (PAD). The nurse knows that the teaching was effective based on which statement?

"I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet."

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

An older adult client visits the clinic for a blood pressure check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about blood pressure medicine?

A possible adverse effect of blood pressure medicine is dizziness when you stand.

Which condition contributes to secondary hypertension?

Arterial vasoconstriction

A patient with a diagnosis of deep vein thrombosis (DVT) is being treated with unfractionated heparin, which is being administered intravenously. The nurse who is providing care for this patient should consequently prioritize what assessments?

Assessing the patient for internal or external hemorrhage

The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?

Avoid situations that contribute to ischemic episodes.

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?

Black and South Asian people

The nurse assessing a client who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which characteristic?

Diminished or absent pulses

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.

Which intervention by the client will decrease overall cardiovascular risk?

Higher levels of fitness and exercise

A blood pressure (BP) of 140/90 mm Hg is considered to be:

Hypertension

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:

Hypertension

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

Sit on the edge of the chair and rise slowly.

Which lipoprotein is the main carrier of cholesterol?

Low-density lipoprotein (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.

A client is diagnosed with peripheral arterial disease. Review of the client's chart shows an ankle-brachial index (ABI) on the right of 0.45. This indicates that the right foot has which of the following?

Moderate to severe arterial insufficiency

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse?

Numbness and weakness in the left arm

A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment?

Numbness, cool skin temperature, and pallor

A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities?

Participate in a regular walking program.

A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours?

Peripheral pulses every 15 minutes after surgery

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?

Potassium level

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 client with systemic lupus erythematosus (SLE) complains that his hands become pale, blue, and painful when exposed to the cold. What disease should the nurse cite as an explanation for these signs and symptoms?

Raynaud's disease

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?

Secondary

Which term describes high blood pressure from an identified cause, such as renal disease?

Secondary hypertension

Which medication will likely be prescribed for a client with elevated LDL and triglyceride levels?

Simvastatin, an HMG-CoA reductase inhibitor or 'statin'

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help?

Stress reduction to lower prehypertensive state

The postoperative client has a catheter in his brachial artery for continuous blood pressure monitoring. Which assessment would be a concern for the nurse?

The client states his hand is numb.

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension?

The incidence and prevalence of hypertension increase with age.

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?

Ulcers and infection in the edematous area

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect?

Venous insufficiency

A client arrives at the ED complaining of numbness in left lower leg. Upon assessment, the nurse finds the lower left leg to be cold to touch, pedal and posterior tibial pulses non-palpable, and a sharp line of paralysis/paresthesia. The nurse's next action is based on the fact that:

acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by:

forcing blood into the deep venous system.

The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if:

systolic BP is between 120 and 139 mm Hg.