PrepU Patho Ch. 18 Disorders of Blood Flow and Blood Pressure
The client has been diagnosed with impaired blood flow in the deep venous channels of her legs. The nurse explains that which of the following is the most common cause of this condition? a)Deep vein thrombosis (DVT) b)Pressure on the abdominal veins caused by pregnancy c)Arteriovenous (AV) fistulas d)Congenital venous malformations
a) Deep vein thrombosis (DVT) Secondary varicose veins result from impaired blood flow in the deep venous channels. The most common cause of secondary varicose veins is DVT. Other causes include congenital or acquired AV fistulas, congenital venous malformations, and pressure on the abdominal veins caused by pregnancy or tumors.
The role of inflammation in the etiology of atherosclerosis has emerged over the last few years. Which lab test is a marker for systemic inflammation? a)C-reactive protein b)Lipoprotein(a) c)Homocysteine d)Triglycerides
a)C-reactive protein
A nurse is planning a community education program on hypertension. Which of the following parameters should be included to explain the regulation of arterial blood pressure? a)Cardiac output and systemic vascular resistance b)Heart rate and peripheral resistance c)Blood volume and renal blood flow d)Myocardial contractility and arteriolar constriction
a)Cardiac output and systemic vascular resistance The mean arterial blood pressure is determined mainly by the cardiac output (stroke volume × heart rate) and the peripheral vascular resistance and can be expressed as the product of the two (mean arterial blood pressure = cardiac output × peripheral vascular resistance). The peripheral vascular resistance reflects changes in the radius of the arterioles as well as the viscosity or thickness of the blood.
A 70-year-old male client presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which of the following medical diagnosis/possible treatment plan listed below? a)Raynaud disease that will require antiplatelet medications b)Atherosclerotic occlusive disease necessitating thrombolytic therapy c)Giant cell temporal arteritis that will be treated with corticosteroids d)Acute arterial occlusion that will be treated with angioplasty
b)Atherosclerotic occlusive disease necessitating thrombolytic therapy
Which of the following is associated with stasis of blood, increased blood coagulability and vessel wall injury? a)Peripheral artery disease (PAD) b)Venous thrombosis c)Chronic venous insufficiency d)Varicose veins
b)Venous thrombosis
A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which of the following accounts for this lack of change in the diastolic pressure? a)Stroke volume increased with blood loss. b)Blood volume rapidly increased. c)Heart rate increased with blood loss. d)Systemic vasoconstriction maintained the diastolic pressure.
d)Systemic vasoconstriction maintained the diastolic pressure.
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. a)Being female b)Inactive lifestyle c)High salt consumption d)Obesity e)Poor performance in school
b)Inactive lifestyle c)High salt consumption d)Obesity The prevalence of hypertension in children and adolescents in increasing due to increases in obesity, and lifestyle factors such as lack of exercise and consumption of high-calorie, high-salt foods. Gender is not a factor nor is academic performance.
A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease? a)"I should have my LDL monitored." b)"I don't need to monitor my blood pressure." c)"Diabetes mellitus has no effect on my condition." d)"I should stay in bed with my legs elevated."
a)"I should have my LDL monitored." Intermittent claudication is the primary symptom of chronic obstructive arterial disease. The two goals of treatment are to decrease their considerable cardiovascular risk and to reduce symptoms. Walking (slowly) to the point of claudication is encouraged because it increases collateral circulation. Addressing blood pressure and high lipid levels are measures to reduce cardiovascular risk. People with diabetes mellitus (DM) develop more extensive and rapidly progressive vascular disease than do people who do not have DM.
A 52-year-old man who is moderately obese has recently been diagnosed with hypertension. Which of the client's statements indicates a need for further health-promotion teaching? Select all that apply a)"I will drink at least eight glasses of water every day." b)"I'm resolving to eat organic foods from now on." c)"I'm planning to lose 15 pounds before the end of this year." d)"I've starting going to the gym before work three times a week." e)"I'm trying to cut back on the amount of salt that I cook with and add to my food."
a)"I will drink at least eight glasses of water every day." b)"I'm resolving to eat organic foods from now on."
The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below which of the following? a)140/90 b)140/60 c)100/60 d)100/90
a)140/90 The main objective of hypertension management is to achieve a pressure of 140/90, although persons with renal disease or diabetes are advised to aim for 130/80 or lower. Persons with blood pressure between 140/90 and 120/80 are considered to be prehypertensive and should be monitored at regular intervals to detect any rise in pressure.
Which of the following patients is at greatest risk for orthostatic hypotension? a)A 66-year-old post-surgery patient on bed rest b)A 70-year-old female patient who has taken the same antihypertensive medication for 10 years c)A 42-year-old male patient with history of pulmonary embolism d)A 20-year-old pregnant patient at 36 weeks gestation
a)A 66-year-old post-surgery patient on bed rest Post-surgery patients who have been immobile are at greatest risk for developing othostatic hypotension. The 70-year-old female may also be at some risk: age is a risk factor, as is administration of some antihypertensive medications.
The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be: a)Apply sequential pneumatic compression devices to lower extremities b)Apply ice compresses to the site of the DVT hourly c)Ensure that the client remains on bed rest d)Massage legs to maintain blood flow
a)Apply sequential pneumatic compression devices to lower extremities The application of sequential pneumatic compression devices augments blood flow and reduces stasis. Early ambulation is encouraged. Ice applications would not be recommended due to venous constriction.
The nurse is reviewing a client's medications and lab results. The client has a high LDL level. Which medication can raise this level? a)Beta blockers b)Anticoagulants c)Glucocorticoids d)Antiplatelet agents
a)Beta blockers Medications such as beta blockers, estrogens and protease inhibitors can increase lipid levels.
In pregnancy, which of the following data are diagnostic for pre-eclampsia and eclampsia? a)Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy b)Blood pressure 140/90 mm Hg and glucose in the urine during the 36th week of pregnancy c)Blood pressure 130/88 mm Hg and hyperglycemia occurring during the 22nd week of pregnancy d)Blood pressure 90/60 mm Hg and proteinuria in the second trimester
a)Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy Pre-eclampsia and eclampsia are defined as an elevation in blood pressure (systolic >140 mm Hg or diastolic >90 mm Hg) and proteinuria (≥300 in 24 hours) developing after 20 weeks of gestation.
The nurse knows that peripheral vascular resistance is an important factor in blood pressure regulation. Which statements regarding peripheral vascular resistance are correct? Select all that apply. a)Blood pressure can be maintained despite changes in cardiac output and resistance. b)Peripheral resistance is influenced by arteriolar constriction. c)Mean arterial pressure is determined by cardiac output and peripheral vascular resistance. d)Peripheral resistance is influenced by blood viscosity. e)Changes in cardiac output or resistance rapidly result in major increase or decrease in blood pressure.
a)Blood pressure can be maintained despite changes in cardiac output and resistance. b)Peripheral resistance is influenced by arteriolar constriction. c)Mean arterial pressure is determined by cardiac output and peripheral vascular resistance. d)Peripheral resistance is influenced by blood viscosity. Mean arterial pressure is influenced by cardiac output and peripheral vascular resistance. That resistance is influenced by arteriolar radius and blood viscosity or resistance to flow. Cardiac output can adjust to changes in resistance, and resistance can adjust to changes in cardiac output to maintain blood pressure.
Select the statements that most accurately describe secondary hypertension. Select all that apply. a)Can be corrected or cured by surgery or specific medical treatment b)Obstructive sleep apnea is an independent risk factor for secondary hypertension c)An elevation in blood pressure due to an unknown cause d)Kidney disease is one of the most common causes e)Accounts for 5% to 10% of hypertension cases f)May be caused by oral contraceptives
a)Can be corrected or cured by surgery or specific medical treatment b)Obstructive sleep apnea is an independent risk factor for secondary hypertension d)Kidney disease is one of the most common causes e)Accounts for 5% to 10% of hypertension cases
The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply. a)It is the most common cardiovascular disorder. b)The incidence increases with age. c)It is often associated with individuals of normal weight. d)The diastolic pressure is equal to 80 mm Hg. e)The systolic pressure is greater than or equal to 140 mm Hg.
a)It is the most common cardiovascular disorder. b)The incidence increases with age. e)The systolic pressure is greater than or equal to 140 mm Hg.
The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which of the following lipoproteins is the main carrier of cholesterol? a)LDL b)HDL c)VLDL d)IDL
a)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 client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent which of the following? a)Pulmonary embolism b)Acute myocardial infarction c)Loss of pulses in the limb d)Cerebrovascular accident
a)Pulmonary embolism The most common site of a deep vein thrombosis (DVT) is in the venous sinuses in the soleus muscle and posterior tibial and peroneal veins. The risk of pulmonary embolism emphasizes the need for early detection and treatment of DVT. The other options are caused by occlusions in the arterial system.
A nurse is evaluating hypertension risk factors with an African American male who is a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. His paternal grandfather had a stroke. The lawyer drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 pounds in the past year. Which of the following are nonmodifiable risk factors associated with this diagnosis? Select all that apply. a)Race b)Excessive alcohol consumption c)Obesity d)Family history e)Stress
a)Race d)Family history
Which of the following is the site of chylomicron synthesis? a)Small intestine b)Large intestine c)Stomach d)Pancreas
a)Small intestine There are two sites of lipoprotein sythesis - the small intestine and the liver. The chylomicrons are synthesized in the wall of the small intestine.
A nurse is planning a community education program on lifestyle modification to manage hypertension. Which of the following topics should be included in the teaching plan? Select all that apply. a)Stop smoking. b)Avoid aerobic physical activity. c)Limit alcohol consumption. d)Consume a diet rich in fruits, vegetables, and low-fat dairy products. e)Reduce dietary sodium intake.
a)Stop smoking c)Limit alcohol consumption. d)Consume a diet rich in fruits, vegetables, and low-fat dairy products. e)Reduce dietary sodium intake.
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? a)Stupor and hyperreflexia b)Papilledema and lethargy c)Restlessness and nervousness d)Headache and confusion
d)Headache and confusion
When trying to educate a patient about the release of free radicals and the role they play in formation of atherosclerosis, which of the following statements is most accurate? a)Activated cells roam the vascular system looking for inflammatory cells to engulf. b)Activated cells that release free radical oxidize LDL which is harmful to the lining of your blood vessels. c)Oxidized free radicals product toxic metabolic waste that can kill liver cells. d)The end result of oxidation is rupture of the plaque resulting in hemorrhage.
b)Activated cells that release free radical oxidize LDL which is harmful to the lining of your blood vessels.
The nurse practitioner working in an overnight sleep lab assessing and diagnosing patients with sleep apnea. During this diagnostic procedure, the nurse notes that a patient's blood pressure is 162/97. The nurse explains this connection to the patient based on which of the following pathophysiological principles? a)When airways are obstructed, the body will retain extracellular fluid so that this fluid can be shifted to intravascular space to increase volume. b)During apneic periods the patient experiences hypoxemia which stimulates chemoreceptors to induce vasoconstriction. c)When the patient starts to snore, their epiglottis is closed over the trachea. d)Specialized cells are located in the back of the throat what signals when the airway is obstructed which sends signals to the kidney to increase pulse rate.
b)During apneic periods the patient experiences hypoxemia which stimulates chemoreceptors to induce vasoconstriction.
Raynaud disease or phenonemon is a functional disorder caused by intense vasospasm of the arteries and arterioles in which of the following? a)Brain b)Fingers c)Lungs d)Heart
b)Fingers Raynaud disease is a disorder caused by intense vasospasm of the arteries and arterioles in the fingers and, less often, the toes.
During assessment of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. Which aspects of the pathophysiology of aneurysms would the healthcare provider explain to this client? a)Aneurysms are commonly a result of poorly controlled diabetes mellitus. b)Hypertension is a frequent modifiable contributor to aneurysms. c)Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures. d)Aneurysms can normally be resolved with lifestyle and diet modifications
b)Hypertension is a frequent modifiable contributor to aneurysms. Hypertension is associated with over half of aneurysms. They are not consequences of diabetes, and while some are asymptomatic in early stages, this is not necessarily the norm and does not necessarily culminate in a rupture. Aneurysms normally require surgical repair.
A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for: a)Arterial insufficiency b)Pulmonary embolism c)Polyarteritis nodosa d)Vasculitis
b)Pulmonary embolism Deep venous thrombosis (DVT) most commonly occurs in the lower extremities. DVT of the lower extremity is a serious disorder, complicated by pulmonary embolism, recurrent episodes of DVT, and development of chronic venous insufficiency. Isolated calf thrombi often are asymptomatic. If left untreated, they may extend to the larger, more proximal veins, with an increased risk of pulmonary emboli.
A patient is diagnosed with stage 2 hypertension. The nurse knows that which of the following is characteristic of stage 2 hypertension? a)Sustained diastolic pressure of 90-99 mm Hg b)Sustained systolic pressure equal to or greater that 160 mm Hg c)Sustained diastolic pressure of 81-89 mm Hg d)Sustained systolic pressure of 140-159 mm Hg
b)Sustained systolic pressure equal to or greater that 160 mm Hg
The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which of the following initial signs of this condition? a)Hemiplegia b)Syncope c)A pulsating mass in the abdomen d)The pulse is unobtainable in one or both arms
c)A pulsating mass in the abdomen
Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall. a)Chemoreceptors b)Cardiovascular centers c)Baroreceptors d)Neural pathways
c)Baroreceptors Baroreceptors are pressure-sensitive receptors located in the walls of blood vessels and the heart. The arterial chemoreceptors are cells that monitor the oxygen, carbon dioxide, and hydrogen ion content of the blood. The cardiovascular center transmits impulses to the blood vessels. Neural control of the blood pressure is related to the integration and modulation of autonomic nervous system (ANS) response.
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? a)Aboriginals and South Asians b)East Asians and blacks c)Blacks and South Asians d)Aboriginals and Caucasians
c)Blacks and South Asians
A patient has developed atherosclerosis. The nurse knows that a major cause for this disorder is which of the following? a)History of myocardial infarction b)Elevated HDL cholesterol c)Heart failure d)Hypertension
d)Hypertension Constant high pressure damages arterial walls and promotes formation and rupture of plaque, with subsequent stroke and myocardial infarction. Atherosclerosis can also contribute to heart failure. Elevated HDL cholesterol would mitigate the development of atherosclerosis.
The nurse is preparing to determine the blood pressure in an older adult. Which steps in the procedure should be utilized? Select all that apply. a)Cuff is inflated to 50 mm Hg above the palpated pressure. b)Korotkoff sounds provide the most reliable readings. c)Measurements are taken in supine and standing positions. d)Preliminary determination is made by palpation. e)Measurements are taken on several different occasions.
c)Measurements are taken in supine and standing positions. d)Preliminary determination is made by palpation. e)Measurements are taken on several different occasions. Blood pressure variability is particularly prevalent among older adults, so it is especially important to obtain multiple measurements on different occasions to establish a diagnosis of hypertension. Although sitting has been the standard position for blood pressure measurement, it is recommended that blood pressure also be taken in the supine and standing positions in the elderly. Because some older adults have what is referred to as the auscultatory gap, it is recommended that a preliminary determination of systolic blood pressure be made by palpation and the cuff be inflated 30 mm Hg above this value for auscultatory measurement of blood pressure. In some older adults, the indirect measurement using a blood pressure cuff and the Korotkoff sounds will give falsely elevated readings.
A nurse is providing care for a number of older clients on a restorative care unit of a hospital. Many of the clients have diagnoses or histories of hypertension, and the nurse is responsible for administering a number of medications relevant to blood pressure control. Which assessment is the nurse most justified in eliminating during a busy morning on the unit? a)Checking the recent potassium levels of a client receiving an ACE inhibitor. b)Measuring the heart rate of a client who takes a beta-adrenergic blocker. c)Measuring the pulse of a client taking an ACE inhibitor. d)Noting the sodium and potassium levels of a client who is receiving a diuretic.
c)Measuring the pulse of a client taking an ACE inhibitor. ACE inhibitors act on the renin--angiotensin--aldosterone system and are thus not significant influences on heart rate. They can, however, induce hyperkalemia, and it would be prudent for the nurse to check potassium levels. Beta-adrenergic blockers affect a client's heart rate and diuretics can affect electrolyte levels.
A patient's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that which of the following conditions correctly describes this patient's blood pressure? a)Normal blood pressure b)Stage 1 Hypertension c)Prehypertension d)Stage 2 Hypertension
c)Prehypertension
A patient is prescribed an angiotensin converting enzyme inhibitor (ACEI) for hypertension. The nurse knows that ACEIs are contraindicated by which clinical condition? a)Heart failure b)Diabetes c)Renal artery stenosis d)Coronary artery disease
c)Renal artery stenosis
A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for: a)Chest pain radiating to the right arm b)Late hypertensive crisis c)Tearing or ripping-type pain in the chest or back d)Tonic-clonic seizures
c)Tearing or ripping-type pain in the chest or back A major symptom of a dissecting aneurysm is the abrupt presence of excruciating pain, described as tearing or ripping. Pain associated with dissection of the ascending aorta frequently is located in the anterior chest, and pain associated with dissection of the descending aorta often is located in the back. In the early stages, blood pressure typically is moderately or markedly elevated.
A physiotherapist is measuring the lying, sitting, and standing blood pressure of a patient who has been admitted to hospital following a syncopal episode and recent falls. Which of the following facts about the patient best relate to these health problems? a)The patient has a history of acute and chronic renal failure. b)The patient's cardiac ejection fraction was 40% during his last echocardiogram. c)The client is 89 years old and takes a diuretic medication for his congestive heart failure. d)The patient is male and has a history of hypertension.
c)The client is 89 years old and takes a diuretic medication for his congestive heart failure. Old age and diuretic use are strongly associated with orthostatic hypotension, which is normally marked by falls and syncope. Gender, hypertension, stroke volume, and kidney disease are less likely to be causative factors.
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? a)The client left work 1 hour ago. b)The client ate a hamburger 45 minutes prior to the reading. c)The client just smoked a cigarette. d)The client took her antihypertensive medication 2 hours ago.
c)The client just smoked a cigarette. People should be seated when blood pressure is taken, and should not have ingested caffeine or have smoked 30 minutes before the measurement.
The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following? a)Hormonal activity b)Humoral influence c)The kidneys d)Neural mechanisms
c)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.
A 28-year-old client, who is a heavy smoker, tells the practitioner that he has been experiencing pain in his feet and lower legs for several months. The practitioner notes that pulses in the feet are diminished and believes the client may have which of the following? a)Acute arterial occlusion b)Raynaud phenomenon c)Thromboangiitis obliterans d)Thrombophlebitis
c)Thromboangiitis obliterans
The nurse is providing education for a patient diagnosed with essential hypertension. The nurse will state that the cause of this disorder is which of the following? a)Hyperaldosteronism b)Decreased renal blood flow c)Unknown d)Pheochromocytoma
c)Unknown Essential or primary hypertension has no identifiable cause, although there are many risk factors. The other options are causes of secondary hypertension, for which a cause can be identified and often treated.
Which of the following blood vessel cells form the predominant cellular layer in the tunica media and produce vasoconstriction and/or dilation of blood vessels? a)Collagen tissue b)Endothelial cells c)Vascular smooth muscle cells (SMCs) d)Extracellular matrix cells
c)Vascular smooth muscle cells (SMCs)
When a 55 year old patients routine blood work returns, the nurse notes that their C-reactive protein (CRP) is elevated. The patient asks what that means. The nurse responds: a)"This means you have high levels of HDL to balance the LDL found in animal proteins." b)"You are consuming high levels of folate, which works with the B vitamins and riboflavin to metabolize animal protein." c)"You must eat a lot of red meat since this means you have a lot of fat floating in your vessels." d)"This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease."
d)"This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease." CRP is a serum marker for systemic inflammation. Elevated levels are associated with vascular disease. The normal metabolism of homocysteine requires adequate levels of folate, vitamin B6, vitamin B12, and riboflavin. CRP is not associated with red meat consumption. LDL is an independent risk factor for development of premature coronary heart disease.
Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential? a)African-Canadian man who leads a sedentary lifestyle b)40-year-old smoker who eats excessive amounts of salt and saturated fats c)69-year-old woman with a diagnosis of cardiometabolic syndrome d)51-year-old man who has been diagnosed with glomerulonephritis
d)51-year-old man who has been diagnosed with glomerulonephritis
Which of the following types of aortic aneurysms is the most common? a)Ascending aorta b)Aortic arch c)Thoracic d)Abdominal aortic
d)Abdominal aortic Aortic aneurysms may involve any part of the aorta: the ascending aorta, aortic arch, descending aorta, thoracoabdominal aorta or abdominal aorta. Abdominal aortic aneurysms, which are the most frequent form of aneurysm, are associated with severe atherosclerosis.
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? a)Venules b)Aorta c)Capillaries d)Arterioles
d)Arterioles
An elderly patient arrives to the healthcare provider's office complaining of a "sore" that won't heal on their lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is: a)Initiation of Coumadin therapy to maintain an INR of 2-3.0 above norm. b)Hydrotherapy treatments to facilitate improvement in circulation. c)Long-term antibiotic therapy to facilitate healing of the wound. d)Compression therapy to help facilitate blood flow back to the vena cava.
d)Compression therapy to help facilitate blood flow back to the vena cava.
A nurse is teaching a patient with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the patient understands when the patient correctly matches which of the following drug categories to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion? a)Beta blockers b)angiotensin-converting-enzyme inhibitors c)Calcium channel blockers d)Diuretics
d)Diuretics
A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit? a)Excessive sweating and pallor b)Variability in blood pressure and weight loss c)Nervousness and periodic severe headache d)Periodic severe headache and marked variability in blood pressure
d)Periodic severe headache and marked variability in blood pressure
A female client tells the health care provider that she has recently been experiencing episodes of changes occurring in the color of her fingertips especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing: a)Atherosclerosis b)Vasculitis c)Thromboangiitis obliterans d)Raynaud phenomenon
d)Raynaud phenomenon Raynaud phenomenon is seen in otherwise healthy young women, and it often is precipitated by exposure to cold or by strong emotions and usually is limited to the fingers. The ischemic phase of Raynaud phenomenon is manifested by changes in skin color that progress from pallor to cyanosis and progress to hyperemia. The other conditions do not manifest these changes.
A patient presents to the emergency department with complaints of bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. Which of the following is a potential diagnosis for this patient? a)Atherosclerotic occlusive disease b)Deep-vein thrombosis c)Frostbite related to hypothermia d)Raynaud's disease
d)Raynaud's disease
A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which of the following interventions? a)Trendelenburg therapy or sclerotherapy b)Surgery or Trendelenburg therapy c)Surgical or fibrotherapy d)Sclerotherapy or surgery
d)Sclerotherapy or surgery Sclerotherapy, which often is used in the treatment of small residual varicosities, involves the injection of a sclerosing agent into the collapsed superficial veins to produce fibrosis of the vessel lumen. Surgical treatment consists of removing the varicosities and the incompetent perforating veins, but it is limited to persons with patent deep venous channels. Sclerotherapy produces fibrosis of the vessel lumen. There is no fibrotherapy for varicose veins. There is no Trendelenburg therapy for varicose veins. There is a Trendelenburg test that is diagnostic for primary or secondary varicose veins.
The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client? a)The client can take decongestants as needed. b)Treatment with vasoconstrictor medications may be indicated. c)Anxiety and stress may precipitate vasodilation in predisposed people. d)The client must protect the entire body from cold, not just the extremities.
d)The client must protect the entire body from cold, not just the extremities. Treatment measures are directed toward eliminating factors that cause vasospasm. Abstinence from smoking and protection from cold are priorities. The entire body must be protected from cold, not just the extremities. Avoidance of stress and anxiety is another important factor, as they may precipitate vascular spasm in predisposed people. Vasoconstrictor medications, such as decongestants, should be avoided. Treatment with vasodilator drugs may be indicated.
