Ch. 26: Disorders of Blood Flow and Blood Pressure Regulation

The nurse is reviewing a client's history and recognizes that the client smokes cigarettes. The nurse is concerned because smoking does which of the following?

Injures the endothelial cells lining the blood vessels, thereby promoting thrombus development

A nurse is administering medication to treat familial hypercholesterolemia. Which medication lowers blood levels of low-density lipoproteins (LDL)?

Statins

The dietitian is teaching a client about cholesterol reduction strategies. Which comment by the client indicates that he understands the teaching?

"I should avoid fats that are manufactured from vegetable oils and used to extend the shelf life of fast foods."

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by the health care provider. Which client statement indicates a need for further health promotion teaching?

"I'm going to eat organic foods from now on but I'm glad I don't have to watch my fat intake."

The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state:

- It is the most common cardiovascular disorder. - The incidence increases with age. - The systolic pressure is ≥140 mm Hg.

A client has been diagnosed with diabetes mellitus. Which lab result would the practitioner expect?

Elevation of triglycerides

A nurse is evaluating hypertension risk factors with a black 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 lb (6.8 kg) in the past year. Which risk factors or hypertension are nonmodifiable? Select all that apply.

- Race - Family History

A nurse working on a gerontology unit notes that the majority of the clients on the unit are prescribed antihypertensive medications. When it comes to the aging process, which phenomenon is primarily a contributing factor to hypertension in the older adult population? Select all that apply.

- Stiffening of large arteries like the aorta - Decreased baroreceptor sensitivity and renal blood flow - Increased peripheral vascular resistance

Which client will likely experience difficulty maintaining lipoprotein synthesis, resulting in elevated LDL levels?

35-year-old client with history of hepatitis C and B with end-stage liver disease.

Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?

51-year-old man who has been diagnosed with glomerulonephritis

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

The practitioner is reviewing the medication list of a client with Raynaud disease. Which medication would the practitioner expect the client to be receiving?

A calcium channel-blocker

The physician understands that which client is at risk for developing primary hyperlipoproteinemia?

A client with familial hypercholesterolemia

Which type of aortic aneurysm is the most common?

Abdominal aortic

When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate?

Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which factor has most likely resulted in the client's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

A client with chronic renal failure secondary to diabetes has just been diagnosed with secondary hypertension. This increase in blood pressure is likely caused by which physiologic factor?

Activation of the renin-angiotensin-aldosterone mechanism

A client taking an antihypertensive drug for several months comes to the physician's office with a dry, persistent cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

Angiotensin-converting enzyme (ACE) inhibitors

A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which has lead to a diagnosis of deep vein thrombosis (DVT). What treatment option will be of greatest benefit to prevent further thrombus formation?

Anticoagulation therapy and elevation of the leg

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.

Baroreceptors

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as:

Berry aneurysm

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy

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.

A critical care nurse is carefully monitoring a client's mean arterial pressure. Which combination of factors is responsible for mean arterial blood pressure?

Cardiac output multiplied by systemic vascular resistance

The nurse obtains a blood pressure reading of 150/96 mm Hg from a client at the clinic. What instructions for follow-up does the nurse anticipate giving to this client?

Confirm within 2 months

An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug?

Hypotension

From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate?

Deep vein thrombophlebitis of the leg

The client has been diagnosed with impaired blood flow in the deep venous channels of her legs. The nurse explains that the most common cause of this condition is:

Deep vein thrombosis (DVT)

Which function is performed by arteries such as the coronary and renal arteries?

Distribution of blood to organs that are controlled by contraction and relaxation of these vessels

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly matches which drug category to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion?

Diuretics

The nurse knows that which group of antihypertensive drugs is usually the least expensive and are well tolerated?

Diuretics

The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as:

Fibrous atheromatous plaque

Raynaud disease or phenomenon is a functional disorder caused by intense vasospasm of the arteries and arterioles in the:

Fingers

The nurse is providing medication teaching to a client recently diagnosed with polyarteritis nodosa. The nurse explains that the client will receive three months of cytotoxic immunosuppressant agents followed by which of the following?

Glucocorticoids

The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?

Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring?

HDL

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?

Headache and confusion

The student attends a health fair and has his serum cholesterol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol?

It is believed to play an active role in the pathogenesis of the atherosclerotic lesion.

The pediatrician is examining a young client and notes necrotizing damage to the coronary arteries in the child's echocardiogram. The pediatrician suspects the child has which of the following?

Kawasaki disease

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

Which of the following are characteristic signs of acute arterial embolism?

Pallor, pulselessness, and pain

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which physiologic process?

Peripheral vascular resistance

The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control?

Promotes retention of water

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:

Pulmonary embolism

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 diagnosed with giant cell arteritis will likely experience pain located in which region of the head?

Temporal

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

The client must protect the entire body from cold, not just the extremities.

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.

Which assessment finding of a newly admitted 30-year-old male client would be most likely to cause his physician to suspect polyarteritis nodosa?

The man's blood pressure is 178/102 and he has abnormal liver function tests.

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

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Will prevent the conversion of angiotensin I to angiotensin II

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement?

apply sequential pneumatic compression devices to lower extremities

An older adult client's blood pressure (BP) is 120/80 mm Hg when in a lying position. When the nurse retakes the client's BP in a sitting position, the BP is 92/60 mm Hg. Which intervention is appropriate for the nurse to implement?

Encouraging the client to maintain hydration throughout the day

Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis?

Hypercholesterolemia

A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is:

Hypertension

A client presents to the emergency department with a sudden onset of acute pain in his left lower leg. The practitioner is unable to palpate pedal pulses and finds the client to be in atrial fibrillation. Which test will the practitioner order to find the source of the emboli?

Echocardiogram

Which intervention by the client will decrease overall cardiovascular risk?

Higher levels of fitness and exercise