Unit 10 - Class Activities Flashcards
Essential/ Primary: Hypertension would be diagnosed in a 40 year old male whose blood pressure readings were consistently at or above which of the following?
a. 120/90 mm Hg.
b. 130/85 mm Hg.
c. 140/90 mm Hg.
d. 160/80 mm Hg.
c. 140/90 mm Hg.
* American Heart Association standards define hypertension as a consistent systolic blood pressure level greater than 140mm Hg. And a consistent diastolic blood pressure greater than 90mm Hg.
The Client admitted with Peripheral Vascular disease (PVD) asks the nurse why her legs hurt when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:
a. Decreased blood flow
b. Increased blood flow
c. Slow blood flow
d. Thrombus formation
a. Decreased blood flow
* Decreased blood flow is a common characteristic of all PVD. When the demand for oxygen to the working muscles becomes greater than the supply, pain is the outcome..
no identifiable cause
primary/essential hypertension
Captopril ( capoten) an angiotensin-converting enzyme (ACE) inhibitor, may be administered to a client with heart failure / or HTN because it acts as a :
a. Vasopressor
b. Volume expander
c. Vasodilator
d. Potassium-sparing diuretic
c. Vasodilator
* Angiotensin-converting enzyme /ACE inhibitors have become the vasodilators of choice in the client with mild to severe heart failure. Vasodilator dugs are the only class of drugs clearly shown to improve survival in overt heart failure. ACE inhibitors do not act as vasopressors volume expanders or diuretics.
The client has a long history of hypertension and has developed heart failure. The nurse would anticipate giving medications to do which of the following?
a. Increase preload.
b. Decrease afterload.
c. Decrease contractility.
d. Decrease cardiac output
b. Decrease afterload (afterload=pressure against which Ht. must work to eject blood during systole)
* Rationale: The client likely has developed heart failure secondary to the hypertension, which is an increase in afterload. The nurse would anticipate giving medication to decrease afterload. There would be no reason to increase preload, decrease contractility, or decrease cardiac output.
An overweight client taking warfarin (Coumadin) has a nursing diagnosis of ineffective tissue perfusion relate to decreased arterial blood flow. What should the nurse instruct the client to do/Select all that apply?
a. apply lanolin or petroleum jelly to intact skin
b. Encourage a reduced-calorie, reduced –fat diet
c. Inspect the involved areas daily for new ulcerations
d. Instruct the client to limit activities of daily living (ADL’s)
e. Use an electric razor to shave
a. apply lanolin or petroleum jelly to intact skin
b. Encourage a reduced-calorie, reduced –fat diet
c. Inspect the involved areas daily for new ulcerations
e. Use an electric razor to shave
Mr. Thomas is being assessed for PVD. He complains of aching pain for the past 6 months. His skin feels warm and there is edema preset. He has a pedal pulse. His skin appears thick and dry/scaly. What condition would his S/S’s indicate?
A.Acute venous PVD
B.Chronic arterial PVD
C.Chronic venous PVD
D.Acute arterial PVD
C.Chronic venous PVD
Which of the following factors is the most important in determining the resistance of a vessel?
a. length of the vessel
b. Diameter of the vessel
c. Blood being too thin
d. Blood being too thick
b. Diameter of the vessel
* The diameter of the vessel is the most important component in determining resistance in the systemic circulation. The length of the vessel is also a factor in determining resistance. Viscosity, whether the blood is “thin” or “thick”, is less important when discussing blood flow.
A common abnormal laboratory result associated with the development of peripheral vascular disease (PVD)
a. High serum calcium level
b. High serum lipid levels
c. Low serum potassium levels
d. Low serum lipid levels
b. High serum lipid levels
* High serum lipid levels are associated with a increased incidence of PVD. High serum calcium level, low serum potassium level, and low serum lipid levels have no relation to PVD.
Which of the following lipid abnormalities is a risk factor for the development of atherosclerosis and peripheral vascular disease?
a. Low concentration of triglycerides
b. High levels of high-density lipid (HDL) cholesterol
c. High levels of low-density lipid (LDL) cholesterol
d. Low levels of LDL cholesterol
c. High levels of low-density lipid (LDL) cholesterol
* An increased LDL cholesterol concentration has been documented as a risk factor for the development of atherosclerosis. LDL cholesterol is not broken down in the liver but is deposited into the intima of the blood vessels. Low triglyceride levels are desirable. High HDL and low LDL levels are beneficial and are known to be protective for the cardiovascular system.
Which of the following is an important regulator of blood flow in the peripheral circulation of the human body?
a. Autonomic nervous system
b. Central nervous system
c. Parasympathetic nervous system
d. Sympathetic nervous system
d. Sympathetic nervous system
* It is the sympathetic nervous system (adrenergic) that is involved in regulating the blood flow in the peripheral blood vessels. The autonomic nervous system is divided into two branches, the sympathetic branch and the parasympathetic branch. The parasympathetic nervous system does not control peripheral blood flow. The central nervous system is composed of the brain and the spinal cord and does not have an influential effect on peripheral blood flow.
A client with peripheral vascular disease has chronic severe pretibial and ankle edema bilaterally. Because the client is on complete bed rest and circulation is compromised, one goal is to maintain tissue integrity. Which of the following interventions will help achieve this outcome?
a. Administering pain medication
b. Encouraging fluids
c. Turning the client every 1 to 2 hours
d. Maintaining hygiene
c. Turning the client every 1 to 2 hours
* The client is at greater risk for skin breakdown in the lower extremities related to the edema and to remaining in one position, which increases capillary pressure. Turning the client every 1 to 2 hours promotes vasodilation and prevents vascular compression. Encouraging fluids is not a direct intervention for maintaining skin integrity ALTHOUGH being well hydrated is a goal for most clients (keep vascular volume etc. Maintaining hygiene does influence skin integrity but is secondary in this situation
The client is on strict bed rest following hip surgery. What nursing intervention would support vascular health?
a. Place pillows under the unaffected knee for support.
b. Position the bed to flex the knees at least 20 degrees.
c. Have the client alternately flex and extend the feet several times a day.
d. Keep the client in a prone position for at least 20 minutes twice a day.
c. Have the client alternately flex and extend the feet several times a day.
* Rationale: Alternating flexion and extension of the feet will help keep clots from forming in the extremities. Active contraction and relaxation of calf muscles is also used for this purpose. Placing pillows under the knees or positioning the bed so that the knees are in more than 15 degrees of flexion supports the development of clotting. The client would not be placed in the prone (on abdomen) position.
