a. Left ventricular overload b. Impending circulatory collapse. Extracellular electrolyte imbalances. G)insutcient ‘oxygen reaching the heart muscle. 2. Which of the following is an uncontrollable risk factor that has been linked to development of coronary artery disease (CAD)? a. Exercise Obesity 6 Gender High — cholesterol level 3. A client with ar ngina pectoris asks the nurse, “What information does provide?” The nurse would appropriately respond that ECG gives informatig about the @ Electrical conduction of the myocardium. . Oxygenation and perfusion of the heart. ¢. Contractile status of the ventricles d. Physical integrity of the muscle. 4. How should the nurse instruct the client with angina pectoris to take Sublingy; nitroglycerine when chest pain occurs? a. Take one tablet very 2 to 5 minutes until the pain subsides. b. Take one tablet and fest for 10 minutes. Call the Physician if the pai persists after 10 minutes. g Take one tablet, then an additional tablet every 5 minutes for a total three tablets. Call the Physician if pain Persists after three tablets, d. Take one tablet. If pain persists after 5 Minutes, take two tablets. |f still persists 5 minutes later, call the Physician, _ 5. Proper hand Placement [ for chest compressions du reduce the tisk Of which of the following complications? a, Gastrointestina| bleeding : Myocardial infarction Emesis C, Rib fracture ring CPR is essential ~ Ventilation ratio in CPRis:of the following findin} net ne indicate congestive heart fai Gvp = 17 em. H0 ioe SJ Serum potassium = 4m Eq/L. swnich §. fourly urine output = 30 to 60 mis ne client will undergo left — sided cardiac catheter: zation. Which of the followit Nd ‘ould not be included in : patient te: ‘2. “You will experience warm oe fy the contrast medium is injected.” “You will receive anesthesia” J “You will be placed ina 7 tunnel — You have to tell me if you have Bays . seafoods.” ne type of artificial cardiac pace pf mi I firings per minute is: pacemaker which provides 2 specific number Fixed rate pacemaker. ‘ J Demand rate pacemaker. Temporary pacemaker. it pacemaker. c. dg. Permanent ich of the following signs and symplorne would most likely be experienced by iGlient with right — sided ‘congestive heart failure? pnea, crackles, ankle edema. - 6 Dyspnea, Engorged neck vein, enlarged liver, Hemoptysis. hypertension, pallor ae at d. Syncope, hemolytic ‘anemia, clubbing of fingers in to the client with congestive the following? heart failure. The nurse administers digoxit rse should first check which of as Pulse rate Apical rate Blood pressure d. Respiratory rate ich of the following is NOT a characteristic of chest pain in myocardial in? it last for more than 30 minutes. It radiates to the entire chest, neck and left arm. a Itis relieved by rest rf in character. It is crushing In of the client with angina the following may precipitate the chest pain ris? a. Taking awambath Having frequent rest periods. Eating 4 large meal. Avoiding exposure to cold. ich of414. Which of he following results of enzyme st so ne of myocardial infarction (M1)? tuts dome not niente Pe 2 Elevated Ck-MB b. Elevated SGOT (AST) a Elevated LDH @) Elevated SGPT (ALT) 46. The folowing nursing interventions should be included in the NUrSiNg Care ply ny the client with Mi, EXCEPT: 1S Piace the client in semi - Fowler's position E haminister oxygen by nasal cannula as ordered Py encourage use of bedpan for defecation b provide low sodium, low fat and low cholesterol diet You may now check your answers.ANSWERS AND RATIONALES Care of Clients with Cardioy, ‘ascular Diso) rders : D. Insufficient ox ‘orrect Answer: GEN rea Sang 1. C2ffasod lactic acid production due to anaeng,tn® heart muscle, causes b irtates nerve endings in the myocardium, therebp coe Lactic acid chest pain, a,B and C are not causes of chest pain in M.| : C. Gender has b correct Answer: iS been linked ‘Zan uncontrollable or non-modifiable risk eae “oronary artery disease and \B and D are incorrect. Exercise, obesi Avatrollable or modifiable factors, ty and high cholesterol levels are all |, correct Answer: A. Electrical conduction of th } Teflects the transmission of electrical cardiac ines FG directly ut the heart, | i F | B,C and D are incorrect. ECG does not give 4 | and perfusion of the heart. Contractility ea enatiCn about oxygenation of the heart muscle may possibly be evaluated in cae ats int | } but not directly through ECG. | | Correct Answer: C. Take nitroglycerine at a minute interval. f the chest pain persists after tires way oe ot > ablets at S- the nurse should call the physician, lets, suspect MI. Then | A,B and D are incorrect instructions in nitroglycerine therapy. Correct Answer: D. Proper hand placem _ rent during chest essential to reduce the risk of rib fractures, which a ectieTeressionsiis and other internal injuries. pneumothorax A, B and C are incorrect. Gastrointestinal bleeding and myocardial infarction are generally not considered complications of CPR. Although the vi - a on ei vomit during CPR, this is not associated with poor hand aera ae with distention of the stomach. Correct Answer: C. The compression — ventilation ratio for CPR is 30:2 in all ages. Correct Answer: B. CVP of 17 cm. water indicates congestive heart failure and circulatory overload. The normal CVP reading is 5 — 12 cm. water. A, C and D are within normal limits. BUN = 10 to 20 mojdl.; potassium = 3.5-5.5 mEq/L; and hourly urine output = 30 to 60 mis. serum—zz (Gorrect Anewer: C. “You wil be placed ineiuded in patient teaching for "2, Uel ~ tke gevice” SMOUE Ng - tine Catheter zation. -Card p? catheterization involves radiographic serge" a Stratis ni On ot the jdministration of contrast medium through a caye heart strictures fol A, B and D are instructions/information to be undergoes cardiac catheterization included when the i leg, 9. Correct Answer: A. The type of artificial cardiac pacemaker which a specific number of electrical firings per minute is fixed rate Pacomanrovide, B, C and Dare incorrect. A demand rate pacemaker provides electrica, fr when the heart rate becomes slow. A temporary pacemaker jg hy inserted in preparation for insertion of permanent pacemaker. jt , Sth, extemal power pulsator generator. A permanent pacemaker 's impand either through transvenous (endocardial) approach oF Sranstho, = (epicardial) approach. Its power pulsator Dy 2s impia, me ‘subcutaneously in the right precordium (transvenous approa® belay, te umbilicus (transthoracic approach). 40. Correct Answer: B. Engorged neck vein, enlarged es ee Sain ay signs and symptoms experienced by the client wee 1 Hes See eSty heart failure. The signs and symptoms of right — oat Ve hess failure are due to damming back of blood in the venous correct. Although ankle edema is experienced by the Cle les are manifestations of left — sided CHF Hema, IF, but syncope and clubbing of fingers ay pe A, C and D are int dyspnea and crac anemia occurs in right sided CHI manifestations of left - sided CHF. must check the apical rate (heart Tate) fry 11. Correct Answer: B. The nurse before digoxin administration. Digoxin slows down heart rate (negaig chronotropic effect). If the heart rate is below 60bpm, the nurse withholds te medication because it causes bradycardia. If the heart rate is 120 bpm above, the nurse withholds the medication because it can cause Teboung tachycardia. 12. Correct Answer: C. The chest pain in M.I. is not relieved by rest A, Band D are characteristics of chest pain in M.!. rge meal precipitates chest pain in the ciien 13. Correct Answer: C. Eating a la with angina pectoris. The other precipitating factors are: exertion, exposure tp cold and strong emotions. A, B and D do not precipitate chest pain in MI.ct Answer: D. Elevated SGPT orrmyocardium does not produce S cee Not indicate the presence of Ml. Only liver cells produce SGPT. c A tne ™ a. Band Care enzyme studies that indicate the presence of M. orrect Answer: C. Use of bed ro is lac workload and mi tate another M.I. attack. Use of bedsid 5 "ea eae this will not include use of Valsalva manors Me Preferred, ; dD are nursing interventions that should be included i Ni pie plan of the client with M1. included in the nursing iw | 5 ‘ Th i i . ) fy Are you happy with your achievement level? ember, it should be 80 % and Above (12 to 15 correct oe answers). te, he in 0 tePractice Test No. 5 Disorders \Bt H “1 Care of Clients with Cardiac to CAD (Coronary Artery & jents is most predisposed these cli wg } , ore te he gient with a history of 20 pack years of smoking. é whose father and brother died of M I. ion Are cient f 1 The (2Y% accountant ‘client who sits 8 hrs./day- fi Tne dient who had menopaused 5 years ago. istention), the head of bed should be elevated? D. 15° is gy } - for JVD (jugular vein di ane SANs: B. 30° C. 20° Asey cent ‘on heparin therapy has APTT result of 80 seconds. This indicates that: ig the client 1S prone to bleeding. may itis the therapeutic effect of the drug. The client may develop thromboembolism p, The client is not receiving adequate dose of s indicates low cardiac output? the drug. Msg of the following finding: BUN of 40 mg./dl en g BUA of 5mg. idl. | ¢ Hourly urine output is 50mis. sium) is 4 5 mEq/L Yt with | p Serum K (pota: hic of the following results of enzyme studies does not indicate MI? 4. Elevated AST Elevated CK - MB B Elevated ALT Elevated LDH ihich of the following ECG changes indicates hypokalemia? A. Elevated ST segment Peaked T - wave B. Prolonged QRS complex Dy epressed ST segment terization. Which of the The client will undergo right — sided cardiac cathel loving should not be included in patient teaching? A. “You have to fast for 6-8 hours before the pt B. “You will experience warm or flushing sensation as is injected 2 a “You will be under general anesthesia. if you have allergy to seafoods.” D. “You have to tell me ikely experiencing hyper jure.” the contrast medium olemia if the CVP The client is evaluated to more iil ‘eading is: ce A. 10. cm. of HO 2 B. Bom. of HO @" com. of HOi is a characteristic of Re, 7 wd eroeeree while siting anaaratie Pain in anging * itis localized on the left chest. wana TV. Pecin, Si is precipitated by eating a large meal, D. It occurs for more than an hour. 10. The following are the correct nursing interventions hen nitroglycerine EXCEPT: ath, A. Takea maximum dose of 3 tablets at 5 - minute j Sit at the edge of the bed before standing, fal. 6 Take sips of water after placing the tablet under the D. Always carry 3 tablets in the pocket. tongue, (PTCA). This procedure is done by A, Surgical stripping of atheroma. Insertion of balloon — tipped catheter to compress atheroma, Using native graft for revascularization of the heart. D. Insertion of stent into the coronary vessel. 11. The client will undergo Percutaneous Transluminal Coronary , 12. Which of the following is not a characteristic of chest Pain in Myocardia| int (ML)? A. The pain is described as crushing. The pain radiates to one or both ams, the neck and the back, The pain is relieved by rest. r The pain is relieved by morphine sulfate per lV. 13. Which of the following nursing interventions is not included in the prevention Vasovagal stimulation in the client with MI? é Avoid giving very hot or very cold drinks. Encourage use of bed pan on defecation. C. Administer Colace as ordered. D. Advise client to avoid holding his breath when tuming to side. 14. What is the most common cause of death in the period of M.1.? Cardiogenic shock C. Pulmonary embolism Ventricular dysrhythmias D. Cardiac tamponade 15. Whi sili 5. Which Of the following is the first — line of drug to relieve PVC’s? Digoxin (Lanoxin) C. Phenytoin (Dilantin) —Fecaine (Xylocaine) D. Procainamide (1 18. The priority nurs; acid diagnosis for the client with dysrhythmias is: g Dectsed feelz output“ "C. Alteration im comfort issue i. a 17.The ty Perfusion D. Activity intolerance PS Of artic. ; heart ttificial card = @ Demarowing is true of cardioversion? ne fol o revert cardiac arrest. it" i electric shock is applied during the R-wave. Oirvaves unsynehronized application of electric shock to the heart. & isdone on the Wa vill be done to an adult client by 2 rescuers. The ratio of extemal ; WR vessions with ventilation is: wg :2 pase e082’ D.1:5 ign. of left — sided CHF? rial of the following is NOT a si 14, orthopnea C. )sctes B. Clubbing of fingers ~Hemoptysis nurse administers digoxin to the client. The nurse should first: ‘4, Check pulse rate C..Check the respiratory rate 3. Check blood pressure (Ddcheck the apical rate the client is given digitalis and furosemide. Which of the following foods should te included to prevent adverse side — effects of the drugs? A. Whole milk C. Canned tuna D. Eggs @)oims fruits \ The following are nursing diagnoses for the client with left — sided CHF EXCEPT: A. Impaired gas exchange B. Decreased cardiac output C.. Decreased tissue perfusion luid volume excessPractice Test No. 5 : | Answers and Rationales i‘ Care of Clients with Cardiac Disorders | __g positive family history for coronary artery diseases is the primary increases predisposition to these diseases om - | ef, A. To assess for jugular vein distention (JVD), the head of bed should red at 45° angle. Normally, if the head of bed is placed in flat position, ] wack vein is engorged and when the head of bed is elevated at 45° angle, the 1 vein flattens. If it remains engorged, this is JVD, which indicates ~ atory | food or right - sided CHF. ] | sgswor: B. The therapeutic effect of Heparin is PTT or APTT x 2 to 2.25. The / gmal value of APTT is 30 to 45 seconds. Therefore 30 to 45 seconds x2 = 60 / p90 seconds. A result of 80 seconds indicates therapeutic effect of Heparin mnswer: A. BUN of 40 mg/dL is elevated. This indi I icates low cardiac output, | jexeased tissue perfusion that leads to accumulation of waste products, as ’ sfidenced by elevated BUN levels, ] B, Cand D are all normal values. | Answer: B. Elevated ALT (SGPT) does not indicate Mi, | not produced by the myocardium. It is produced only by (SGOT), CK — MB and LDL indicate presence of MI. * Answer Depressed ST segment indicates hypokalemia. Elevated ST segment, prolonged QRS complex, peaked T- wave indicates hyperkalemia. because this enzyme is the liver. Elevated AST Answer: C. Cardiac catheterization does not j ‘equires local anesthesia only. Frequire general anesthesia. It A, B and D are to be included when giving patient teachings in Preparation for cardiac catheterization. " Answer: D. A client is experiencing hypervolemia if the CVP reading is 14 cm. ‘1.0. The normal CVP reading is 5 to 12 em. of H.O (average of 4 to 10 cm. a Water).‘ ~ating a large meal — a motions (anger, excitement) E —xposure to cold in angina pectoris radiates to the left back. It is not localized. shoulder, Meck zg A and D describe myocardial infarction. . Answer: C. When administering Nitroglycerine sublingual, sips given before placing the tablet under the tongue, not after. k of wat ay membrane moist hastens absorption of sublingual nitroglycerine 2 My of water after placing the tablet under the tongue makes the patient aan ‘ig of the medication. Sublingual absorption is faster than oral absont= because of presence of lots of blood vessels under the tongue. Thay A, B and D are correct nursing interventions when acing Nitroglycerine sublingual. 11. Answer: B. Percutaneous Transluminal Coronary Angioplasty (PTCA) inh, insertion of balloon — tipped catheter to compress atheroma. A -Describes endarterectomy. C -Describes Coronary Artery Bypass Graft (CABG). D -Describes Coronary Stenting. 12. Answer: C. The chest pain in MI is not relieved by rest. DIGITALI A, Band D are characteristics of MI. 13. Answer: B. Use of bedpan on defecation among clients with MI causes vasovagal stimulation and May trigger cardiac arrest. A, C and D are nursing interventions that may prevent vasovagal stimulaion 14. Answer: B. Ventricul among MI clients, 15. Ay nswer: B. Lidocaine j i ents Conair? ere 's the first line of drug to relieve Premature V lar dysrhythmias are the most common causes of dt! 16. Answer: TI ae mas Secreted cara ron, Musing diagnosis for the cent with dss carta : thereby reducing cardec oy tmias reduce the force of cardiacides electical firings only rate pacemaker ig one which giv’ re aed among that artificial cardiac pacemaker 5 Teale (HR) becomes slow is aint ker rate artificial cardiac paceMaXce “a ctrcal firings per minute. THIS IS Ue if el aareat block. Cardioversion is synchronous application of ele ps0 Crest paddles. Its done to revert dYSi pare T — wav wat i during the R — wave, never on the Es 3 10 mulating it to contract. es a preset clients with bent? A a th io of compression .¢. When performing CPR to adult, child, infant, the ratio > baton is always 30:2. CPR has been revamped by American Heart sssociation. | answer: C- Ascites is not a manifestation of left — sided CHF. It reflects venous | Aer up. Therefore, itis a manifestation of right — sided CHF. A, Band D are signs of left — sided CHF (left — sided CHF — pulmonary ' dema, “left — lungs’). i i answer: D. Digoxin reduces heart rate. Therefore, the nurse should check apical ‘ae before administration of the medication. If the apical rate is 60 bpm or below, or 120 bpm and above, do not give the medication. It may cause bradycardia or rebound tachycardia. Answer Citrus fruits are potassium — rich foods. Furosemide is a potassium — wasting diuretic. It may cause hypokalemia. DIGITALIS ia = DGITALIS TOXICITY oan Answer: D. Fluid volume excess is not a nursing diagnosis for the client with left F 7 i - sided CHF. It is more appropriate for the cli i i — si 3 F. ient with right — sided CHF due to A, B and C are appropriate nursing diagnosi : 4 sided CHF due to pulmonary edema and code cea the client with left — Feel good, cardiology Nurse!CRITICAL THINKING EXERCISES oon ion ° Care of Clients with Peripheral Vascular Disorders ; ve e a ety i ii . 70" ‘One goal in caring for a client with arterial OCcIUSiVe disease, EO KIN (2 Cesaiation in the affected extremity. TO achieve this gut © li otro" eo encourages the client to: 1 the es neo" a. Avoid eating low-fat-foods, 4 fol Elevate the legs above the heart of S. $9 ‘c_ ) Stop smoking ae Begin a jogging program. 1 * oe a a ‘i The client with Buerger's disease experiences which of the fol pb ey paras and symptoms? , owe ¢ Bansatio ‘a. Thickening of the intima and media of the artery. é ; Gg Inflammation and fibrosis of arteries, veins and nerves. Bi curse Tc Vasospasm lasting several minutes. sik gutfona! 4. Pain, pallor and pulselessness. is penicill ents with Raynaud's disease. The i ‘quia! |. Stress can produce vasospasm in cli states she is worried about making the necessary behavioral changes control the vasospastic episodes. Which of the following diagnoses appropriate? Activity intolerance related to Raynaud’s disease. Anxiety related to change In health status. % Disturbed body image related to illness treatment. d. Impaired social interaction related to self — concept disturbance. Which of the following increases the risk of having a large abdominal anitmale is diagnosed to have Buergers disease eras lo tripe arch of the foot and trombophicali of te ithe following factors is associated rape el) rger's erg Se jg a 7a Qoay p ge il pattern towal peripheral vascular disease. they smoking NIST, a ristory © ff recent insect bites. & Hient exposure to alergons the fol following manifestations would least Ii fienced wc abdominal, aortic aneurysm (AAA)? ae By 18 fi et ate abdominal mass. Ollowin, 2 nit on auscultation of the mass. Hyperactive bowel sounds. < f Sensation ‘of “heart beating in the abdomen.” (Furosemide) is contraindicated if the client has hypersensitivity to: Sulfonamides f Penicillin SEaSe. The cli c aminoglycosides ioral changes ¢, Quiaolones 7 1g diagnoses «! 4 y cient with with hypertension is ‘on ACE inhibitor (Monopril). Which of the jowing diuretics is contrainmale is diagnosed to have Buerger's di Me ication Wine erch of Gao ed TORENT a Which ‘of the following factors is as: * eo of the s rger’s jal pattem toward peripheral vascular disease. ele jo? se oil 8 gmoking ” Fretory of recon insect bites. si Hgant exposure 10 aterden= of tne following manifestations would least Ii rienced 1 ed iat with abdominal, aortic aneurysm (AAA)? ae By a pulsatile abdominal mass. p. Briton ‘auscultation of the mass. ze Hyperactive bowel sounds. ¢. Sensation ‘of “heart beating in the abdomen.” mide) is contraindi li i ‘ isk es : indicated if the client has hypersensitivity to: p. Penicilin c ‘Aminoglycosides d, Quiaolones 7 A cient with hypertension is on ACE inhibitor (Monopril). Which folowing diuretics is contraindicated? Sete ft a. Lasix sease. The The di ioral. change 19. diagnoses «| " @-ea0ceNSWERS AND RATIONALES al ith Peripheral Vascular Diso, ripheral der re of Clients rs, Ca . Smoking should be stopped. Ht causes vasoosn, Answer: 1, Comect ot Answel ne primary factor a: disease is inflammation of arteries : i: B. Bu ed with Buerger’s disease is Cigarette om A W's itestyle and health cause a ; B, Changes in a client re 3. Correct Answer: per the primary factor assoq, Correct Answ Hypertension is the pri J anes ceri veatenng of aerial walls that results to imeversibie is’) rysm, It cau 2 aneurys t life — fon C. Pulmonary embolism is the most cept ot DVT (deep vein thrombosis) and thrombophlebitis, Chest en trek commun fel mantesiabon. Other signs and symptoms are dyspn, a ay! petweer diaphoresis, and apprehension. eis. 0 ns, a yndly 6 Correct Answer: B. The primary factor associated with Buerger’s dis Ne profour ins Cigarette smoking. It also has an autoimmune component. oe napter aims t 7 Sorrect Answer: C. Hyperactive bowel movement sounds are Not related} a the c jannnal aoric aneurysm. The other choices (a, b, and d) are Manifestations asa atitudes in the ¢ AMA lah fective and efficie or A. Furosemide IS conti a Byers: Taindicated if the cliem baljging Outcomes Atthe end of this Ct 1. Conduct _nursiny actual or potent 2 Teach a cli a dient e ‘ = 4 x : § Discuss risk fa Pale skin on oj h; thin, shiny ski! ; ic dis "shear ten 8: BaNgrena ae ot F885; diminished or asi Deon & plan 'nd in the legs S; decreased sensattt!Practice Test No. 6 care of Clients with Peripheral vascular Diseases E .g testis done to assess: : (267 erosis obliterans aenevens! ar hlebitis & uergers disease Thrombop! 8 0 plethysmography is done to er menial insufficiency /enous insufficiency A /venous insufficiency . Phlebothrombosis 4 Arterial y «¢ he following nursing diagnoses has the highest priority for the client a" arterial occlusive disease? tered tissue perfusion C. Knowledge deficit \pecreased cardiac output D. Noncompliance sent teaching in the prevention of hypertension includes the following EXCEPT: o Moderation in sodium intake Decrease saturated fats intake JReduce intake of potassium rich foods D. Have regular pattern of exercise the client is receiving anti — hypertensive therapy. Client teaching should include i tefollowing EXCEPT: ‘A. Practice gradual change in position. yt B. Avoid prolonged sitting or standing, i Avoid very warm baths. | \ Take medications only when symptoms of hypertension become evident such as headache, dizziness. The following are appropriate client teachings in arterial insufficiency EXCEPT: i éofiees legs in slight dependency to promote arterial flow. a ub the legs from ankle to knee for 10 minutes. ai C. Use several layers of clothing during cold weather. D. Avoid crossing the legs. ’ Fusifarm aneurysm is described as: (A. Putpouching of both sides of the artery. &~ Outpouching of only one side of the artery. C. Separation or tear in the tunica intima and tunica media. D. Anastomosis of an artery and vein. ie ' The following are characteristics of Raynaud's disease EXCEPT: | A. Itis characterized by vasospasm of arteries in the digits. B. itis triggered by exposure to cold and emotional stress. Itis more common among cigarette — smoking males. . It may be characterized by ulcerations on the fingertips and toes,9. Which of the following patients is at greatest rig, thrombosis? for @ A 45 — year old obese woman on birth contro, 4 “2¥eoping | A 65 — year old woman with in-situ cervical Pas Sy C. A35—year old malnourished man. cancer, D. A 25-year old man with fractured tibia. 10. The most common etiologic factor for thromboar A. Prolonged sitting or standing nai Obliterang ig. Hereditary incompetency of the valves of the Veit Cigarette smoking ns D. Obesity 11. The following are characteristics of venous insufficiency y A. Brown pigments around ankle EXCEPT, Peripheral pulses are present Ulcers develop in the toes D. Edema is present, diminished by elevation 12. The following are appropriate patient teachings in ricositi A. Elevate legs for 15 to 30 minutes at eee * Eceny . Avoid prolonged sitting or standing Use elastic stay — up stockings . Avoid constricting clothings Ansy ap OF bie » Ansa Ans Cold Mal AnePractice Test No. 6 Answers and Rationales care of the Clients with Peripheral Vascular Diseases Trendelenburg test is done to detect incompetent’ valves of the ops doit presence of varicose veins. oe sine valves of the veins are competent, retum of pinkish color in the legs yeoes upwards. This isthe normal direction of flow of venous blood. 3 ifthe valves of the veins are incompetent, retum of pinkish color in the Pa from the thighs downwards. This is due to reflux of venous blood. od Impedance plethysmography is done to assess venous insufficiency. jerer-b, Altered tissue pertusion is the highest priority nursing diagnosis for se" with acute arterial occlusive disease. This results from decreased supply oxygenated blood to_different body organs, especially in the lower extremities. em, yswer: C Reducing intake of potassium rich foods should not be included when ing health teachings to clients with hypertension. Low potassium — rich foods ake will further predispose clients to hypertension. inswer: D. The client with hypertension should take anti — hypertensive therapy areguiar basis for life, to ensure adequate control of the condition, and not only hen symptoms occur. A, B, and C are correct client teaching to prevent postural hypotension during anti— hypertensive therapy. Answer: B. Rubbing the legs from ankle to knee for 10 minutes is not ‘propriate client teaching in arterial insufficiency. This may cause dislodgment blood clots if present, which may lead to pulmonary embolism. Answer: A. . Fusiform aneurysm is outpouching of both sides of the artery. Answer: C. Raynaud’s disease is more common among females primarily due to oe exposure. Buerger’s disease is more common among cigarette — smoking males, énswer: A. Obesity leads to venous stasis; the estrogen content of birth control tls increases risk for thromboembolism. Therefore, this client has the highest "Sk to develop deep vein thrombosis (DVT).a Thromboangitis Obliterans or Buerger. 10. Answer: =: so acaetceronaeal " ’ ment of ulcers in the toes is - 11. answer: Ge ery, no of venous nse. characterote A, B and D are characteristics Of\venotts inautiera -C. Elastic stay — up stockings have’ gartar tans "2 (ares sais. Torfoe, Xi inaporoprios for PST use stay — up stockings. Stand up, do some leg exercises, You have to prevent PVD’s!