Nokea
Clients taking vasodilator drugs have a greater risk for postprandial hypotension. Which of the following is the best nursing explanation for this phenomenon?
- A. Gravity pulls blood to the lower extremities while sitting
- B. Blood is being diverted to the gastrointestinal tract
- C. Decreased peripheral blood flow results
- D. Bronchospasms are increased when food enters the stomach
Correct Answer: B
Rationale: During digestion, blood is diverted to the GI tract which decreases cerebral blood flow and increases potential of orthostatic hypotension. Although gravity does pull blood to the lower extremities while sitting, this is not the primary concern with postprandial hypotension. Decreased peripheral blood flow does not result in postprandial hypotension. Bronchospasms are associated more with asthma not diversion of blood flow.
You may also like to solve these questions
Which nursing actions would be of greatest importance in the management of a client preparing for angioplasty?
- A. Inform client of diagnostic tests
- B. Remove hair from skin insertion sites
- C. Assess distal pulses
- D. Withhold anticoagulant therapy
Correct Answer: D
Rationale: The nurse knows to withhold the anticoagulant therapy to decrease chance of hemorrhage during the procedure. The nurse does inform the client of diagnostic test, will assess pulses, and prep the skin prior to the angioplasty, but this is not the most important action to be taken.
The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?
- A. Assess the client's mental and emotional status
- B. Assess the skin of the client
- C. Assess the characteristics of chest pain
- D. Assess for any kind of drug abuse
Correct Answer: C
Rationale: The nurse should assess the characteristics of chest pain for a client with CAD. Assessing the client's mental and emotional status, skin, or for drug abuse will not assist the nurse in evaluating the client for CAD. The assessment should be aimed at evaluating for adequate blood flow to the heart.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) immediately following confirmed diagnosis of acute myocardial infarction. The client is overtly anxious and crying. Which response by the nurse is most appropriate?
- A. Everything will be fine. Your family is here for you
- B. Don't cry; you have the best team of doctors
- C. Would you like something to calm your nerves?
- D. Tell me what concerns you most
Correct Answer: D
Rationale: Allowing the client to share feelings tends to relieve or reduce emotional distress. Telling a client that everything is fine negates the feelings they are expressing. Telling a client not to cry can be viewed as insensitive to the feelings being expressed. Providing a prescribed sedative may be helpful but does not address the fears and concerns of the client.
In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD?
- A. To dilate coronary arteries
- B. To decrease workload of the heart
- C. To decrease homocysteine levels
- D. To prevent angiotensin II conversion
Correct Answer: B
Rationale: Beta-adrenergic blockers are used in the treatment of CAD to decrease the consumption of myocardial oxygen by reducing heart rate and workload of the heart. Nitrates are used for vasodilation. Anti-lipid drugs (such as statins and B vitamins) are used to decrease homocysteine levels. ACE inhibitors inhibit the conversion of angiotensin.
A client is prescribed a nitroglycerin transdermal patch to treat angina. Which statement does the nurse include when reinforcing medication teaching to the client prior to discharge?
- A. You do not need the effects of this medication while you sleep
- B. The medication patch causes headaches so you should remove it daily
- C. The patch should be worn for 12 hours and then removed for 12 hours
- D. Skin irritation is common when the patch is worn for more than 12 hours
Correct Answer: C
Rationale: A transdermal nitroglycerin patch is prescribed for the prevention of angina pectoris. Nitroglycerin transdermal patches are typically applied for 12 to 14 hours, and then removed for the same amount of time. Though it is true that common adverse effects of nitroglycerin are headaches and contact dermatitis and that there is less demand on the heart when the client rests, these are not the reasons for applying and removing the patch for the same length of time in a 24-hour period.