A co-worker asks the nurse is to review the following discharge ...

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A co-worker asks the nurse is to review the following discharge instructions with an assigned patient. Based on the content to be reviewed, the nurse should realize that the patient has what health problem?
 
  1. thromboangiitis obliterans
  2. atherosclerosis
  3. Raynaud disease
  4. Buerger disease

Question 2

The nurse is teaching a community education class on hypertension and risk factors for this disorder. What is the primary risk factor leading to the higher incidence of hypertension in older adults?
 
  1. being a black adult
  2. being a white male
  3. having a family history of hypertension
  4. age-related increase in the systolic blood pressure

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Answer to Question 1

Correct Answer: 3
The patient with Raynaud disease has spasms of the small arteries in the digits. There is no specific treatment and the patient is taught to manage the disorder. This includes taking calcium channel blockers such as nifedipine, avoiding exposure to cold and stress, smoking cessation, preventing injuries to the extremities and managing stress. Thromboangiitis obliterans is an inflammatory process manifested by pain and diminished cessation in the extremities. Digits or extremities may be pale, cyanotic or ruddy, and cool or cold to the touch. There are no specific medications to treat this disorder. Smoking cessation is the one most important component in managing this disorder. Blood flow may be improved by exercise, keeping the extremities warm and elevated, and avoiding stress. Buerger disease is another name for this disorder. Atherosclerosis involves deposits of fat, which result in obstruction and hardening of the arteries. Pain is the primary symptom. Management includes smoking cessation, lowering cholesterol, managing hypertension, controlling diabetes, and weight loss.

Answer to Question 2

Correct Answer: 4
An age-related increase in the systolic blood pressure is the primary factor leading to the high incidence of hypertension in older adults. Systolic blood pressure continues to rise with aging, unlike the diastolic blood pressure, which tends to rise until age 50 and then levels off. The other options are also risk factors for hypertension in older adults.

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