Author Question: The nurse examines the peripheral vascular system of a client diagnosed with chronic bronchitis 22 ... (Read 101 times)

lidoalex · **on:** Jun 25, 2018

The nurse examines the peripheral vascular system of a client diagnosed with chronic bronchitis 22 years ago. The nurse examines the client's hand. Which statement by the client is consistent with the client's diagnosis?

1. My fingers look so pointy and narrow at the ends.
2. My fingernails are as hard as a rock.
3. My nails always look a little bluish.
4. My nails have a lot of strange ridges in them.

Question 2

The nurse is assessing the blood pressure of a client. The nurse obtains the blood pressure in both of the client's arms.

The nurse determines that there is a difference of 15 mmHg in the systolic readings between the arms and repeats the assessment with the same results. Based on this data, which does the nurse suspect?
1. Inaccurate technique.
2. Anxiety.
3. Unilateral arterial obstruction.
4. Shock.

xiazhe · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 3
The statement regarding blueness is a likely statement from someone who has a long history of disorder resulting in chronic hypoxia. The nails may look blue or gray due to oxygen deprivation. Many times, clients with a long-term history of chronic hypoxia such as chronic bronchitis, will exhibit clubbing of their fingers. The fingertips will look large at the ends, not pointy and narrow. Clients with lung problems resulting in chronic hypoxia will more likely to complain that their nails are soft and spongy. Ridges in the nails are more likely the result of another disorder such as a nutritional deficiency.

Answer to Question 2

Correct Answer: 3
A difference of readings 10 mmHg or more between arms may indicate an obstruction of arterial blood flow to one arm and is considered an abnormal finding. After repeating the procedure and determining the results were the same, the nurse would not necessarily assume that the technique was faulty. Client anxiety may result in a higher blood pressure reading. It would not result in a difference between blood pressures assessed in each arm. If the client is developing clinical manifestations associated with shock, the nurse would most likely determine that the client's blood pressure is lower than normal. Shock would not result in a difference between blood pressures assessed in each arm.