A client has hypertension and asks the nurse how this condition ...

[newbem]

A client has hypertension and asks the nurse how this condition can lead to heart failure. Which is the best response by the nurse?
 
  1. Hypertension limits the ability of your heart to stretch before emptying, or afterload; your heart works harder and weakens.
  2. Hypertension causes resistance in your aorta, or afterload; your heart works harder and weakens.
  3. Hypertension causes resistance in your blood vessels, or afterload; your heart works harder and weakens.
  4. Hypertension limits the amount of blood entering your left ventricle, or afterload; your heart works harder and weakens.

Question 2

The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which manifestation?
 
  1. Urinary retention
  2. Tachycardia
  3. Tolerance
  4. Hypotension

[xiazhe]

Answer to Question 1

Correct Answer: 3
Rationale 1: The ability of the heart to stretch before emptying is known as preload, not afterload.
Rationale 2: Afterload refers to peripheral resistance, not to resistance in the aorta.
Rationale 3: The most common cause of increased afterload is an increase in peripheral resistance due to hypertension.
Rationale 4: Afterload refers to peripheral resistance, not to the amount of blood entering the left ventricle.
Global Rationale: The most common cause of increased afterload is an increase in peripheral resistance due to hypertension. The ability of the heart to stretch before emptying is known as preload, not afterload. Afterload refers to peripheral resistance, not to resistance in the aorta or the amount of blood entering the left ventricle.

Answer to Question 2

Correct Answer: 3
Rationale 1: Urinary retention is not associated with isosorbide dinitrate.
Rationale 2: Reflex tachycardia is an adverse effect of isosorbide dinitrate, but it is a short-term one.
Rationale 3: Tolerance is a common problem with the use of longer-acting organic nitrates. Clients often are instructed to remove the transdermal patch for 612 hours each day to delay development of tolerance to the drug.
Rationale 4: Hypotension is an adverse effect of isosorbide dinitrate, but it is dose related.
Global Rationale: Tolerance is a common problem with the use of longer-acting organic nitrates. Clients often are instructed to remove the transdermal patch for 612 hours each day to delay development of tolerance to the drug. Urinary retention is not associated with isosorbide dinitrate. Reflex tachycardia is an adverse effect of isosorbide dinitrate, but it is a short-term one. Hypotension is an adverse effect of isosorbide dinitrate, but it is dose related.

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Excellent

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Gracias!