A patient has been diagnosed with Raynaud's disease and asks the nurse what occurs with this disease. Which of the following is the most appropriate response?

"Arteriolar vasoconstriction occurs, most often in the fingertips with symptoms of coldness, pain, and pale skin."

"Peripheral vasospasm occurs in the lower limbs as a result of valve damage from long-standing venous stasis."

"Arterial vessel occlusion is caused by many clots that develop in the heart and are carried to the bloodstream."

"Thrombosis related to prolonged vasoconstriction caused by overexposure to the cold occurs."

Answer and Explanation

The Correct Answer is A

A. "Arteriolar vasoconstriction occurs, most often in the fingertips with symptoms of coldness, pain, and pale skin.": Raynaud disease involves episodes of vasospasm in the small arteries and arterioles, primarily in the fingers and toes, leading to symptoms like coldness, pain, pallor, and sometimes color changes in the skin.
B. "Peripheral vasospasm occurs in the lower limbs as a result of valve damage from long-standing venous stasis.": This description is more characteristic of venous insufficiency or chronic venous stasis rather than Raynaud disease, which affects the small arteries in the extremities.
C. "Arterial vessel occlusion is caused by many clots that develop in the heart and are carried to the bloodstream.": This describes an embolic event rather than the vasospasm typical of Raynaud disease.
D. "Thrombosis related to prolonged vasoconstriction caused by overexposure to the cold occurs.": While exposure to cold can trigger Raynaud's symptoms, the primary issue is episodic vasospasm, not thrombosis. Raynaud’s is not characterized by blood clot formation.

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Correct Answer is D

Explanation

Has the patient been taking his medications as prescribed? This is the most important information to collect. Understanding the patient's medication adherence is crucial because if the patient is not taking his medications as prescribed, it could explain why his blood pressure is elevated. Noncompliance with medication regimens is a common cause of hypertensive urgency and can lead to severe complications. Therefore, knowing whether he has been taking his medications regularly and correctly would directly influence the management plan and help identify the cause of the current crisis.

Does the patient hurt anywhere else? While it’s important to assess for pain and discomfort to address immediate symptoms, this information does not directly address the potential cause of the elevated blood pressure. The patient already reported pain in the head, chest, and left leg, so the primary concern is managing his hypertensive urgency and understanding its underlying causes rather than identifying additional pain locations at this moment.

When does the patient take his furosemide? Knowing the timing of furosemide intake could provide insights into his diuretic therapy management and its potential impact on his blood pressure. However, it is less immediately relevant than understanding whether he has been taking all his medications as prescribed. This question might be more pertinent once medication adherence is confirmed to understand diuretic effects throughout the day.

Has the patient fallen before? This is relevant for assessing the risk of recurrent falls and potential underlying issues such as orthostatic hypotension or balance problems, which are crucial for long-term management and safety. However, it is not as immediately critical in the context of the current hypertensive urgency and the elevated blood pressure despite medication.

A. "Smoking cessation is important because nicotine is a vasoconstrictor." B. "Adequate fluid intake is important to maintain blood pressure." C. Those most affected are middle-aged women after menopause." D. "A low-fat diet is required to reduce atherosclerosis in large arteries."

Correct Answer is A

Explanation

A. "Smoking cessation is important because nicotine is a vasoconstrictor.": Buerger disease is strongly associated with tobacco use, and nicotine causes vasoconstriction, which exacerbates the condition. Smoking cessation is crucial in managing and preventing progression.
B. "Adequate fluid intake is important to maintain blood pressure.": While staying hydrated is generally important, it is not specifically related to the management of Buerger disease, which is more focused on vascular health and smoking cessation.
C. "Those most affected are middle-aged women after menopause.": Buerger disease predominantly affects young male smokers, not middle-aged women.
D. "A low-fat diet is required to reduce atherosclerosis in large arteries.": Buerger disease involves inflammation and thrombosis in small and medium-sized arteries and veins, not atherosclerosis in large arteries. Therefore, a low-fat diet, while beneficial for general cardiovascular health, is not specifically targeted for Buerger disease.

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A patient has been diagnosed with Raynaud's disease and asks the nurse what occurs with this disease. Which of the following is the most appropriate response?

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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