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 C

Explanation

A. Calcium 9.4 mg/dL: This is within the normal range for calcium (8.5-10.2 mg/dL), so it is not a concern.
B. Sodium 140 mEq/L: This value is within the normal range for sodium (135-145 mEq/L), so it is not a concern.
C. Potassium 2.5 mEq/L: This is below the normal range for potassium (3.5-5.0 mEq/L) and indicates hypokalemia, which is a common side effect of furosemide, a diuretic. Hypokalemia can cause serious cardiac issues and requires prompt attention.
D. Magnesium 1.9 mEq/L: This is within the normal range for magnesium (1.5-2.5 mEq/L), so it is not a concern.

A. Have the patient lie in bed with a pillow under the knees. B. Evaluate the distal pulses. C. Cover the patient with a blanket. D. Notify the physician.

Correct Answer is B

Explanation

A. Have the patient lie in bed with a pillow under the knees: Elevation of the legs can reduce blood flow to the feet, worsening symptoms. Additionally, putting a pillow under the knees can compress arteries further, exacerbating ischemia.
B. Evaluate the distal pulses: Assessing the distal pulses is crucial for determining the severity of blood flow impairment and helps in understanding the extent of peripheral arterial disease.
C. Cover the patient with a blanket: While warmth might provide some comfort, it does not address the underlying vascular issue and is not a primary intervention for this condition.
D. Notify the physician: While it may be necessary eventually, evaluating the patient's distal pulses first will provide critical information that the nurse can report to the physician.

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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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