Client education about Buerger's disease should include what important life style medication?
smoking cessation.
reduction of alcohol intake.
avoiding cold remedies.
weight reduction.
The Correct Answer is A
A. smoking cessation.: Thromboangiitis obliterans is an inflammatory vascular disease strongly linked to tobacco use. The primary pathophysiological trigger is an autoimmune response to nicotine that leads to segmental vasculitis and digital ischemia. Complete abstinence from all tobacco products is the only effective way to halt the progression of the disease and prevent gangrene or amputation.
B. reduction of alcohol intake.: While excessive ethanol consumption is detrimental to overall cardiovascular health, it is not the primary causative agent for Buerger's disease. Alcohol does not induce the specific segmental inflammation of small and medium-sized arteries seen in this pathology. Smoking cessation remains a far more critical lifestyle modification for these patients.
C. avoiding cold remedies.: Some over-the-counter cold medications contain sympathomimetics that can cause peripheral vasoconstriction. While patients with Raynaud's phenomenon should be cautious, these drugs do not drive the inflammatory process of Buerger's disease. The focus of nursing education must prioritize the elimination of tobacco rather than secondary pharmacological triggers.
D. weight reduction.: Obesity is a significant risk factor for atherosclerosis, but Buerger's disease is a non-atherosclerotic inflammatory condition. While maintaining a healthy body mass index is beneficial for systemic health, it does not stop the specific vasculitis associated with this condition. Tobacco use is the specific modifiable factor that determines the clinical trajectory.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Give 2 rescue breaths: In cardiac arrest due to V.Fib, the priority is circulation. High-quality chest compressions are initiated immediately to maintain perfusion until defibrillation can be performed. Rescue breaths are not the first step.
B. Start chest compressions: V.Fib is a lethal rhythm with no effective cardiac output. Immediate chest compressions are essential to circulate oxygenated blood to vital organs while preparing for defibrillation. This is the first action in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).
C. Assess the client: While assessment is important, in the context of a witnessed rhythm strip showing V.Fib and an alarm, the nurse should assume cardiac arrest and act immediately. Delaying compressions to reassess wastes critical seconds.
D. Call a code blue/call 911: This is necessary, but it comes after starting chest compressions. The priority is to begin CPR without delay, then activate emergency response and prepare for defibrillation.
Correct Answer is D
Explanation
A. Nitroglycerin: This vasodilator is used to treat anginal chest pain by reducing preload and dilating coronary arteries. It has no role in the management of atrial fibrillation, which is characterized by an irregularly irregular rhythm. Using a nitrate here would not address the underlying electrical disorganized activity in the atria.
B. Hydrochlorothiazide: As a thiazide diuretic, this medication is used primarily for the long-term management of hypertension and mild fluid retention. It does not possess any antiarrhythmic properties and would not be effective in controlling the ventricular rate. Diuretics are not the standard of care for treating an acute rhythm disturbance on a telemetry strip.
C. Atropine: This anticholinergic agent is indicated for the treatment of symptomatic bradycardia by increasing the heart rate. Atrial fibrillation often requires rate control to prevent tachycardia-induced cardiomyopathy rather than stimulation of a faster rate. Atropine could potentially worsen the clinical situation by causing a dangerously rapid ventricular response.
D. Warfarin: Atrial fibrillation causes blood to pool in the atria, which significantly increases the risk of mural thrombus formation and subsequent embolic stroke. Anticoagulation is a mandatory component of management to prevent these life-altering thromboembolic complications. Warfarin is a standard oral anticoagulant used to maintain a therapeutic INR in patients with this chronic dysrhythmia.
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