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 B
Explanation
A. Irregular heart beat with a rate of 86 bpm: While a rate of 86 is within the normal range, the persistence of an irregular rhythm indicates that the client has not returned to normal sinus rhythm. The primary goal of therapy includes rhythm stabilization or better rate control. An irregular rhythm still suggests a deviation from the previous day's successful conversion.
B. No edema noted in the bilateral extremities: The resolution of peripheral edema is a direct indicator that diuretic therapy and heart failure management have been effective. It demonstrates that the excess fluid has been successfully mobilized and excreted from the body. This finding confirms an improvement in the client's congestive state.
C. hypoactive bowel sounds in all 4 quadrants: Hypoactive bowel sounds were present at the start of the assessment and their persistence does not indicate a successful cardiovascular intervention. This finding is likely unrelated to the primary cardiac issue or may be a side effect of other medications. Improvement in cardiac output usually improves systemic perfusion, including the gut.
D. Decreased urine output: Successful treatment with a diuretic like furosemide should result in increased, not decreased, urine output. A decrease in output would suggest worsening renal perfusion or a lack of response to the medication. Effective management of heart failure aims to reduce fluid volume through diuresis.
Correct Answer is D
Explanation
A. Insert a 20-gauge peripheral IV catheter: Establishing venous access is necessary for administering intravenous diuretics but is not the most immediate action. Assessment of the clinical status must precede invasive interventions to determine the severity of the fluid overload. The nurse should prioritize gathering objective data on respiratory compromise before performing venipuncture.
B. Administer oxygen at 2 liters per minute via nasal cannula: The current oxygen saturation is 94% on room air, which is generally considered acceptable for many patients. While supplemental oxygen may be indicated later, it is not the most critical first step given these stable saturation levels. Respiratory assessment should guide the necessity and titration of oxygen therapy.
C. Place the client on a cardiac monitor: Continuous cardiac monitoring is important for detecting arrhythmias associated with heart failure or electrolyte shifts. However, it does not provide immediate information regarding the patient's primary risk of pulmonary congestion or respiratory distress. Monitoring is an adjunctive task rather than the primary diagnostic priority.
D. Auscultate the client's breath sounds: Assessing for crackles or diminished sounds is the priority to determine the extent of pulmonary edema. This assessment provides immediate data on the severity of the fluid-volume overload and the risk of respiratory failure. Objective respiratory findings are essential for prioritizing subsequent medical and nursing interventions.
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