In your patient with chronic kidney disease, you know that it is important to teach them about lifestyle modifications and make sure they are on the proper treatment in regards to hypertension, Why is it necessary for them to control their blood pressure?
So they do not have to miss their dialysis treatments
To prevent increased urine output
They should not be on multiple blood pressure medications
Due to an increased risk of death due to cardiovascular disease (CVD)
The Correct Answer is D
A. So they do not have to miss their dialysis treatments is incorrect because blood pressure control is not primarily about dialysis attendance. While uncontrolled hypertension may contribute to complications, this is not the main rationale for strict blood pressure management.
B. To prevent increased urine output is incorrect because hypertension does not directly cause increased urine output in chronic kidney disease (CKD). CKD often leads to reduced urine output as kidney function declines.
C. They should not be on multiple blood pressure medications is incorrect because many patients with CKD require combination therapy to effectively manage blood pressure. Avoiding multiple medications is not the primary goal.
D. Due to an increased risk of death due to cardiovascular disease (CVD) is correct because patients with CKD have a significantly higher risk of cardiovascular complications, including heart attack, heart failure, and stroke. Hypertension accelerates kidney damage and contributes to left ventricular hypertrophy and atherosclerosis, increasing morbidity and mortality. Controlling blood pressure is a critical intervention to slow CKD progression and reduce cardiovascular risk, which is the leading cause of death in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Cerebral vasodilation and increased ICP is correct because PaCO2 is a potent regulator of cerebral blood flow (CBF). A PaCO2 of 60 mmHg indicates hypercapnia, which causes cerebral vasodilation, increasing blood volume in the brain and raising intracranial pressure (ICP). This effect can further compromise cerebral perfusion, especially when CPP is already low.
B. Cerebral vasoconstriction and decreased ICP is incorrect because hypocapnia (low PaCO2), not hypercapnia, causes cerebral vasoconstriction, which temporarily reduces cerebral blood flow and ICP.
C. No effect on ICP is incorrect because PaCO2 directly influences cerebral vessel tone. Changes in PaCO2 significantly affect ICP and are a key consideration in mechanically ventilated patients with traumatic brain injury.
Correct Answer is C
Explanation
A. You auscultate the site of anastomosis with your stethoscope and listen for a rushing sound is incorrect because this describes assessing for a bruit, which is the auditory evaluation of blood flow through the AV fistula. While listening for a bruit is important to evaluate patency, it does not assess the thrill, which is a tactilefinding.
B. You place a blood pressure cuff on the arm of the AV fistula to look for pulsations at the site is incorrect because using a blood pressure cuff in this way is not part of standard assessment for thrill and may actually compromise the fistula if pressure is applied inappropriately. Cuffs are used for blood pressure measurement but not for evaluating fistula patency.
C. You want to palpate the site of anastomosis for a buzzing sensation is correct because a thrillis a palpable vibrationfelt over the AV fistula, usually at the site of the anastomosis between the artery and vein. The thrill is produced by turbulent blood flowthrough the fistula and indicates that the access is patent and functioning properly. Nurses assess the thrill by gently placing the fingertips over the fistula; a strong, continuous vibration is expected in a healthy, mature fistula ready for hemodialysis.
D. You check for capillary refill distal from the site of anastomosis is incorrect because capillary refill evaluates peripheral perfusion to the handbut does not provide information about fistula patency or flow. Although distal perfusion is important to assess (to ensure adequate circulation and avoid ischemia), it does not substitute for palpating the thrill or auscultating the bruit.
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