The nurse correctly tells the client and family member how angioplasty with stenting is utilized to treat angina by using which explanation?
"A tiny balloon is used to open up the blocked artery and a wire mesh stent is placed to keep the artery open."
"The blocked artery is bypassed to an areas where there is proper blood flow for the heart muscle."
"A tiny blade is used to cut away the plaque buildup and a stent is placed to keep the blood flowing properly."
"The blood clot or plaque is dissolved, allowing for adequate blood flow and oxygen to flow to the heart muscle."
The Correct Answer is A
A. "A tiny balloon is used to open up the blocked artery and a wire mesh stent is placed to keep the artery open.": Percutaneous transluminal coronary angioplasty involves inflating a balloon to compress atherosclerotic plaque against the arterial wall. The subsequent placement of a stent provides structural support to prevent the vessel from recoiling or reclosing. This accurately describes the mechanical process of restoring coronary blood flow.
B. "The blocked artery is bypassed to an areas where there is proper blood flow for the heart muscle.": This explanation describes a coronary artery bypass graft (CABG), which is a surgical procedure, not an angioplasty. Bypassing involves using a graft vessel to create a new route for blood flow around an obstruction. Angioplasty is a minimally invasive catheter-based intervention that works within the original vessel.
C. "A tiny blade is used to cut away the plaque buildup and a stent is placed to keep the blood flowing properly.": The use of a cutting device to remove plaque is known as an atherectomy, which is a different procedure from standard angioplasty. While sometimes used together, angioplasty primarily relies on pressure and displacement rather than excision. Atherectomy is reserved for specific types of calcified or hard lesions.
D. "The blood clot or plaque is dissolved, allowing for adequate blood flow and oxygen to flow to the heart muscle.": This describes thrombolytic therapy or fibrinolysis, which uses medications to chemically break down clots. Angioplasty is a mechanical intervention rather than a pharmacological one. While medications are used during the procedure, the primary mechanism of opening the vessel is physical dilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "I will notify my doctor if my urine output increases after a few doses.": Diuresis is the intended pharmacological outcome for a patient with heart failure receiving loop diuretics. Increased urinary frequency and volume indicate that the medication is effectively reducing fluid overload. Reporting this expected finding would be an unnecessary use of clinical resources.
B. "I will not eat my usual banana with my breakfast cereal in the morning.": Furosemide promotes the excretion of potassium in the distal tubule and the loop of Henle. Bananas are a high-potassium food that helps prevent the development of hypokalemia during diuretic therapy. Restricting dietary potassium while taking a non-potassium-sparing diuretic increases the risk of cardiac arrhythmias.
C. "I will need to change positions slowly when going from laying down to sitting and then sitting to standing.": Rapid fluid volume reduction and vasodilation can lead to a significant drop in blood pressure upon standing. This orthostatic hypotension increases the risk of falls and syncope in older adult patients. Gradual transitions allow the body's baroreceptors to adjust and maintain adequate cerebral perfusion.
D. "I will take my furosemide with a full glass of water just before bed time.": Administering loop diuretics in the evening results in nocturia, which disrupts the patient's sleep cycle and increases fall risks at night. Medication should be taken in the morning to allow for peak diuresis during waking hours. Timing the dose correctly is essential for maintaining patient safety and quality of life.
Correct Answer is A
Explanation
A. Peripheral vascular disease: Intermittent claudication, or pain that occurs during ambulation and is relieved by rest, is a hallmark of arterial insufficiency. Mottling and hairlessness are objective signs of chronic tissue ischemia due to reduced peripheral blood flow. These findings indicate that the arterial supply is failing to meet the metabolic demands of the lower extremity.
B. Coronary artery disease: This condition involves the narrowing of the arteries supplying the heart muscle, typically presenting as chest pain or angina. While it shares the same underlying atherosclerotic process as peripheral vascular disease, it does not directly cause leg mottling or hairlessness. The client’s specific symptoms are localized to the peripheral rather than the cardiac circulation.
C. Right sided heart failure: Right-sided failure primarily manifests as systemic venous congestion, leading to jugular venous distention and dependent edema. It does not typically cause intermittent claudication or the skin changes associated with arterial deprivation. While it affects the lower extremities, it presents with swelling rather than mottling and hair loss.
D. Arterial embolism: An acute embolism usually presents with the "six Ps," including sudden, severe pain, pulselessness, and pallor. The client's report of intermittent pain relieved by rest suggests a chronic, progressive narrowing rather than an acute, total occlusion. An embolism is an emergency that would not typically be relieved simply by resting.
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