HESI PATHO, Patho Hesi 2021/2022Questions, Pathophysiology
HESI. Graded A+Which rationale best supports an older client's risk of complications related
... [Show More] to a dysrhythmia? - An older client is intolerant of decreased cardiac output which may cause dizziness and falls
In an older client, cardiac output is decreased and a loss of contractility and elasticity reduces systemic and cerebral blood flow, so dysrhythmias, such as bradycardia or tachycardia is poorly tolerated, and increases the client's risk for syncope, falls, transient ischemic attacks, and possibly dementia.
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The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? - Ptosis of the left eyelid
Ptosis is the term to describe an eyelid droop that covers a large portion of the iris
astigmatism -- distortion of the lens of the eye, causing decreased visual acuity.
nystagmus - eye makes uncontrolled movements; oculomotor nerve or eyelid muscle disorder that is characterized by rapid, rhythmic movement of both eyes.
exophthalmos - protrusion of the eyeballs that occurs with hyperthyroidism
The nurse is measuring blood pressure on all four extremities of a child with coarctation of the aorta. Which blood pressure finding should the nurse expect to obtain? - Lower in the legs than the arms
In coarctation of the aorta, a congenital constriction is found at the aorta near the ductus arteriosus region that lies past the left subclavian arteries, which perfuses the upper extremities. the child should have higher blood pressures in the upper extremities than in the legs.
The nurse reviews the CBC findings of an adolescent with acute myelogenous leukemia. The hemoglobin is 13.8, hematocrit is 36.7 WBC is 8,200 and platelet count is 115,000., Based on these findings, what is the priority nursing dx for this client's plan of care? - Risk for injury
A client with AML is at risk for anemia, neurtropenia, and thrombocytopenia. These CBC findings indicate that the platelet count is low (Normal 250,000-400,000) which places this client at an increased risk for injury, usually manifested as bruising or bleeding.
hemoglobin: 12-16 female
14-18 male
hematocrit: 37-47 female
42-52 male
WBC: 5,000-10,000
Platelets: 250,000-400,000
A nurse is planning to teach self-care measures to a female client about prevention of yeasts infections. Which instructions should the nurse provide? - Avoid-tight fitting clothing do not use bubble-bath or bath salts
A common genital tract infection in females is cadidiasis, which is an overgrowth of the normal vaginal flora of Candida albicans that thrives in an environment that is warm and moist and perpetuated by tight-fitting clothing, underwear, or pantyhose made of nonabsorbant materials. The client should wear clothing that is loose fitting and absorbent, such as cotton underwear, and avoid using bubble-bath or bath salts which further irritate sensitive genital tissue
A client with asthma receives a rx for high blood pressure during a clinic visit. Which rx should the nurse anticipate the client to receive that is least likely to exacerbate asthma? - Metoprolol tartrate (lopressor)
The best antihypertensive agent for clients with asthma is lopressor a beta blocking agent which is also cardioselective and less likely to cause bronchocontriction.
Which signs and symptoms are associated with arterial insufficiency? - Pallor, intermittent claudication
Pallor and intermittent claudication are signs related to stage II of PVD, which results in arterial insufficiency. Arterial insufficiency causes impaired perfusion resulting in hypoxic pain or intermittent claudication (pain in legs when working out bc not enough blood flow)
Pedal edema, brown pigmentation are signs related to venous insufficiency
Blanched skin, lower extremity ulcers are not specific to arterial disease
Peripheral neuropathy may be related to complications of diabetes mellitus resulting in poor circulation
A man who was recently diagnosed with huntington's disease asks the nurse if his adolescent son should be tested for the disease. What response is best for the nurse to provide? - Testing is needed bc there is a 50% risk of passing the gene to each offspring
Huntingdon's disease, a progressively incapacitating, fatal neuromuscular disease, is an autosomal dominant inherited disease that has a 50% risk of developing in each child of those who have the disorder. The risk of autosomal dominant inheritance should be explained and emphasized.
A client with aortic valve stenosis develops HF. Which pathophysiological finding occurs in the myocardial cells as a result of the increased cardiac workload? - Increase in size
Hypertension and incompetent or stenotic heart valves cause an increase in the workload of the heart by increasing afterload which requires an increase in teh force of contraction to pump blood out of the heart. Myocardial hypertrophy results bc the cells increase in surface area or size by increasing the amount of contractile proteins, but the quantity of fibers remains constant. As myocardial hypertrophy progresses, the heart becomes ineffective as a pump bc the ventricular wall cannot develop enough tension to cause effective contraction, which causes myocardial irritability due to hypoxia.
While the nurse obt [Show Less]