A client with chronic peripheral arterial disease (PAD) asks the nurse why this disease developed. Which explanation by the nurse is most accurate?

"Excess sodium from hypertension causes direct injury to the arteries, reducing blood flow and causing obstruction."

"Excess fats in your diet are stored in the lining of the arteries, causing them to constrict."

"A combination of platelets and fats accumulate, narrowing the artery and reducing blood flow to the extremities."

"Injury to the arteries causes them to spasm, reducing blood flow to the extremities."

Answer and Explanation

The Correct Answer is C

Choice A Reason
While hypertension can contribute to the development of PAD, it does not directly cause fats to deposit in the arteries. Hypertension can damage the arterial walls, making them more susceptible to atherosclerosis, but it is not the primary mechanism of PAD development.

Choice B Reason
Excess fats in the diet can contribute to atherosclerosis, which is the accumulation of plaques in the arterial walls. However, the fats do not simply get stored; they combine with other substances, including calcium and inflammatory cells, to form plaques that can restrict blood flow.

Choice C Reason
This statement is the most accurate. PAD is primarily caused by atherosclerosis, which is the buildup of plaques formed by fats, cholesterol, calcium, and other substances in the blood. These plaques can harden and narrow the arteries, leading to reduced blood flow to the extremities. The process can be exacerbated by factors such as smoking, diabetes, and high cholesterol.

Arterial spasms can occur, but they are not the typical cause of chronic PAD. Spasms are more often associated with conditions like Raynaud's phenomenon or can be a response to stress or cold temperatures. PAD is usually a result of progressive atherosclerosis rather than intermittent spasms.

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Correct Answer is B

Explanation

Choice A reason:
Performing a 12-lead electrocardiogram and calling a rapid response team are important steps when a pulmonary embolism is suspected. However, these actions are not the immediate first-line interventions. The priority is to address the client's oxygenation needs to prevent further hypoxemia and potential cardiac arrest.

Choice B reason:
Elevating the head of the bed and applying 2 liters of nasal oxygen is the most appropriate initial intervention. This position helps improve the expansion of the lungs and oxygenation, while the supplemental oxygen can help alleviate hypoxemia, which is critical in the management of a pulmonary embolism.

Choice C reason:
While ensuring the client remains calm is beneficial, administering lorazepam is not the first-line treatment for a suspected pulmonary embolism. Lorazepam may be used for its anxiolytic effects, but it does not address the immediate life-threatening issues of oxygenation and potential hemodynamic instability.

Choice D reason:
Increasing the intravenous rate may be considered to maintain adequate hydration and venous return, but it is not the first intervention for a suspected pulmonary embolism. The priority is to stabilize the client's respiratory status and oxygenation.

A. Place the client on a 35% Venturi mask. B. Encourage the client to increase liquid intake throughout the day. C. Administer dextromethorphan 30 mg PO every six hours as needed. D. Encourage pursed-lip breathing when the client is out of bed.

Correct Answer is B

Explanation

Choice a reason:
Placing the client on a 35% Venturi mask would provide a controlled amount of oxygen which is beneficial for clients with chronic obstructive pulmonary disease (COPD) who may retain carbon dioxide. However, this intervention is not directly related to the management of a non-productive cough and difficulty expectorating secretions.

Choice b reason:
Encouraging the client to increase liquid intake throughout the day can help thin the bronchial secretions, making them easier to expectorate. Adequate hydration is essential in the management of chronic bronchitis to help clear mucus from the airways.

Choice c reason:
Administering dextromethorphan, a cough suppressant, may be used to control a non-productive cough. However, it would not assist with the expectoration of secretions and could potentially inhibit the cough reflex needed to clear the airways.

Choice d reason:
Encouraging pursed-lip breathing can help improve ventilation and oxygenation by promoting more effective exhalation. This technique can be beneficial for clients with COPD but does not directly address the issue of expectorating secretions.

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A client with chronic peripheral arterial disease (PAD) asks the nurse why this disease developed. Which explanation by the nurse is most accurate?

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