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NURS 8022 Chapter 24: Alterations of Cardiovascular Function Huether & McCance: Understanding Pathophysiology, 6th Edition

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. A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins? a. Extreme exercise b. Long periods of standing c. Trauma to the deep veins d. Ischemia ANS: B The probable cause of the patient’s varicose veins is gradual venous distention caused by the action of gravity on blood in the legs due to long periods of standing. Varicose veins are most likely due to long periods of standing leading to the action of gravity promoting venous distention. Exercise would help prevent this. Trauma can occur, but usually this affects the more superficial veins. Ischemia affects arteries not veins. REF: p. 598 2. A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is: a. deep vein thrombus formation. b. skin hyperpigmentation. c. gangrene. d. edema above the knee. ANS: B Symptoms include edema of the lower extremities and hyperpigmentation of the skin of the feet and ankles but deep vein thrombi do not form. Edema in these areas may extend to the knees but not above. Gangrene does not occur in veins but in arteries. REF: p. 598 3. Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a result of progressive superior vena cava: a. inflammation. b. occlusion. c. distention. d. sclerosis. ANS: B SVCS is a progressive occlusion of the SVC that leads to venous distention in the upper extremities and head. This distention is not a result of progressive inflammation, distention, or sclerosis. REF: p. 5994. A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart? a. Thromboembolism b. Deep vein thrombosis c. Superior vena cava syndrome (SVCS) d. Chronic venous insufficiency ANS: C SVCS is a progressive occlusion of the superior vena cava that leads to venous distention in the upper extremities and head. Thromboembolism would not lead to the generalized symptoms described in the patient. Deep vein thrombosis would not lead to upper extremity symptoms. Chronic venous insufficiency would primarily affect one extremity. REF: p. 59

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