Question

a nurse is assisting in the care of a client who has pulmonary edema and a chronic condition known as renal vascular disease. clients with renal vascular disease have a higher risk of developing pulmonary edema due to which of the following?
occurs prior to myocardial infarction (mi)
decreased cardiac filling pressure
buildup of fluid in the lungs
chronic hypertension

Explanation:

Renal vascular disease often leads to chronic hypertension. Chronic hypertension increases the workload on the heart. Over time, this can cause left - sided heart failure. In left - sided heart failure, the heart cannot pump blood effectively out of the left ventricle. As a result, blood backs up into the pulmonary circulation. This backup of blood increases the pressure in the pulmonary capillaries. When the pressure in the pulmonary capillaries exceeds the oncotic pressure (the pressure that keeps fluid in the capillaries), fluid leaks out of the capillaries and into the alveoli and interstitial spaces of the lungs, causing pulmonary edema.

• Occurs prior to myocardial infarction (MI): Renal vascular disease is not directly related to being a prior event to MI in the context of causing pulmonary edema. MI can cause pulmonary edema due to left - ventricular failure, but the question is about the relationship between renal vascular disease and pulmonary edema.
• Decreased cardiac filling pressure: Decreased cardiac filling pressure would not cause fluid to back up into the lungs. In fact, it would likely lead to decreased cardiac output rather than pulmonary edema.
• Buildup of fluid in the lungs: This is the result (pulmonary edema itself), not the cause related to renal vascular disease.

Answer:

Chronic hypertension