Question

Which assessment finding on a 78-year-old woman most likely reflects age-related decreased blood vessel elasticity and increased peripheral resistance? A. An irregular peripheral pulse B. An increase in blood pressure C. Night time confusion D. Wide QRS complexes on the ECG

Short answer

An increase in blood pressure (Option B) is the most likely assessment finding that reflects age-related decreased blood vessel elasticity and increased peripheral resistance.

Step-by-step solution

- Understand Age-Related Changes

Acknowledge that with aging, blood vessels tend to lose their elasticity, leading to arteriosclerosis. This stiffening of the blood vessels can cause increased peripheral resistance within the cardiovascular system.

- Associate Clinical Manifestations

Increased peripheral resistance due to decreased elasticity typically results in elevated blood pressure. Therefore, an increase in blood pressure can be a direct indication of such age-related changes in the cardiovascular system.

- Eliminate Unrelated Options

An irregular peripheral pulse is more indicative of arrhythmias or peripheral vascular disease than of decreased elasticity and increased peripheral resistance. Night time confusion could be related to various factors such as neurological changes or medication effects. Wide QRS complexes indicate issues with ventricular depolarization and are not directly associated with vessel elasticity and peripheral resistance.

- Select the Most Likely Finding

Based on the understanding of physiological changes and by eliminating the unrelated options, determine that an increase in blood pressure (Option B) is the most likely clinical finding that reflects age-related decreased blood vessel elasticity and increased peripheral resistance.

Key concepts

Blood Vessel Elasticity

As individuals age, one of the most significant changes observed within the cardiovascular system is a reduction in the elasticity of blood vessels. The walls of arteries are normally elastic, enabling them to stretch and recoil as the heart pumps blood through them. This elasticity helps to maintain steady blood flow and accommodate the variations in blood pressure that occur with physical activity and rest. But with age, the structural proteins within the vessel walls, such as elastin and collagen, undergo changes that lead to stiffness, a condition known as arteriosclerosis.

Arteriosclerosis can have wide-ranging effects on the body's circulation. Decreased elasticity means that arteries are less able to expand with each heartbeat. As a result, when the heart pumps blood, the pressure within these less pliant arteries increases, leading to higher systolic blood pressure readings. Over time, this increased workload on the heart can lead to hypertrophy of the heart muscle and other cardiovascular complications.

Understanding the impact of this loss of elasticity is crucial for healthcare providers as it influences how they monitor and manage the health of their aging patients. For example, medications that target blood pressure and promote vascular health are often a vital part of treatment plans for older adults.

Peripheral Resistance

Peripheral resistance refers to the opposition to blood flow offered by the arterioles, the small branches of arteries that lead into capillaries. It is an essential factor in determining blood pressure levels. Several factors can influence peripheral resistance, including blood vessel diameter, blood viscosity, and the overall length of the vascular network. In the context of aging, increased peripheral resistance often accompanies the decrease in blood vessel elasticity.

As vessels become more rigid, their ability to dilate in response to increased blood flow is impeded. This failure to dilate properly creates a higher resistance for the blood to overcome, thus raising blood pressure. Increased peripheral resistance can place undue stress on the cardiovascular system, potentially leading to conditions such as hypertension, left ventricular hypertrophy, and an increased risk of heart failure or stroke.

Management of increased peripheral resistance often includes lifestyle modifications such as exercise, diet changes, and if necessary, pharmacotherapy to improve vessel function and reduce blood pressure. These approaches aim to reduce the cardiovascular risks associated with high resistance in the peripheral vasculature.

NCLEX-RN Examination Preparation

Preparing for the NCLEX-RN examination is a pivotal step for nursing students aiming to become registered nurses. The NCLEX-RN tests a candidate's knowledge and ability to apply concepts related to quality and safe patient care, including the physiological adaptations across a patient's lifespan - such as age-related cardiovascular changes.

To effectively prepare for questions on cardiovascular topics, including blood vessel elasticity and peripheral resistance, students should familiarize themselves with the physiological principles and be able to recognize the clinical manifestations of these changes. A solid understanding of how these changes affect blood pressure and overall cardiovascular health is critical.

Study plans for the NCLEX-RN should incorporate a variety of learning methods, including review courses, practice questions, and simulations that address gerontological nursing care. Resources such as textbooks, peer discussion groups, and online platforms that offer step-by-step solutions to textbook exercises can significantly enhance comprehension of cardiovascular principles. Students should also focus on mastering test-taking strategies, managing time effectively, and building stamina for this comprehensive examination.