Peripheral Vascular Disease Worksheet

You're assessing a patient's health history for peripheral vascular disease. What signs and symptoms reported by the patient would indicate the patient may be experiencing peripheral arterial disease? Select all that apply. A. "I often wake up at night with leg pain and have to dangle my leg out of bed to ease the pain." B. "If I stand or sit too long my legs start to feel heavy and achy." C. "It hurts to elevate my legs." D. "Sometimes when I'm walking my legs start to cramp and tingle to the point where I can't walk until the pain goes away."

A. "I often wake up at night with leg pain and have to dangle my leg out of bed to ease the pain." C. "It hurts to elevate my legs." D. "Sometimes when I'm walking my legs start to cramp and tingle to the point where I can't walk until the pain goes away." The answers are A, C, and D. Peripheral arterial disease occurs when there is the impediment of blood flow to the lower extremities (hence the lower extremities are being deprived of blood flow and this causes pain). The pain most commonly occurs at night and can wake up the patient. I t is known as "rest pain". This occurs because when the legs are horizontal the blood flow is compromised and it causes pain...therefore the patient will report they dangle the leg off the bed to help ease the pain (the dependent position (dangling) will help blood flow down to the extremity). In addition, it hurts to elevate the legs (again because this further compromises blood flow). Option B occurs in peripheral venous disease. Option C is known as intermittent claudication and is a HALLMARK sign and symptom in PAD.

Select below all the characteristics that can present with an arterial ulcer A. Found on the lateral malleolus, dorsum of foot, or end of toes B. Found on the medial malleolus or medial part of lower leg C. Deep, round, defines edges and has a "punched out" appearance D. Minimal drainage E. Edematous F. Brown pigmented skin surrounding the ulcer G. Wound base is pale

A. Found on the lateral malleolus, dorsum of foot, or end of toes C. Deep, round, defines edges and has a "punched out" appearance D. Minimal drainage G. Wound base is pale

A patient is diagnosed with Raynaud's disease. What explanations below most accurately describe this condition? Select all the apply A. Raynaud's disease is triggered by cold temperatures or stress B. Raynaud's disease occurs due to a vasospasm of the peripheral veins C. Raynaud's disease affects the toes, fingers, and sometimes the ears and nose D. Raynaud's disease is prevented by glucose control

A. Raynaud's disease is triggered by cold temperatures or stress C. Raynaud's disease affects the toes, fingers, and sometimes the ears and nose The answers are A and C. Raynaud's Disease occurs when vasospasm of peripheral arteries occurs. It mainly affects the fingers and toes (it can also affect the ears/nose). It is triggered by exposure to cold or during stress. It can be prevented by keeping the toes, fingers, ears, and nose warm and avoid stress. Medications can also be used as well that help prevent vasospasm

Your patient has severe peripheral venous disease. During the head-to-toe nursing assessment, you would expect to find what skin characteristics of the lower extremities? Select all the apply A. Thick, tough B. Thin, scaly C. Hairless D. Brown pigmented

A. Thick, tough D. Brown pigmented The answers are A and D. This is commonly found in severe peripheral venous disease. Options B and C are found in peripheral ARTERIAL disease.

A patient has an ulcer on the medial malleolus. The ulcer is shallow with irregular edges. The wound base is red. Wound drainage is also present. What type of ulcer is this based on the scenario's description? A. Venous ulcer B. Arterial ulcer C. Diabetic ulcer

A. Venous ulcer

You're providing discharge teaching to a patient with peripheral arterial disease. Which statement by the patient requires you to re-educate the patient? A. "It is important I quit smoking" B. "To prevent my feet and legs from getting too cold at night, I will use a heating pad" C. "A walking program would be beneficial in treatment of my PAD" D. "I will avoid wearing tight socks or shoes"

B. "To prevent my feet and legs from getting too cold at night, I will use a heating pad" The answer is B. The patient should try to prevent the feet and legs from getting too cold because this causes vasoconstriction, which impedes blood flow further. Therefore, they should dress warmly with LOOSE layers. However, they should AVOID using heating pads because of the reduce of sensation from compromised blood flow. A walking program is a great way to prevent intermittent claudication, lower the cholesterol, and improve oxygen levels in the blood....which are all great ways of treating PAD.

A patient has severe peripheral venous disease. What important information below will the nurse provide to the patient about how to alleviate signs and symptoms associated with the disease? Select all the apply. A. Elevate the lower extremities below heart level frequently B. Application of compression stockings C. Limit long periods of standing and sitting D. Use the knee-flexed position while lying in bed

B. Application of compression stockings C. Limit long periods of standing and sitting The answers are B and C. The patient with peripheral VENOUS disease should elevate the lower extremities ABOVE heart level (this helps return blood to the heart and decrease swelling/pain), avoid crossing the legs (or the knee-flexed position) because this impedes blood flow, and limit long periods of standing and sitting (this limits blood return to the heart and increases swelling). In addition, the application of compression stockings is very beneficial in peripheral venous disease because it helps blood return to the heart and prevents the stasis of blood in the lower extremities.

Your patient has returned from a peripheral artery bypass for the treatment of peripheral arterial disease. The nurse will make it PRIORITY to? A. Assess the surgical site for excessive drainage B. Assess and grade lower extremity pulses bilaterally C. Apply compression stockings D. Elevate the lower extremity above heart level

B. Assess and grade lower extremity pulses bilaterally The answer is B. A peripheral artery bypass is performed to treat severe cases of PAD. The surgeon will "bypass" the blockage in the lower extremity and have blood flow re-routed around the blockage. This will provide blood flow back to the lower extremity. It is PRIORITY that the nurse assesses and grades the lower extremity pulses bilaterally frequently. If the pulses diminish or become absent the nurse should notify the physician immediately.

The most common cause of peripheral arterial disease is? A. Diabetes B. Deep vein thrombosis C. Atherosclerosis D. Pregnancy

C. Atherosclerosis The answer is C. Atherosclerosis is the most common cause of PAD (peripheral arterial disease). This is the collection of fatty plaques on the artery wall. This blocks blood flow.

Your patient reports experiencing dull and achy sensations in the lower extremities. You note that the lower extremities have edema and brownish pigmentation. Pulses are present bilaterally and the extremities feel warm to the touch. To help alleviate the patient's symptoms, the nurse will position the lower extremities in the? A. Dependent position B. Horizontal position C. Elevated position above heart level D. Knee-flexed position

C. Elevated position above heart level The answer is C. Based on the signs and symptoms in the scenario above, the patient is experiencing peripheral VENOUS disease. The blood is stagnant (or static) in the lower extremities and can't flow back to the heart. Therefore, the patient is experiencing dull and achy sensations along with edema and brownish pigmentation. The nurse should place the patient's lower extremities in the elevated position above the heart to help facilitate blood return to the heart and alleviate the pain

A patient has an arterial ulcer on the lower extremity. What risk factors for peripheral arterial disease are in the patient's health history? Select all that apply A. Pregnancy B. Being female C. High cholesterol D. Diabetes mellitus E. Uncontrolled hypertension F. Varicose veins G. Smoking

C. High cholesterol D. Diabetes mellitus E. Uncontrolled hypertension G. Smoking The answers are C, D, E, and G. High cholesterol, diabetes mellitus, uncontrolled hypertension, and smoking are risk factors for peripheral arterial disease (PAD). Pregnancy, being female, varicose veins are risk factors for peripheral venous disease.

Your patient is diagnosed with Buerger's disease. The nurse will make it priority to educate the patient about implementing? A. low fat diet B. Blood glucose control C. Smoking cessation D. Blood pressure control

C. Smoking cessation

Your patient has severe peripheral arterial disease. When the lower extremities are elevated you would expect them to appear _________ and, when they are in the dependent position you would expect them to appear ________. Fill in the blanks A. cyanotic; rubor B. Rubor; pallor C. cyanotic; pallor D. pallor; rubor

D. pallor; rubor The answer is D. In severe PAD, if the lower extremities are elevated they will turn pale (pallor). However, if they are in the dependent position (dangling) they will appear rubor (red and warm...this occurs due to inflammation of the vessels).

True or false. Peripheral venous disease can occur due to narrowing of the valves in the veins of the lower extremities.

False. Peripheral venous disease is associated with over stretched valves

True or false. Peripheral arterial disease leads to a decrease in rich oxygenated blood being delivered to the lower extremities, which leads to ischemia and necrosis of skin tissue

True