ADULT HEATH 2 THE FIRST 15

A nurse is assessing a patient who has been diagnosed with venous insufficiency. What would she expect to see? Select all: •A. swelling of the legs or ankles (edema) •B. pain that gets better when you stand and gets worse when you raise your legs •C. aching, throbbing, or a feeling of heaviness in your legs •D. thickening of the skin on your legs or ankles •E. skin that is changing color, especially around the ankles •F. Ulcers on the foot

A C D E Normally, the valves in your veins make sure that blood flows toward your heart. But when these valves don't work well, blood can also flow backwards. This can cause blood to collect (pool) in your legs.pain that gets WORSE when you stand and gets BETTER when you raise your legs. Ulcers are common on the lower legs

Because a client has mitral stenosis and is a prospective MECHANICAL valve recipient, the nurse preoperatively assesses the client's past compliance with medical regimens. Lack of compliance with which of the following regimens would pose the greatest health hazard to this client A. Medication Therapy B. Diet Modification C. Activity Restrictions D. Dental Care

A •Anticoagulants may be prescribed for the client with advanced valvular heart disease to prevent emboli. •Post-op, all clients with mechanical valves are maintained indefinitely on anticoagulation therapy. Adhering strictly to a dosage schedule and observing specific precautions are necessary to prevent hemorrhage or thromboembolism. Patient will need maintain proper labs for anticoagulation. •Episodic prophylaxis is required to prevent infective endocarditis after dental procedures or upper respiratory, GI, or GU surgery.

Select all the signs and symptoms associated with Hepatitis? A. Arthralgia B. Bilirubin 1 mg/dL C. Ammonia 15 mcg/dL D. Dark urine E. Vision changes F. Yellowing of the sclera G. Fever H. Loss of appetite

A, D, F, G, and H. The bilirubin and ammonia levels are normal in these options, but they would be abnormal in Hepatitis. A normal bilirubin is 1 or less, and a normal ammonia is 15-45 mcg/dL.

A nurse is providing discharge teaching to the partner of a client who has a new diagnosis of hepatitis A. Which of the following instructions should the nurse include in the teaching? •A. Encourage her to eat foods high in carbs •B. Have her perform moderate exercise to restore her strength more quickly •C. During the illness, she may take Tylenol (acetaminophen) for fever or discomfort D. The provider will prescribe medication to help her liver heal faster

A. Clients diet should be high in carbs and calories, with only moderate amounts of protein, and fat, especially if nausea is present.

A nurse is caring for patient that has cirrhosis. Which of the following medications can the nurse expect to administer to the client select all that apply A. Diuretic B. Beta‑blocking agent C. opioid analgesic D. lactuloseE. sedative

A. Diuretic - treats ascites (accumulation of fluid in abdomen) caused by portal hypertension- high blood pressure in the veins that bring blood to the liver B. Beta‑blocking agent -By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol help to lower the blood pressure in the portal veins D. Lactulose - rids the body of ammonia through the GI system (BM). It will prevent a build of ammonia that could lead to hepatic encephalopathy.

A patient is receiving treatment for infective endocarditis. The patient has a history of intravenous drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a transesophageal echocardiogram tomorrow. On assessment, you find tender, red lesions on the patient's hands and feet. You know that this is a common finding in patients with infective endocarditis and is known as?

A. Janeway Lesions B. Roth Spots C. Osler's Nodes D. Trousseau's Sign Answer is C...Osler's Nodes. ◦ They are TENDER, red lesions on the hands and feet. Don't get this confused with Janeway Lesions which are NON-TENDER, red lesions on the PALMS of the hands and SOLES of the feet. Roth spots are retinal hemorrhages with white centers and Trousseau's Sign is found in hypocalcemia.

A nurse is reviewing the medical record of a client who has heart failure. Which of the following findings should the nurse expect? •A. BNP of 200 •Bradycardia •Fluid restriction of 3 L per day •4 g sodium diet

A. Ventricular natriuretic peptide or brain natriuretic peptide, also known as B-type natriuretic peptide, is a hormone secreted by cardiomyocytes in the heart ventricles in response to stretching caused by increased ventricular blood volume. The nurse should identify that a client who has heart failure will have an elevated B- type natriuretic peptide (BNP) level of > 100. BNP is released into the clients bloodstream due to decreased cardiac output, a process called natriuresis.

You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: select all that apply A. Excessive coughing B. Sleeping on the back C. Drinking juice D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

A. excessive coughing D. alcohol consumption F. vomiting Esophageal varices are dilated vessels that are connected from the throat to the stomach. They can become enlarged due to portal hypertension in cirrhosis and can rupture (this is a medical emergency). The patient should avoid activities that could rupture these vessels, such as excessive cough, vomiting, drinking alcohol, and constipation (straining increases thoracic pressure.)

A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? •A. Aspirin EC 325 mg per NG tube daily •B. Atorvastatin 40 mg per NG tube daily •C. Propranolol 20 mg per NG tube daily •D. Sucralfate 2 g oral suspension per NG tube BID

Aspirin cannot be crushed because it is EC • •Atorvastatin is a used to treat high cholesterol •Propanol is a beta blocker used to treat tachycardia • •Sucralfate is an antacid, that can be used to treat ulcers

A nurse is assisting with obtaining an electrocardiogram (ECG) for a client who has atrial fibrillation. Which of the following actions should the nurse take? A. Keep the client NPO after midnight. B. Inspect the electrode pads. C. Wash the skin with plain water before placing the electrodes. D. Instruct the client not talk during the test. E. Administer an analgesic prior to the procedure.

B & D Keep the client NPO after midnight is incorrect. The client will not receive anesthesia for to the test, so he does not need to follow a food or fluid restriction prior to the test. Inspect the electrode pads is correct. The gel is necessary to promote electrical conduction between the skin and the electrodes; therefore, the nurse should inspect the electrode pads to check that the gel is present. Wash the skin with plain water before placing the electrodes is incorrect. The nurse should wipe the skin with alcohol where she will place the electrodes to ensure the skin is free of oils. Instruct the client not talk during the test is correct. The nurse should instruct the client to lie quietly and not to talk or move to prevent the recording of artifact. Administer an analgesic prior to the procedure is incorrect. The client does not need to receive an analgesic prior to the test because the test is noninvasive and does cause any discomfort

A nurse is caring for a patient with myocarditis. The nurse has assessed vital signs, What next should the nurse do next?Select All... A.Instruct patient to drink fluids to flush out the virus B.Place a bedside commode in the room C.Elevate the HOB D.Assess level of consciousness E.Assist the patient with a bedpan F.Assess the patient for dyspnea, hypotension, and tachycardia.

B, C, D, F Bedside commode is less stressful to the workload of the heart than a bed pan Keeping the head of the bed elevated will reduce the workload on the heart. Assess cardiovascular status frequently, watching for signs of heart failure, such as dyspnea, hypotension, and tachycardia.

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply: •A. Increase albumin levels •B. Ascites •C. Splenomegaly •D. Fluid volume deficient •E. Esophageal varices

B, C, and E. ascites, splenomegaly, esophageal Portal Hypertension is where the portal vein becomes narrow due to scar tissue in the liver, which is restricting the flow of blood to the liver. Therefore, pressure becomes increased in the portal vein and affects the organs connected via the vein to the liver. The patient may experience ascites, enlarged spleen "splenomegaly", and esophageal varices etc.

Which patients below are at risk for developing complications related to a chronic hepatitis infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply: A. A 55-year-old male with Hepatitis A. B. An infant who contracted Hepatitis B at birth. C. A 32-year-old female with Hepatitis C who reports using IV drugs. D. A 50-year-old male with alcoholism and Hepatitis D. E. A 30-year-old who contracted Hepatitis E.

B,C,D Infants or young children who contract Hepatitis B are at a very high risk of developing chronic Hepatitis B (which is why option B is correct). Option C is correct because most cases of Hepatitis C turn into chronic cases and IV drug use increases this risk even more. Option D is correct because Hepatitis D occurs when Hepatitis B is present and constant usage of alcohol damages the liver. Therefore, the patient is at high risk of developing chronic hepatitis. Hepatitis A and E tend to only cause acute infections....not chronic

Select all the ways a person can become infected with Hepatitis B A. Contaminated food/water B. During the birth process C. IV drug use D. Undercooked pork or wild game E. Hemodialysis F. Sexual intercourse

B,C,E,F Hepatitis B is spread via blood and body fluids. It could be transmitted via the birthing process, IV drug use, hemodialysis, or sexual intercourse etc.

A nurse is completing dietary teaching with a client who has heart failure and is prescribed a 2 g sodium diet. Which of the following statements by the client indicates an understanding of the teaching •A. I should use salt sparingly while cooking •B. I can have yogurt as a dessert •C. I should use baking soda when I bake •D. I should use canned vegetables instead of frozen

B. The client understands the teaching when he selects yogurt as a dessert. Yogurt is a good source of calcium and protein. •Choose fat-free or low-fat dairy products. •Fat-free or low-fat (1%) milk •Fat-free or low-fat plain yogurt •Low-sodium or reduced-sodium cheese Always choose fresh over frozen Know your conversions from mg to gram or gram to mg Remember everyone has a different opinion on what is sparing

A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering to treat atrial fibrillation? •A. Atropine •B. Diltiazem •C. Epinephrine •D. Phenytoin

B. Diltiazem is a calcium channel blocker and is used to slow the ventricular rate in atrial fibrillation or flutter. Diltiazem is also prescribed to treat hypertension, angina, and other tachyarrhythmias

A nurse is caring for a client who has severely elevated blood pressure. Which of the following findings should the nurse identify as a manifestation of hypertension? •A. vertigo •B. epistaxis •C. exophthalmos (bulging eye ball) •D. spondylolisthesis (slipping forward of the vertebral bone)

B. Epistaxis (a nosebleed) is a manifestation of elevated blood pressure. Hypertension is often asymptomatic, but when it is severely elevated, it can also cause headaches, dizziness, facial flushing, and fainting

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. Inform patients that they should avoid using heating pads on their lower extremities because they do not have good sensation and they at high risk for burns.

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? Select all A.Flush the tube with water B.Place the client in the semi-fowlers position C.Cleanse the skin around the tube site D.Aspirate the tube for residual contents

B. Place the client in the semi-fowlers position. (Use ABC priority framework D. To see if patient is tolerating the feeding

Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver (select all that apply)? a. Avoid or limit air travel. b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder. e. Avoid microwave ovens because they interfere with pacemaker function.

B. Take and record a daily pulse rate. C. Obtain and wear a Medic Alert ID device at all times. D. Avoid lifting arm on the side of the pacemaker above shoulder.

Your patient is diagnosed with acute cholecystitis. The patient is extremely nauseous. A nasogastric tube is inserted with GI decompression. The patient reports a pain rating of 9 on 1-10 scale and states the pain radiates to the shoulder blade. Select all the appropriate nursing interventions for the patient: •A. Encourage the patient to consume clear liquids. •B. Administered IV fluids per MD order. •C. Provide mouth care routinely. •D. Keep the patient NPO. •E. Administer analgesic as ordered. •F. Maintain low intermittent suction to NG tube.

B. administer IV fluids per MD order C. provide mouth care routinely D. keep the patient NPO E. administer analgesic as ordered F. maintain low intermittent suction to NG tube The treatment for cholecystitis includes managing pain, managing nausea/vomiting (a NG tube with GI decompression (removal of stomach contents) to low intermittent suction may be ordered to help severe cases), keep patient NPO until signs and symptoms subside, mouth care from vomiting and nasogastric tube, and administer IV fluids to keep the patient hydrated.

A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets •A. Nitroglycerin •B. Aspirin •C. Morphine •D. Metoprolol

B. aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect. The client should chew the first dose of aspirin to allow rapid absorption

What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis? •A. Vaccination •B. Proper disposal of needles •C. Hand hygiene •D. Blood and organ donation screening

C Hand hygiene Hand hygiene can help prevent all types of viral hepatitis. However, not all types of viral Hepatitis have a vaccine available or are spread through needle sticks or blood/organs donations. Don't forget - Hepatitis A and E are spread only via fecal-oral routes. Vaccination is the best protection against HAV & HBV So if a person is exposed to Hep A, make sure others living in the household get the vaccination.

You're assessing a patient's health history. 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 the 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."

C is known as intermittent claudication and is a HALLMARK sign and symptom in PAD.Peripheral arterial disease occurs when there is 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. It 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.

You're providing discharge teaching to a patient being treated for endocarditis. Which statement by the patient demonstrated they understood your teaching about this condition? A. "I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic resistance." B. "I will only wash my hands with soap and water." C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures." D. "I will avoid eating fish and organ meats

C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures Some dental procedures that can cut your gums also may allow bacteria to enter your bloodstream

When teaching a patient about risk factors for AAA, which of the following, if stated by the patient indicates correct understanding? A) Taking ACE inhibitors or ARBS B) Being female C) Genetic disorder D) Straining while pooping

C. Aortic Aneurysm can be caused by being male, smoking, family history or congenital weakness, and hypertension

The MOST common cause of peripheral arterial disease is? A. Diabetes B. DVT C. Atherosclerosis D. Pregnancy

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. Based on the signs and symptoms in the scenario above, the patient is experiencing peripheral VENOUS (PVD) 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 nurse is planning care for a client who has cholelithiasis. Which of the following interventions should the nurse include in the plan? A. Restrict the client's fluid intake B. Restrict the clients calcium intake C. Decrease the clients fat intake D. Decrease the clients potassium intake

C. Decrease the clients fat intake The nurse should decrease the client's fat intake to reduce the occurrence of biliary colic

During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings? •A. Decreased magnesium level •B. Increased calcium level •C. Increased ammonia level •D. Increased creatinine level

C. Increased ammonia level Based on the assessment findings and the fact the patient has cirrhosis, the patient is experiencing hepatic encephalopathy. This is due to the buildup of toxins in the blood, specifically ammonia. The flapping motion of the hands is called "asterixis". Therefore, an increased ammonia level would confirm these abnormal assessment findings

A nurse is providing discharge teaching to a client who has an implantable cardioverter/defibrillator (ICD). Which of the following information should the nurse include? •A. The client cannot travel by air due to security screening. •B. The client should hold his cell phone on the side opposite the ICD. •C. The client should avoid the use of small electric devices. D. The client can carry his ICD in a small pocket

C. The client should keep his cellular phone on the side opposite the ICD, as close proximity could interfere with the ICD's function.

Your recent admission has acute cholecystitis. The patient is awaiting a cholecystostomy. What signs and symptoms are associated with this condition? Select all that apply A. Right lower quadrant pain with rebound tenderness B. Negative Murphy's Sign C. Epigastric pain that radiates to the right scapula D. Pain and fullness that increases after a greasy or spicy meal E. Fever F. Tachycardia G. Nausea

C. epigastric D. pain and fullness that increases after a greasy or spicy meal E. fever F. tachycardia G. nausea What warrants an immediate call to the MD?

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? •A. Thrombophlebitis •B. Hyperactive reflexes •C. Muscle weakness •D. Hypoglycemia

C. muscle weakness Chlorothiazide is a diuretic used to treat hypertension and CHF. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Muscle weakness is a sign of hypokalemia

A nurse is monitoring the lab results of a client who has end-stage liver failure. Which of the following results should the nurse expect? A.Increased serum albumin B.Decreased lactate dehydrogenase C.Decreased serum ammonia D.Increased prothrombin time

D increased prothrombin time Clients who have end-stage liver failure have an inadequate supply of clotting factors and an increased (prolonged) prothrombin time. -All other levels are reversed. Lactate dehydrogenase is an enzyme involved in energy production that is found in almost all of the body's cells. Patients with advanced cirrhosis almost always have hypoalbuminemia caused both by decreased synthesis by the hepatocytes and water and sodium retention that dilutes the content of albumin in the extracellular space

A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? •A. Pain in right upper quadrant radiating to right shoulder •B. Report of pain being worse when sitting upright. •C. Pain relieved with defecation. .D. Epigastric pain radiating to the left shoulder

D. Epigastric refers to the upper region of the abdomen. When the pancreas is swollen it puts more pressure into the LUQ causing pain to radiate to the left shoulder

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? •A. Hepatomegaly •B. Pitting peripheral edema •C. Jugular vein distention •D. Crackles in the lung bases

D. Left sided heart failure presents with pulmonary symptoms such as crackles, dyspnea, cough and orthopnea.

You're caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are •A. High cholesterol and alcohol abuse •B. History of diabetes and smoking •C. Pancreatic cancer and obesity •D. Gallstones and alcohol abuse

D. Main causes of acute pancreatitis are gallstones and alcohol consumption. Remember: Abdominal pain is the predominant symptom. LUQ or mid-epigastrium, commonly radiates to shoulder or back, often occurs 24-48 hrs after fatty meal or heavy alcohol intake. Can have abdominal tenderness with guarding and rigidity, also can be deep, severe, piercing and continuous pain. frequent onset when patient lying down

A nurse is providing teaching to a client who has hypertension and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching •A. Discontinue the medication if a rash develops. •B. Expect increased salivation during the first few weeks of therapy •C. Minimize fiber intake to prevent diarrhea •Avoid driving until the clients reaction to the medication is known.

D. clonidine Avoid driving until the clients reaction to the medication is known. cause drowsiness, weakness, sedation and other CNS effects. Over time, these effects are likely to decrease.

A patient is admitted to the ER with the following signs and symptoms: very painful mid-epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called? •A. Grey-Turner's Sign •B. McBurney's Sign •C. Homan's Sign •D. Cullen's Sign

D. cullens sign This is known as Cullen's Sign. It represents retroperitoneal bleeding from the leakage of digestive enzymes from the inflamed pancreas into the surrounding tissues which is causing bleeding and it is leaking down to umbilicus tissue. Remember the C in Cullen for "circle" and the belly button forms a circle. The patient can also have Grey-Turner's Sign which is a bluish discoloration at the flanks (side of the abdomen). Remember this by TURNER ("turn her" over on her side) which is where the bluish discoloration will be.

The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly? A. Abdominal girth is decreased B. Skin turgor is less than 2 seconds C. Blood glucose is 250 D. Stools appear formed and solid

D. stools appear formed and solid Pancreatic enzymes help the body break down carbs, proteins, and fats because the body is not sufficiently producing digestive enzymes anymore. Hence, the stool will not appear as oily or greasy (decrease in steatorrhea) but appear solid and formed. Remember these treatments: •Effective pain management •Low-fat, bland diet •Supplemental pancreatic enzymes •ELIMINATE ALCOHOL •Bile salts to facilitate absorption of fat soluble vitamins (ADEK) •Control diabetes à teach to monitor blood glucose •Antacids and anticholinergics to decrease gastric acid •it sometimes takes large, frequent doses of analgesic to relieve pain •small frequent meals, patient do not tolerate fatty, rich and stimulating foods •take after meals, have little overall effect on pt outcomes

On physical assessment of a patient with pericarditis, you may hear what type of heart sound? A. S3 or S4 B. mitral murmur C. pleural friction rub D. pericardial friction rub

Dpericardial friction rub •When you have pericarditis, the membrane around your heart is red and swollen, like the skin around a cut that becomes inflamed. Sometimes there is extra fluid in the space between the pericardial layers, which is called pericardial effusion. •pericardial friction rub is a scratching, grating, high pitched sound believed to result from friction between the roughened pericardial and epicardial surfaces. Best heard with the stethoscope diaphragm placed at the apex of the chest. It is hard to differentiate from pleural friction rub, so you can have the patient hold their breath

A patient is diagnosed with Raynaud's Disease. Which explanations below most accurately describe this condition? Select all that 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

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. vasospasm. ◦ Management: patient teaching- preventing recurrent episodes, instruct patient to wear loose, warm clothing as protection from the cold, avoid temperature extremes at all times (exercise indoor during winter months), stop using tobacco, avoid caffeine, stress management. ◦ Treatment: calcium channel blocker is the first line drug therapy when conservative measures are ineffective. Remember, calcium channel blockers work by relaxing smooth muscle of arterioles by blocking influx of calcium into the cells. This reduces frequency and severity of vasospastic attacks

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 that 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

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."

Peripheral venous disease can occur due to narrowing of the valves in the veins of the lower extremities True and False

false Peripheral venous disease can occur due to overstretched valves of the veins (NOT narrowed) in the lower extremities. In addition, it can occur when the veins become damaged

Which of the following are signs and symptoms of worsening heart failure? Select all that apply •A. Weight gain of 6 pounds per week •B. Worsening or new onset of cough •C. Hypotension •D. Increased SOB •E. Confusion •F. Increased urine output

•A. Weight gain of 6 pounds per week •B. Worsening or new onset of cough •C. Hypotension •D. Increased SOB •E. Confusion •F. Increased urine output Fluid backs up into the lung, abdomen, liver, lower body. Perform daily weights at same time everyday and report to MD weight gain of 2 lbs. in a day or 5lbs in a week. if you have a patient that complains of shortness of breath and cough and reports that they are taking cough medicine to control the cough, you should educate them that the cough they are experiencing could be a worsening of their heart failure Place client in high fowlers position: helps decrease venous return because of the pooling of blood in the extremities. Also increases thoracic capacity, allowing for improved ventilation.

A nurse in a clinic is assessing the lower extremities and ankles of a client who has a history of peripheral arterial disease. Which of the following findings should the nurse expect? •A. Pitting edema •Areas of reddish-brown pigmentation •Dry, pale skin with minimal body hair •Sunburned appearance with desquamation

•C. Dry, pale skin with minimal body hair Peripheral artery disease is a circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease, your extremities, usually your legs, don't receive enough blood flow to keep up with demand A client who has peripheral arterial disease can display dry, scaly, pale, or mottled skin with minimal body hair because of narrowing of the arteries in the legs and feet. This causes a decrease in blood flow to the distal extremities, which can lead to tissue damage. Common manifestations are intermittent claudication (leg pain with exercise), cold or numb feet as rest, loss of hair on lower legs, and weakened pulses. Do not confuse this with chronic venous insufficiency (CVI) Normally, the vein valves keep blood moving back toward the heart. CVI is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs. CVI causes blood to "pool" or collect in these veins, and this pooling is called stasis. Symptoms include varicose veins, swelling, or skin color changes (reddish- brown pigmentation) on the affected leg. If the condition progresses, leg ulcers can form. •Treatment includes compression stockings, elevating the legs, and moisturizing the skin to prevent cracks. In some cases, surgery may be needed to improve blood flow.