PrepU- Vascular disorders

A client with peripheral arterial disease asks the nurse about using a heating pad to warm the feet. The nurse's best response is which of the following? "It is better to put the heating pad on your abdomen, which causes vasodilation and warmth to your feet." "A heating pad to your feet is fine as long as the temperature stays below 105 degrees F." "A heating pad to your feet is a good idea because it increases the metabolic rate." "It is better to soak your feet in hot water as long as the water temperature is below 110 degrees F."

"It is better to put the heating pad on your abdomen, which causes vasodilation and warmth to your feet."

A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate? Mechanical compression and prophylactic anticoagulation Mechanical compression only Prophylactic anticoagulation only Early ambulation only

Mechanical compression and prophylactic anticoagulation

While receiving a heparin infusion to treat deep vein thrombosis, a client reports bleeding in the gums when brushing teeth. What should the nurse do first? Stop the heparin infusion immediately. Notify the health care provider. Administer a coumarin derivative, as ordered, to counteract heparin. Reassure the client that bleeding gums are a normal effect of heparin.

Notify the health care provider.

A patient is being treated for chronic venous stasis ulcers of the lower extremities. What medication does the nurse understand will increase peripheral blood flow by decreasing the viscosity of blood and assist with the healing of the ulcers? Heparin Warfarin (Coumadin) Aspirin Pentoxifylline (Trental)

Pentoxifylline (Trental)

While receiving heparin to treat a pulmonary embolus, a client passes bright red urine. What should the nurse do first? Decrease the heparin infusion rate. Prepare to administer protamine sulfate. Monitor the partial thromboplastin time (PTT). Start an I.V. infusion of dextrose 5% in water (D5W).

Prepare to administer protamine sulfate.

In preparation for cardiac surgery, a client was taught about measures to prevent venous thromboembolism. What statement indicates that the client clearly understood this education? "I'll try to stay in bed for the first few days to allow myself to heal." "I'll make sure that I don't cross my legs when I'm resting in bed." "I'll keep pillows under my knees to help my blood circulate better." "I'll put on those compression stockings if I get pain in my calves."

"I'll make sure that I don't cross my legs when I'm resting in bed."

A client admitted to the medical-surgical unit with a venous thromboembolism (VTE) is started on enoxaparin and warfarin. The client asks the nurse why two medications are needed. Which response by the nurse is accurate? "Administration of two anticoagulants decreases the risk of recurrent venous thrombosis." "Enoxaparin will dissolve the clot, and warfarin will prevent any more clots from occurring." "The enoxaparin will work immediately, but the warfarin takes several days to achieve its full effect." "Because of the potential for a pulmonary embolism, it is important for you to take at least two anticoagulants."

"The enoxaparin will work immediately, but the warfarin takes several days to achieve its full effect."

Place the pathophysiological steps in order of how a client with obesity is at greater risk for venous thromboembolism in comparison to the general population. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. -Formation of a thrombus -Increased adipose tissue -Blood stasis -Impairment of peripheral blood flow

1.Increased adipose tissue 2Impairment of peripheral blood flow 3.Blood stasis 4.Formation of a thrombus

The nurse is administering anticoagulant therapy with heparin. What International Normalized Ratio (INR) would the nurse know is within therapeutic range? 0.5 to 1.0 1.5 to 2.5 2.0 to 2.5 3.0 to 3.5

2.0 to 2.5

Beginning warfarin concomitantly with heparin can provide a stable INR by which day of heparin treatment? 5 2 3 4

5

Which nursing diagnosis is most significant in planning the care for a client with Raynaud's disease? Acute Pain Disturbed Sensory Perception Self-Care Deficit Activity Intolerance

Acute Pain

A nurse cares for a client who is post op from bariatric surgery. What risk factors does the nurse recognize increases the client's risk for developing venous thromboembolism (VTE)? Select all that apply. Age Higher BMI History of a VTE Gender Ethnicity

Age Higher BMI History of a VTE

The nurse is providing discharge teaching for a client who developed a pulmonary embolism after total knee surgery. The client has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client? Warfarin will continue to break up the clot over a period of weeks Warfarin must be taken concurrent with ASA to achieve anticoagulation. Anticoagulant therapy usually lasts between 3 and 6 months. He should take a vitamin supplement containing vitamin K

Anticoagulant therapy usually lasts between 3 and 6 months.

The nurse is educating a patient with chronic venous insufficiency about prevention of complications related to the disorder. What should the nurse include in the information given to the patient? (Select all that apply.) Avoid constricting garments. Elevate the legs above the heart level for 30 minutes every 2 hours. Sit as much as possible to rest the valves in the legs. Sleep with the foot of the bed elevated about 6 inches. Sit on the side of the bed and dangle the feet.

Avoid constricting garments. Elevate the legs above the heart level for 30 minutes every 2 hours. Sleep with the foot of the bed elevated about 6 inches.

Which of the following is accurate regarding the effects of nicotine and tobacco smoke on the body? Select all that apply. Causes vasospasm Reduces circulation to the extremities Impairs transport and cellular use of oxygen Increases blood viscosity Decreases blood viscosity

Causes vasospasm Reduces circulation to the extremities Impairs transport and cellular use of oxygen Increases blood viscosity

The nurse is assessing a patient with suspected acute venous insufficiency. What clinical manifestations would indicate this condition to the nurse? (Select all that apply.) Cool and cyanotic skin Initial absence of edema Sharp pain that may be relieved by the elevation of the extremity Full superficial veins Brisk capillary refill of the toes

Cool and cyanotic skin Sharp pain that may be relieved by the elevation of the extremity Full superficial veins

A nurse in a long-term care facility is caring for an 83-year-old woman who has a history of heart failure and peripheral arterial disease (PAD). At present, the client is unable to stand or ambulate. The nurse should implement measures to prevent what complication? Aortitis Deep vein thrombosis Thoracic aortic aneurysm Raynaud disease

Deep vein thrombosis

The nurse knows which diagnostic test is used to document the anatomic site of reflux and provides a quantitative measure of the severity of valvular reflux? Contrast phlebography Duplex ultrasound scan Lymphangiography Lymphoscintigraphy

Duplex ultrasound scan

The nurse is admitting a 32-year-old woman to the presurgical unit. The nurse learns during the admission assessment that the client takes oral contraceptives. The nurse's postoperative plan of care should include what intervention? Early ambulation and leg exercises Cessation of the oral contraceptives until 3 weeks postoperative Doppler ultrasound of peripheral circulation twice daily Dependent positioning of the client's extremities when at rest

Early ambulation and leg exercises

The surgeon's preoperative assessment of a client has identified that the client is at a high risk for venous thromboembolism. Once the client is admitted to the postsurgical unit, what intervention should the nurse prioritize to reduce the client's risk of this complication? Maintain the head of the bed at 45 degrees or higher. Encourage early ambulation. Encourage oral fluid intake. Perform passive range-of-motion exercises every 8 hours.

Encourage early ambulation.

Which observation regarding ulcer formation on the client's lower extremity indicates to the nurse that the ulcer is a result of venous insufficiency? Large and superficial Though superficial, is very painful Base is pale to black Is deep, involving the joint space

Large and superficial

A client comes to the walk-in clinic with reports of pain in his foot following stepping on a roofing nail 4 days ago. The client has a visible red streak running up his foot and ankle. What health problem should the nurse suspect? Cellulitis Local inflammation Elephantiasis Lymphangitis

Lymphangitis

A female client is readmitted to the facility with a warm, tender, reddened area on her right calf. Which contributing factor should the nurse recognize as most important? History of increased aspirin use Recent pelvic surgery An active daily walking program A history of diabetes mellitus

Recent pelvic surgery

A nurse is admitting a new client with a deep vein thrombosis in her left leg. During the admission process, which information provided by the client would be a contraindication to anticoagulant therapy? Scheduled eye surgery in 1 week A cerebral vascular bleed 10 years ago Three vaginal births, the most recent 18 months ago Diet that includes many green, leafy vegetables every day

Scheduled eye surgery in 1 week

The nurse is caring for a patient with venous insufficiency. For what should the nurse assess the patient's lower extremities? Rubor Cellulitis Dermatitis Ulceration

Ulceration

The nurse is providing care for a client who has just been diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis? Numbness and tingling in the distal extremities Unequal peripheral pulses between extremities Visible clubbing of the fingers and toes Reddened extremities with muscle atrophy

Unequal peripheral pulses between extremities

A client is being discharged home after a hysterectomy. When providing discharge education for this client, the nurse has cautioned the client against sitting for long periods. This advice addresses the client's risk of what surgical complication? Pudendal nerve damage Fatigue Venous thromboembolism Hemorrhage

Venous thromboembolism

A client has been diagnosed with Raynaud's disease. Which self-care strategies minimize risks associated with this disease? Select all that apply. Wear gloves to protect hands from injury when performing tasks. Do not smoke, or stop smoking. Avoid over-the-counter decongestants and cold remedies. Refrain from going outdoors in cold weather. Limit activities that place stress on the ulnar nerve.

Wear gloves to protect hands from injury when performing tasks. Do not smoke, or stop smoking. Avoid over-the-counter decongestants and cold remedies.

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: encouraging ambulation to prevent pooling of blood. providing warmth to the extremity. elevating the extremity to prevent pooling of blood. forcing blood into the deep venous system.

forcing blood into the deep venous system.