Adaptive Quizzes- Chapter 30 PVD

Pallor Pallor is the initial symptom in Raynaud's followed by cyanosis and aching pain. Gangrene can occur with persistent attacks and interference of blood flow. Clubbing of the fingers is a symptom associated with chronic oxygen deprivation to the distal phalanges.

A client with Raynaud's disease complains of cold and numbness in the fingers. Which of the following would the nurse identify as an early sign of vasoconstriction? Cyanosis Gangrene Pallor Clubbing of the fingers

- The aneurysm may be preparing to rupture. Signs of impending rupture include severe back or abdominal pain, which may be persistent or intermittent. Indications of a rupturing AAA include constant, intense back pain; falling blood pressure; and decreasing hematocrit.

A client with a diagnosed abdominal aortic aneurysm (AAA) develops severe lower back pain. Which is the most likely cause? - The aneurysm has become obstructed. - The aneurysm may be preparing to rupture. - The client is experiencing inflammation of the aneurysm. - The client is experiencing normal sensations associated with this condition.

- keep the affected leg level or slightly dependent. While the physician makes treatment decisions, the nurse should maintain the client on bed rest, keeping the affected leg level or slightly dependent (to aid circulation) and protecting it from pressure and other trauma. Warming the leg with a heating pad (or chilling it with an ice pack) would further compromise tissue perfusion and increase injury to the leg. Elevating the leg would worsen tissue ischemia. Shaving an ischemic leg could cause accidental trauma from cuts or nicks.

A client with no known history of peripheral vascular disease comes to the emergency department complaining of sudden onset of lower leg pain. Inspection and palpation reveal absent pulses; paresthesia; and a mottled, cyanotic, cold, and cadaverous left calf. While the physician determines the appropriate therapy, the nurse should: - place a heating pad around the affected calf. - elevate the affected leg as high as possible. - keep the affected leg level or slightly dependent. - shave the affected leg in anticipation of surgery.

Computed tomography Transesophageal echocardiography X-ray

A patient is suspected to have a thoracic aortic aneurysm. What diagnostic test(s) does the nurse anticipate preparing the patient for? (Select all that apply.) - Computed tomography - Transesophageal echocardiography - X-ray - Electroencephalogram - Electrocardiogram (ECG)

- Dorsiflex the foot while the leg is elevated to check for calf pain. Homan's sign is indicated by pain in the calf after the foot is sharply dorsiflexed.

A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg? - Dorsiflex the foot while the leg is elevated to check for calf pain. - Elevate the patient's legs for 20 minutes and then lower them slowly while checking for areas of inadequate blood return. - Extend the leg, plantar flex the foot, and check for the patency of the dorsalis pedis pulse. - Lower the patient's legs and massage the calf muscles to note any areas of tenderness.

- Taking daily walks Taking daily walks relieves symptoms of intermittent claudication, although the exact mechanism is unclear. Anaerobic exercise may make these symptoms worse.

On a routine visit to the physician, a client with chronic arterial occlusive disease reports that he's stopped smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, which additional measure should the nurse recommend? - Taking daily walks - Engaging in anaerobic exercise - Reducing daily fat intake to less than 45% of total calories - Abstaining from foods that increase levels of high-density lipoproteins (HDLs)

- abdominal aorta, just below the renal arteries.

The most common site of aneurysm formation is in the: - abdominal aorta, just below the renal arteries. - ascending aorta, around the aortic arch. - descending aorta, beyond the subclavian arteries. - aortic arch, around the ascending and descending aorta.

- In 3 to 5 days Oral anticoagulants, such as warfarin, are monitored by the PT or the INR. Because the full anticoagulant effect of warfarin is delayed for 3 to 5 days, it is usually administered concurrently with heparin until desired anticoagulation has been achieved (i.e., when the PT is 1.5 to 2 times normal or the INR is 2.0 to 3.0) (Holbrook et al., 2012).

The nurse is caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). When does the nurse understand that therapeutic benefits will begin? - Within 12 hours - Within the first 24 hours - In 2 days - In 3 to 5 days

- Ulceration Venous ulceration is the most serious complication of chronic venous insufficiency and can be associated with other conditions affecting the circulation of the lower extremities. Cellulitis or dermatitis may complicate the care of chronic venous insufficiency and venous ulcerations.

The nurse is caring for a patient with venous insufficiency. What should the nurse assess the patient's lower extremities for? - Rudor - Cellulitis - Dermatitis - Ulceration

- 1.5 to 2.5 times the baseline control. A normal PTT level is 21 to 35 seconds. A reading of more than 100 seconds indicates a significant risk of hemorrhage.

When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of: - 1.5 to 2.5 times the baseline control. - 2.5 to 3.0 times the baseline control. - 3.5 times the baseline control. - 4.5 times the baseline control.

Dissecting Dissection results from a rupture in the intimal layer, resulting in bleeding between the intimal and medial layers of the arterial wall. Saccular aneurysms collect blood in the weakened outpouching. In a false aneurysm, the mass is actually a pulsating hematoma. An anastomotic aneurysm occurs as a result of infection at arterial suture or graft sites.

Which aneurysm results in bleeding into the layers of the arterial wall? Saccular Dissecting False Anastomotic

Fibrinolytic Thrombolytic (fibrinolytic) therapy lyses and dissolves thrombi in 50% of clients. Anticoagulants, platelet inhibitors, and factor XA inhibitors do not lyse or dissolve thrombi.

Which class of medication lyses and dissolves thrombi? Fibrinolytic Anticoagulant Platelet inhibitors Factor XA inhibitors

Stasis of blood Vessel wall injury Altered coagulation

Which of the following are alterations noted in Virchow's triad? Select all that apply. Stasis of blood Vessel wall injury Altered coagulation Edema Tenderness

Constant, intense back pain Decreasing blood pressure Decreasing hematocrit

Which of the following are indications of a rupturing aortic aneurysm? Select all that apply. Constant, intense back pain Decreasing blood pressure Decreasing hematocrit Increasing blood pressure Increasing hematocrit

- Increased abdominal and back pain Pain in the abdomen and back signify that the aneurysm is pressing downward on the lumbar nerve root and is causing more pain. The pulse rate would increase with aneurysm extension. Chest pain radiating down the arm would indicate myocardial infarction. Blood pressure would decrease with aneurysm extension, and the respiratory rate may not be affected.

Which sign or symptom suggests that a client's abdominal aortic aneurysm is extending? - Increased abdominal and back pain - Decreased pulse rate and blood pressure - Retrosternal back pain radiating to the left arm - Elevated blood pressure and rapid respirations