PVD

The nurse is caring for a client recently diagnosed with peripheral vascular disease​ (PVD). Which intervention should the nurse teach the​ client? (Select all that​ apply.) A. Put on​ above-the-knee elastic hose with the legs elevated. B. Elevate the legs when asleep or resting. C. Avoid crossing the legs when in a sitting position. D. Encourage wearing​ knee-high compression stockings. E. Avoid walking or standing to allow the legs to rest.

Put on​ above-the-knee elastic hose with the legs elevated. B. Elevate the legs when asleep or resting. C. Avoid crossing the legs when in a sitting position.​ Rationale: Nursing interventions for PVD include elevating the legs when resting or​ asleep, avoiding crossing the legs or putting pressure on the back of the​ knees, and putting on hose after the legs have been elevated. The client should be encouraged to walk as much as possible. Compression hose should be above the knee and tighter over the feet than the top of the leg.

A client with chronic peripheral vascular disease​ (PVD) reports continuous pain in the bilateral lower extremities at rest and has pregangrenous lesions on his left foot. The nurse should expect to prepare the client for which collaborative​ intervention? A. Revascularization surgery B. Intense pulsed light​ (IPL) C. Semirigid boots D. Smoking cessation classes

Revascularization surgery​ Rationale: When PVD is severe enough to cause pain with rest and pregangrenous or gangrenous​ lesions, revascularization therapy is likely necessary. IPL and semirigid boots are used to treat stasis pigmentation. Although smoking cessation is vital in the treatment of​ PVD, there is no information in this scenario that the client smokes.​ Additionally, smoking cessation alone will not treat severe PVD.

The nurse is completing a physical assessment on a client with edema and pooling of blood in the veins of the lower extremities. The nurse suspects the diagnosis of chronic venous insufficiency. Which additional assessment finding should the nurse expect to​ observe? A. Cool feet and toes B. Gangrene C. Absent pedal pulses D. Skin hyperpigmentation

Skin hyperpigmentation​ Rationale: Symptoms of chronic venous insufficiency include edema of the lower extremities and hyperpigmentation of the skin of the feet and ankles. Absent​ pulses, cool skin on the feet and​ toes, and gangrene are signs of an arterial​ problem, not a venous problem.

The nurse is teaching a client about lifestyle modifications to promote vasodilation in a client with peripheral vascular disease​ (PVD). Which intervention should the nurse​ suggest? A. Stop smoking. B. Wash extremities in cool water. C. Walk daily. D. Take an aspirin daily.

Stop smoking.​ Rationale: Smoking causes​ vasoconstriction, so stopping smoking will improve vasodilation. Increasing activity such as walking may lead to collateral circulation but does not cause vasodilation. The use of aspirin may impede platelet clumping but does not cause vasodilation. Cool water may cause vasoconstriction to occur.

The nurse is evaluating the goal established for a client with peripheral vascular​ disease, "The client will learn appropriate foot and wound​ care." Which outcome demonstrates goal​ achievement? A. The client demonstrates proper wound care techniques to the nurse. B. The client informs the nurse that the wound is improving C. The​ client's leg ulcer is showing signs of healing. D. The​ client's leg wound shows no signs of infection.

The client demonstrates proper wound care techniques to the nurse.​ Rationale: Client goals are​ measurable, specific,​ realistic, and achievable. The client verbalizing proper wound care demonstrates goal achievement. The ulcer showing signs of healing and​ improvement, and no signs of infection are medical outcomes.

The nurse is teaching a client about the endarterectomy she will undergo soon for peripheral atherosclerosis. Which statement should the nurse include in the​ teaching? A. The purpose of an endarterectomy is to remove plaque from the artery. B. The purpose of an endarterectomy is to vaporize the occluding material. C. An endarterectomy is the first choice of treatment for peripheral atherosclerosis. D. An endarterectomy allows for the placement of a bypass graft.

The purpose of an endarterectomy is to remove plaque from the artery.​ Rationale: An endarterectomy is performed to remove plaque from an occluded artery. Laser or thermal angioplasty is used to vaporize occluding material. Surgery is not a first​ choice, but is performed if symptoms are​ progressive, severe, or disabling. Bypass grafts are placed during bypass graft surgery.

A nurse is examining a client diagnosed with peripheral vascular disease​ (PVD) who has an ulcer on the great right toe. Which additional assessment finding should the nurse​ expect? (Select all that​ apply). A. There is an absence of hair on the legs. B. There is brown pigmentation of the lower extremity. C. The extremity is cool to touch. D. There is pitting edema in the lower extremity. E. The toenails are thickened.

There is an absence of hair on the legs. C. The extremity is cool to touch. E. The toenails are thickened.​ Rationale: Wounds on the​ toes, absence of hair on the​ legs, cool​ extremities, and thick toenails are all features of arterial problems. Venous problems are characterized by brown pigmentation of the skin of the lower extremity and edema.

The nurse is performing a nursing assessment for a client with peripheral vascular disease​ (PVD). Which data should the nurse collect during the health​ history? (Select all that​ apply.) A. Presence of skin discoloration B. Current medications C. Presence of pain D. Current diet E. History of coronary artery disease

Current medications C. Presence of pain D. Current diet E. History of coronary artery disease​ Rationale: During the health history portion of the nursing assessment for the client with​ PVD, the nurse will assess client history of coronary artery disease​ (CAD), current medications and​ diet, and any complaints of pain. Presence of skin discoloration would be assessed during the physical exam portion of the nursing assessment.

The nurse is performing an assessment on a client with peripheral vascular disease​ (PVD). Which finding should the nurse​ expect? A. Dilated blood vessels in the eye B. Decreased sensation of the upper extremities C. Wheezing upon auscultation of the lungs D. Delayed capillary refill in the lower extremities

Delayed capillary refill in the lower extremities​ Rationale: Delayed capillary refill in the lower extremities may be present in the client with PVD. The other clinical manifestations are not present in the client with PVD.

A community health nurse is teaching a group of adults about the risk factors associated with peripheral vascular disease​ (PVD) and chronic venous insufficiency​ (CVI). Which risk factor should the nurse​ include? (Select all that​ apply.) A. Male sex B. Excess body weight C. Age 45 or older D. Physical inactivity E. Increased cholesterol levels

Excess body weight Physical inactivity E. Increased cholesterol levels​ Rationale: Risk factors associated with PVD and CVI include increased cholesterol​ levels, excess body weight or​ obesity, and physical inactivity. Clients age 50 and older are at greatest risk for developing PVD or CVI. Males and females are equally affected by these conditions.

The nurse is talking to a client with peripheral vascular disease​ (PVD) who reports using biofeedback as a complementary therapy. The nurse knows this serves which purpose for​ PVD? A. Decreasing arterial plaque buildup B. Improving peripheral circulation C. Lowering overall cholesterol D. Reducing stress

Improving peripheral circulation Rationale: Biofeedback is used to improve peripheral​ circulation; biofeedback does not reduce plaque buildup. Exercise and a change in diet can reduce overall cholesterol and slow the progress of PVD. Many alternative therapies are used to reduce​ stress, but that is not a main function of biofeedback.

A home health nurse is caring for a client with peripheral vascular disease​ (PVD). When teaching the client regarding foot and leg​ care, which statement should the nurse​ include? (Select all that​ apply.) A. ​"Dry between your toes after​ showering." B. ​"Avoid using powder on your​ feet." C. ​"When swimming, ensure the water is​ cool, not​ warm." D. ​"Buy shoes in the​ morning, when feet are​ largest." E. ​"Apply moisturizing cream to feet and legs​ daily."

"Dry between your toes after​ showering." ​"Apply moisturizing cream to feet and legs​ daily." Rationale: Foot and leg care for clients with PVD includes applying moisturizing cream to feet and legs daily as well as drying between the toes after showering. The client should use powder on the feet to keep feet dry. When​ swimming, water should be warm because cool water causes​ vasospasm, worsening the​ client's condition. The client should buy shoes in the​ afternoon, when feet are largest

A nurse is teaching a client diagnosed with peripheral arterial disease about proper positioning of the lower extremities. Which client statement indicates a need for further​ teaching? A. ​"I will avoid crossing my​ legs." B. ​"I should hang my legs off the bed while I am​ resting." C. ​"I can sit in a chair while I watch​ television." D. ​"I will elevate my legs and feet on pillows when I lie​ down."

"I will elevate my legs and feet on pillows when I lie​ down."​ Rationale: Elevation of the affected limb can slow arterial blood flow to the​ feet, so this position should be avoided. The client may sleep with the extremities hanging or positioned upright in a chair. The client is also instructed to avoid crossing the legs because this interferes with blood flow.

A nurse is teaching a client about aspirin for peripheral vascular disease​ (PVD). Which client statement indicates that teaching has been​ successful? A. ​"This medication will help decrease the plaque in my​ arteries." B. ​"This medication will thin out my blood so it flows​ easier." C. ​"This medication will prevent me from developing a blood​ clot." D. ​"This medication will open my arteries and increase blood flow to my​ legs.

"This medication will prevent me from developing a blood​ clot." Rationale: Aspirin, an​ antiplatelet, is prescribed in PVD to prevent clot formation. Aspirin does not​ vasodilate, decrease​ viscosity, or help decrease plaque in the arteries. Pentoxifylline​ (Trental) decreases blood viscosity and Cilostazol​ (Pletal) decreases blood viscosity in addition to preventing further clots.

The nurse is assessing a client diagnosed with chronic vascular insufficiency​ (CVI). Which assessment finding should the nurse​ expect? (Select all that​ apply.) A. Pale skin on lower legs B. Lower extremity edema C. Excessive hair growth on the legs D. Cyanosis of lower legs E. Soft subcutaneous tissue on affected areas on leg

Lower extremity edema Cyanosis of lower legs Rationale: Manifestations of CVI include lower extremity edema that worsens with​ standing; itching, dull leg discomfort or pain that increases with​ standing; thin,​ shiny, atrophic​ skin; cyanosis and brown skin pigmentation of lower leg and​ foot; possible weeping​ dermatitis; thick, fibrous​ (hard) subcutaneous​ tissue; and recurrent ulcerations of medial or anterior ankles.

The nurse is preparing to teach a client with a venous stasis ulcer on the left lower leg. Which intervention should the nurse include in the teaching​ plan? A. Application of elastic compression stockings B. How to keep the wound bed clean and dry C. Purpose of antibiotic therapy D. Increased carbohydrate intake to promote wound healing

Application of elastic compression stockings​ Rationale: Use of elastic compression stockings is essential to healing of venous stasis ulcers. High dietary intake of​ protein, rather than​ carbohydrates, is needed for wound healing. Antibiotics are not routinely used for venous ulcers. Moist dressings are used for venous stasis​ ulcers, not dry dressings.

The nurse is caring for a client with peripheral vascular disease​ (PVD). Which nursing intervention should the nurse​ implement? (Select all that​ apply.) A. Keep legs in dependent position during sleep. B. Assess peripheral pulses. C. Keep lower extremities warm. D. Encourage exercise. E. Encourage frequent position change.

Assess peripheral pulses. C. Keep lower extremities warm. D. Encourage exercise. E. Encourage frequent position change.​ Rationale: To evaluate and promote tissue perfusion in the client with​ PVD, the nurse should assess peripheral pulses to ensure adequate​ perfusion, keep lower extremities warm to prevent vasoconstriction associated with cold​ temperatures, encourage exercise to increase circulation to lower​ extremities, and encourage frequent position changes to avoid a decrease in circulation to the lower extremities. The nurse should elevate the legs during sleep and rest. Elevation promotes venous return from the​ extremity, increasing circulation and relieving pain.

The nurse is evaluating a client who​ states, "I usually walk 30 minutes every​ morning, but lately my leg cramps and hurts after just a few minutes. The pain goes away after I stop​ walking, though." Which action should the nurse do first​? A. Notify the healthcare provider. B. Ask the client about skin color changes. C. Discuss benefits of daily exercise. D. Assess the posterior tibial and pedal pulses.

Assess the posterior tibial and pedal pulses.​ Rationale: This client is describing symptoms of intermittent claudication. The nurse should assess the strength and equality of peripheral pulses to determine perfusion. Changes in skin color are important but not the priority. The nurse should complete the assessment before contacting the healthcare provider or discussing the benefits of daily exercise.

A​ client's daughter asks how to prevent peripheral vascular disease. Which information should the nurse include as a preventative​ measure? (Select all that​ apply.) A. Starting blood pressure medications B. Exercising regularly C. Maintaining a healthy weight D. Starting​ cholesterol-lowering medications E. Quitting smoking

B. Exercising regularly C. Maintaining a healthy weight E. Quitting smoking​ Rationale: Preventative measures for PVD include maintaining a healthy lifestyle​ (ideal weight,​ exercising), smoking​ cessation, and following treatment for chronic illnesses. It is outside of the scope of the nurse to prescribe blood pressure or​ cholesterol-lowering medications. It is also unknown whether this client requires those medications.​ However, blood pressure and​ cholesterol-lowering medications can help slow or reverse the progress of PVD if taken as ordered by a provider

A nurse is teaching a client with suspected peripheral vascular disease​ (PVD) about segmental pressure measurements. Which statement should the nurse include in the​ teaching? A. ​"If you have​ PVD, your BP may be lower in your legs than your​ arms." B. ​"We need to do this before surgery to locate and evaluate the blood​ clot." C. ​"If you have​ PVD, the BP in your legs will drop further during​ exercise." D. ​"This uses sound waves reflected off red blood cells to look at blood​ flow."

​"If you have​ PVD, your BP may be lower in your legs than your​ arms." Rationale: Segmental pressure measurements use a Doppler and sphygmomanometer to compare BPs in the upper and lower extremities. In​ PVD, the BP in the legs will be lower than in the arms. A Doppler uses sound waves that reflect off of RBCs to evaluate blood flow. Angiography is done before revascularization surgery to locate and evaluate the extent of the arterial obstruction. A stress test measures pressures in the lower extremities during exercise.