chapter 30 vascular/veinous disorders

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.

Which is a characteristic of arterial insufficiency? Diminished or absent pulses Superficial ulcer Aching, cramping pain Pulses are present but may be difficult to palpate

Diminished or absent pulses

The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack? Report changes in the usual pattern of chest pain. Avoid situations that contribute to ischemic episodes. Avoid fatty foods and exercise. Take over-the-counter decongestants.

Avoid situations that contribute to ischemic episodes.

A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time? Impaired gas exchange related to increased blood flow Excess fluid volume related to peripheral vascular disease Risk for injury related to edema Ineffective peripheral tissue perfusion related to venous congestion

Ineffective peripheral tissue perfusion related to venous congestion (venous inflammation and clot formation impede blood flow in a client with DVT.)

When assessing a client with cellulitis of the right leg, which finding should the nurse expect to observe? Painful skin that is swollen and pale in color Cold, red skin Small, localized blackened area of skin Red, swollen skin with inflammation spreading to surrounding tissues

Red, swollen skin with inflammation spreading to surrounding tissues

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gater area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect? Arterial insufficiency Venous insufficiency Neither venous nor arterial insufficiency Trauma

Venous insufficiency (Symptoms of venous insufficiency include present pedal pulses, edema, pigmentation in gater area, and a reddish blue color.)

A community health nurse teaches a group of older adults about modifiable risk factors that contribute to the development of peripheral arterial disease (PAD). The nurse knows that the teaching was effective based on which statement? "I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet." "I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels." "The older I get the higher my risk for peripheral arterial disease gets." "Because my family is from Italy, I have a higher risk of developing peripheral arterial disease."

"I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet." (The use of tobacco products may be one of the most important risk factors in the development of atherosclerotic lesions.)

A client is recovering from surgical repair of a dissecting aortic aneurysm. Which assessment findings indicate possible bleeding or recurring dissection?

Blood pressure of 82/40 mm Hg and heart rate of 125 beats/minute (Assessment findings that indicate possible bleeding or recurring dissection include hypotension with reflex tachycardia (as evidenced by a blood pressure of 82/40 mm Hg and a heart rate of 125 beats/minute), decreased urine output, and unequal or absent peripheral pulses.)

A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following? Constant, intense back pain and falling blood pressure Constant, intense headache and falling blood pressure Higher than normal blood pressure and falling hematocrit Slow heart rate and high blood pressure

Constant, intense back pain and falling blood pressure

Which of the following is a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot? Contrast phlebography Air plethysmography Lymphangiography Lymphoscintigraphy

Constrast phlebography

As the clinic nurse caring for a client with varicose veins, what is an appropriate nursing action for this client? Demonstrate how to self-administer IV infusions. Demonstrate how to apply and remove elastic support stockings. Assess for the sites of bleeding. Assess for skin integrity.

Demonstrate how to apply and remove elastic support stockings.

The nurse assessing a client who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which characteristic? Diminished or absent pulses Superficial ulcer Aching, cramping pain Pulses that are present but difficult to palpate

Diminished or absent pulses

Which is a risk factor for venous disorders of the lower extremities? Trauma Pacing wires Obesity Surgery

Obesity

Which of the following is the most common site for a dissecting aneurysm? Thoracic area Lumbar area Sacral area Cervical area

Thoracic area

Approximately what percentage of the arterial lumen must be obstructed before intermittent claudication is experienced?

Typically, about 50% of the arterial lumen or 75% of the cross-sectional area must be obstructed before intermittent claudication is experienced.

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue? Loose and wrinkled skin Ulcers and infection in the edematous area Evident scaring Cyanosis

Ulcers and infection in the edematous area

The most important reason for a nurse to encourage a client with peripheral vascular disease to initiate a walking program is that this form of exercise:

decreases venous congestion.