PVD NCLEX

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?

​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 teaching a client about aspirin for peripheral vascular disease​ (PVD). Which client statement indicates that teaching has been​ successful?

​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 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?

​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.

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?

​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 performing an assessment on a client with peripheral vascular disease​ (PVD). Which finding should the nurse​ expect?

​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.

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.)

​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.

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?

​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 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.)

​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.

The nurse is assessing a client diagnosed with chronic vascular insufficiency​ (CVI). Which assessment finding should the nurse​ expect? (Select all that​ apply.)

​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 caring for a client recently diagnosed with peripheral vascular disease​ (PVD). Which intervention should the nurse teach the​ client? (Select all that​ apply.)

​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's daughter asks how to prevent peripheral vascular disease. Which information should the nurse include as a preventative​ measure? (Select all that​ apply.)

​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 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.)

​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.

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?

​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.

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?

​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 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?

​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 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​?

​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.

The nurse is caring for a client with peripheral vascular disease​ (PVD). Which nursing intervention should the nurse​ implement? (Select all that​ apply.)

​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 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?

​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.

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?

​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. Next Question

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).

​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.