A nurse is assessing a client who has chronic venous insufficiency. Which of the following findings should the nurse expect?
Dependent rubor
Thick, deformed toenails
Hair loss
Edema
The Correct Answer is D
Choice A: Dependent rubor
Dependent rubor is a reddish discoloration of the skin that occurs when the leg is in a dependent position (hanging down). This condition is typically associated with arterial insufficiency rather than chronic venous insufficiency. Arterial insufficiency occurs when there is inadequate blood flow through the arteries, leading to symptoms such as pain, cramping, and changes in skin color. Dependent rubor is a sign of poor arterial circulation and is not commonly seen in venous insufficiency.
Choice B: Thick, deformed toenails
Thick, deformed toenails can be a sign of fungal infections or other conditions affecting the nails, but they are not specifically indicative of chronic venous insufficiency. While individuals with chronic venous insufficiency may have poor circulation that can contribute to nail problems, this symptom is not a primary or common finding associated with the condition. Instead, it is more often related to other underlying health issues.
Choice C: Hair loss
Hair loss on the legs can occur due to various reasons, including poor circulation. However, it is more commonly associated with arterial insufficiency rather than chronic venous insufficiency. In arterial insufficiency, the reduced blood flow can lead to hair loss, shiny skin, and other changes in the lower extremities. Chronic venous insufficiency primarily affects the veins and leads to symptoms such as swelling, varicose veins, and skin changes.
Choice D: Edema
Edema, or swelling, is a hallmark symptom of chronic venous insufficiency. This condition occurs when the veins in the legs are unable to effectively return blood to the heart, leading to blood pooling in the lower extremities. The increased pressure in the veins causes fluid to leak into the surrounding tissues, resulting in swelling. Edema is often more pronounced at the end of the day or after prolonged periods of standing or sitting. Managing edema is a key aspect of treating chronic venous insufficiency, and it often involves the use of compression stockings, elevation of the legs, and other measures to improve venous return.
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Correct Answer is B
Explanation
Choice A reason: While some women may start producing milk as early as 24 to 48 hours after delivery, this is not the typical timeframe for most women. The initial milk produced is colostrum, which is different from the mature milk that comes in later.
Choice B reason: For most women, breast milk “comes in” around 3 to 5 days postpartum. This period marks the transition from colostrum to mature milk, which is more abundant and nutritionally rich. During this time, mothers may experience breast engorgement and increased milk production.
Choice C reason: Breast milk typically does not take about 10 days to come in. By this time, most women will have already transitioned to mature milk. If milk production has not started by this time, it may indicate a problem that requires medical attention.
Choice D reason: The timeframe of 6 to 8 days is also not typical for the initial onset of mature milk production. Most women will have their milk come in within the first week postpartum.
Correct Answer is C
Explanation
Choice A: Ulnar Deviation
Ulnar deviation, or the bending of the fingers towards the ulna (the outer bone of the forearm), is more commonly associated with rheumatoid arthritis rather than osteoarthritis. Rheumatoid arthritis typically affects the joints symmetrically and can lead to deformities such as ulnar deviation due to chronic inflammation.
Choice B: Symmetric Joints Affected
Symmetric joint involvement is characteristic of rheumatoid arthritis, not osteoarthritis. Osteoarthritis usually affects joints asymmetrically, meaning it can affect one joint more than the other. It commonly affects weight-bearing joints such as the knees, hips, and spine.
Choice C: Pain Worsens with Activity
Pain that worsens with activity is a hallmark symptom of osteoarthritis. This condition is caused by the breakdown of cartilage in the joints, leading to pain and stiffness, especially after physical activity. The pain typically improves with rest but can become more persistent as the disease progresses.
Choice D: Weight Loss
Weight loss is not a typical manifestation of osteoarthritis. In fact, being overweight or obese is a risk factor for developing osteoarthritis, particularly in weight-bearing joints. Weight management is often recommended to help reduce the stress on affected joints and alleviate symptoms.
