A nurse is assessing client with advanced peripheral arterial disease (PAD). Which of the following findings would the nurse expect?
Shiny, hairless lower extremities.
Warm lower extremities.
Thin toenails.
Lower extremity bilateral pulse 3+
The Correct Answer is A
A) Shiny, hairless lower extremities: In advanced peripheral arterial disease (PAD), the skin on the lower extremities often appears shiny and hairless due to reduced blood flow. The lack of hair growth and the shiny appearance are indicative of ischemia and poor circulation, making this a common finding in clients with advanced PAD.
B) Warm lower extremities: This finding is not typical in advanced PAD. Due to compromised blood flow, the lower extremities are more likely to feel cool or cold to the touch rather than warm. Warm skin can indicate good blood flow, which is usually absent in cases of significant arterial disease.
C) Thin toenails: In advanced PAD, toenails may become thin and brittle due to insufficient blood supply, which can lead to impaired nail growth. This change is consistent with the overall effects of reduced circulation and is an expected finding in clients with advanced PAD.
D) Lower extremity bilateral pulse 3+: A 3+ pulse indicates a strong and bounding pulse, which is not typically present in advanced PAD. In fact, patients with PAD often exhibit diminished or absent pulses in the affected extremities due to poor arterial circulation. Therefore, this finding does not align with the expected assessment results for advanced PAD.
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View Related questions
Correct Answer is D
Explanation
A) Blood pressure 102/76: While this blood pressure reading is on the lower side, it does not typically warrant withholding carvedilol unless the client exhibits symptoms of hypotension, such as dizziness or fainting. Carvedilol is an antihypertensive, but the reading itself is not critically low enough to necessitate holding the medication.
B) Temperature of 100.3 F: A mild fever at this temperature does not directly relate to carvedilol administration. It may indicate an underlying infection or inflammation, but it is not a contraindication for administering the medication. Monitoring the client’s temperature is important, but it does not require notifying the healthcare provider in this context.
C) Respiratory rate 10: A respiratory rate of 10 breaths per minute indicates bradypnea, which can be concerning. However, it is not the primary reason to withhold carvedilol unless the client shows significant respiratory distress. Monitoring is essential, but the decision to withhold the medication would depend on the overall clinical picture.
D) Heart rate of 49: A heart rate of 49 bpm is considered bradycardia and is a significant concern when administering carvedilol, a beta-blocker that can further decrease heart rate. It is essential to hold the medication and notify the healthcare provider, as this bradycardia could lead to potential adverse effects or complications. Monitoring the client's heart rate is crucial in managing their medication safely.
Correct Answer is ["A","D","F"]
Explanation
A) Smoking cessation: Quitting smoking is one of the most critical interventions for clients with peripheral arterial disease (PAD). Smoking contributes to vascular damage and worsens arterial circulation, so cessation can significantly slow disease progression and improve overall cardiovascular health.
B) Wear compression stockings: While compression stockings may be helpful for venous conditions, they are generally not recommended for clients with PAD. In fact, they can impair arterial flow, so this intervention should not be included in the teaching plan.
C) Use a heating pad directly on the legs: Using a heating pad directly on the legs is unsafe for clients with PAD, as it can lead to burns or injuries due to impaired sensation in the extremities. Additionally, excessive heat can exacerbate circulation issues.
D) Exercising will help increase circulation: Regular exercise is beneficial for clients with PAD. Supervised exercise programs, such as walking, can improve circulation and enhance functional capacity, helping to manage symptoms and slow disease progression.
E) Soak feet in hot water daily: Soaking feet in hot water can pose risks, particularly for individuals with PAD, as they may have reduced sensation and are at higher risk for burns or injuries. This practice should not be recommended.
F) Decrease saturated fats in daily diet: Reducing saturated fats in the diet can help improve overall cardiovascular health and lower cholesterol levels, which is beneficial for clients with PAD. A heart-healthy diet can help limit disease progression and improve circulation.