A patient with peripheral arterial disease (PAD) reports leg pain while walking which resolves with rest. The nurse recognizes this symptom as:
Deep vein thrombosis
Restless leg syndrome
Intermittent claudication
Varicose veins
The Correct Answer is C
A. Deep vein thrombosis. Deep vein thrombosis typically causes constant pain, swelling, and redness and does not improve with rest.
B. Restless leg syndrome. Restless leg syndrome is characterized by an uncontrollable urge to move the legs, usually at rest, and is not associated with walking.
C. Intermittent claudication. Intermittent claudication is a common symptom of PAD where muscle pain or cramping occurs during activity and is relieved with rest due to insufficient blood flow.
D. Varicose veins. Varicose veins generally cause aching and swelling rather than pain triggered specifically by walking.
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Correct Answer is B
Explanation
A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys. Reduced blood flow to the kidneys, or renal hypoperfusion, decreases the glomerular filtration rate (GFR) because less blood is being filtered through the kidneys. This can occur in conditions such as shock, severe dehydration, or heart failure, but it is not the primary mechanism in acute tubular necrosis (ATN).
B. The glomerular filtration rate decreases because there is injury to the renal tubular cells. In ATN, the injury to renal tubular cells impairs their function, leading to reduced reabsorption and filtration ability, which contributes to the decrease in GFR.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys. While inflammation may be present, it is not the primary cause of decreased GFR in acute tubular necrosis; reduced blood flow and tubular cell injury are more direct causes.
D. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down. Obstruction is not typically a characteristic of acute tubular necrosis; ATN is usually caused by ischemic or toxic injury, not physical obstruction.
Correct Answer is A
Explanation
A. Reposition the client at least every two hours. Regular repositioning reduces prolonged pressure on specific areas of the body, which helps prevent the formation of pressure injuries.
B. Encourage the client to limit fluid intake. Adequate hydration is important for skin integrity. Limiting fluid intake could lead to dehydration, increasing the risk for skin breakdown.
C. Use a donut-shaped cushion under the client's hips. Donut-shaped cushions can actually increase pressure around the edges of the cushion and restrict blood flow, which could worsen pressure injury risk.
D. Apply a heating pad to the client's back every four hours. Heat can cause skin damage and may increase the risk of burns. Temperature regulation is important, but heating pads are not recommended for pressure injury prevention.