The nurse is planning to teach a client with peripheral arterial disease (PAD) about measures to limit disease progression. Which interventions would the nurse include for this client? (Select all that apply)
Smoking cessation.
Wear compression stockings.
Use a heating pad directly on the legs.
Exercising will help increase circulation.
Soak feet in hot water daily.
Decrease saturated fats in daily diet.
Correct Answer : A,D,F
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.
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View Related questions
Correct Answer is A
Explanation
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.
Correct Answer is D
Explanation
A) Tachycardia: Propranolol is often used to manage tachycardia by reducing heart rate and controlling excessive adrenergic activity. Therefore, this diagnosis would not warrant clarification of the order; it is an appropriate use of the medication.
B) End-stage kidney failure: While caution is necessary when administering medications in clients with renal impairment, propranolol is primarily metabolized by the liver, and its use is not contraindicated in end-stage kidney failure. However, renal function can affect dosing, so monitoring would be important, but this diagnosis alone wouldn't require clarification.
C) Hypertension: Propranolol is commonly prescribed to manage hypertension, making this diagnosis a valid reason for the medication order. The use of propranolol in this context would not need clarification.
D) Asthma: Propranolol is a non-selective beta-blocker, which can cause bronchoconstriction and exacerbate asthma symptoms. This diagnosis would require the nurse to clarify the order, as beta-blockers are generally contraindicated in clients with asthma due to the risk of respiratory complications. If the client has reactive airway disease, an alternative medication should be considered.