A client with peripheral vascular disease (PAD) is at risk of developing complications related to impaired skin integrity. What should the nurse include in the plan of care to prevent skin breakdown?

Encouraging the client to massage the legs daily.

Applying adhesive tape to secure dressings.

Inspecting the skin regularly for redness or signs of breakdown.

Using a donut-shaped cushion for sitting.

Answer and Explanation

The Correct Answer is C

A) This choice is incorrect because encouraging the client to massage the legs daily may not be appropriate for individuals with peripheral vascular disease (PAD). Vigorous massage can damage fragile blood vessels and exacerbate skin breakdown or injury.

B) This choice is incorrect because applying adhesive tape directly to the skin can cause skin trauma and increase the risk of skin breakdown. Dressings should be secured using appropriate medical tapes or dressings that are designed for skin protection.

C) This choice is correct. Regularly inspecting the skin for redness, discoloration, or signs of breakdown is crucial for early detection of impaired skin integrity in clients with peripheral vascular disease (PAD). Prompt identification and intervention can help prevent the development of pressure ulcers or wounds.

D) This choice is incorrect because using a donut-shaped cushion for sitting is generally not recommended for preventing skin breakdown. Donut cushions can increase pressure on the area around the coccyx and may cause more harm than good. Clients at risk of skin breakdown should be repositioned regularly and encouraged to shift their weight to relieve pressure on vulnerable areas.

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Correct Answer is C

Explanation

A) This choice is incorrect because limiting fluid intake is not a standard post-procedure instruction following angioplasty with stent placement. Adequate hydration is important for recovery and overall health.

B) This choice is incorrect because walking is generally encouraged following angioplasty with stent placement. Early mobilization helps prevent complications such as blood clots and promotes blood flow through the treated vessel.

C) This choice is correct. After angioplasty with stent placement, clients are often prescribed dual antiplatelet therapy, which typically includes aspirin and another antiplatelet medication such as clopidogrel. Dual antiplatelet therapy helps prevent blood clots from forming around the stent and reduces the risk of stent re-narrowing (restenosis).

D) This choice is incorrect because applying ice packs to the incision site is not a standard post-procedure instruction after angioplasty with stent placement. Ice packs are not typically used for this type of procedure, and the incision site is usually managed with sterile dressings and wound care.

Questions

A. Deep vein thrombosis (DVT) B. Peripheral artery disease (PAD) C. Raynaud's disease D. Varicose veins

Correct Answer is B

Explanation

A) This choice is incorrect because deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, typically in the legs. DVT is characterized by swelling, warmth, and redness in the affected leg, but it does not cause leg pain that improves with rest.

B) This choice is correct. Peripheral artery disease (PAD) is a condition where there is a narrowing or blockage of the arteries in the extremities, leading to reduced blood flow. The hallmark symptom of PAD is intermittent claudication, which is leg pain that occurs during walking or physical activity and improves with rest.

C) This choice is incorrect because Raynaud's disease is a disorder that affects the blood vessels in the fingers and toes, causing them to spasm and turn white, then blue, and finally red. It is not characterized by leg pain while walking.

D) This choice is incorrect because varicose veins are enlarged and twisted veins, usually in the legs, that can cause discomfort and cosmetic concerns. However, they do not typically cause leg pain that improves with rest.

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A client with peripheral vascular disease (PAD) is at risk of developing complications related to impaired skin integrity. What should the nurse include in the plan of care to prevent skin breakdown?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with peripheral vascular disease (PAD) who undergoes angioplasty with stent placement. Which post-procedure instruction should the nurse include in the client's education?

Correct Answer is C

Explanation

A client reports experiencing leg pain while walking that improves with rest. The nurse should suspect which peripheral vascular disease?

Correct Answer is B

Explanation

A client with chronic venous insufficiency (CVI) presents with edema and skin changes in the lower legs. What should the nurse include in the plan of care to manage these symptoms?

A client with peripheral arterial disease (PAD) has a non-healing ulcer on the foot. The nurse should prioritize which action in the client's plan of care?

A nurse is providing education to a client with chronic venous insufficiency (CVI) about self-care strategies. What should the nurse recommend to the client to promote venous return?

A nurse is assessing a client with suspected peripheral vascular disease. Which finding is most concerning and requires immediate intervention?

A nurse is reviewing the medical history of a client with suspected peripheral vascular disease. Which condition is a significant risk factor for the development of atherosclerosis and peripheral vascular disease?

A client has a history of smoking, diabetes, and hypertension. The nurse should recognize that these risk factors contribute to the development of which peripheral vascular disease?

A client with peripheral vascular disease (PAD) is experiencing cold feet due to reduced blood flow. Which self-care measure should the nurse recommend to the client?

A nurse is assessing a client with peripheral vascular disease. Which non-invasive test can the nurse use to assess blood flow in the legs and detect blockages?