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 D

Explanation

A) This choice is incorrect because weightlifting is not typically recommended for individuals with peripheral vascular disease (PAD). High-intensity weightlifting can increase blood pressure and may not be suitable for clients with cardiovascular conditions.

B) This choice is incorrect because running, especially high-impact running, may be too strenuous for individuals with PAD and could lead to discomfort or injury. Low-impact exercises are generally preferred.

C) This choice is incorrect because high-impact aerobics can be too intense for individuals with PAD and may not be well-tolerated, especially if they experience leg pain during exercise.

D) This choice is correct. Walking is a low-impact exercise that can be beneficial for individuals with peripheral vascular disease. It promotes blood flow in the legs, increases circulation, and helps manage intermittent claudication (pain during walking) associated with PAD. Gradually increasing walking distance and duration can improve cardiovascular fitness and overall health.

A. Swelling and tenderness in the calf B. Intermittent claudication during physical activity C. Cold, pale, and numb fingers or toes D. Ulceration on the lower leg with foul-smelling discharge

Correct Answer is D

Explanation

A) This choice is concerning and may indicate deep vein thrombosis (DVT). Swelling and tenderness in the calf can be a sign of a blood clot, and immediate evaluation is required to prevent potential complications such as a pulmonary embolism. However, it is not as critical as the finding in option D.

B) This choice is concerning and may indicate peripheral artery disease (PAD). Intermittent claudication during physical activity suggests reduced blood flow to the extremities, but it does not require immediate intervention.

C) This choice is concerning and may indicate Raynaud's disease. Raynaud's disease involves the fingers or toes turning white, then blue, and finally red due to blood vessel spasms, but it is not as urgent as the finding in option D.

D) This choice is correct. Ulceration on the lower leg with foul-smelling discharge indicates a severe complication of peripheral vascular disease, possibly related to peripheral artery disease (PAD) or venous insufficiency. Ulcers that have an unpleasant odor and are not healing require immediate intervention to prevent infection and further tissue damage.

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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 providing education to a client with peripheral vascular disease (PAD). The nurse should instruct the client to perform which exercise to improve blood flow in the legs?

Correct Answer is D

Explanation

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

Correct Answer is D

Explanation

A nurse is caring for a client with peripheral vascular disease (PAD) who experiences intermittent claudication. What should the nurse encourage the client to do during episodes of leg pain?

A client with a history of hypertension, hyperlipidemia, and obesity is at risk for developing peripheral vascular disease (PAD) due to:

A client with peripheral vascular disease (PAD) is prescribed cilostazol. The nurse should instruct the client to report which adverse effect immediately?

A client with peripheral vascular disease (PAD) reports experiencing pain in their legs that occurs with walking and is relieved by rest. The nurse recognizes this symptom as:

A nurse is providing education to a client about peripheral vascular diseases. The nurse explains that these diseases primarily affect which body system?

A nurse is assessing a client with peripheral vascular disease. Which condition is a significant risk factor for the development of venous insufficiency?

A client with peripheral vascular disease (PAD) is experiencing intermittent claudication and reports difficulty walking. What should the nurse encourage the client to do to improve exercise tolerance?

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?