A nurse is caring for a client who has deep vein thrombosis (DVT). The client has received intravenous (IV) heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?

Choice A reason f:Intermittent claudication is a classic symptom of PAD, characterized by muscle pain or cramping in the legs triggered by exercise, such as walking, which typically disappears after a few minutes of rest. This symptom occurs due to inadequate blood flow to the muscles during increased demand.

Choice B reason :Darkened skin color near the extremities, also known as hyperpigmentation, can occur in PAD due to the chronic ischemia and the resultant buildup of waste products in the tissue, which may lead to skin changes.

Choice C reason :Warm extremities are not typically associated with PAD. In fact, patients with PAD may have cooler extremities compared to the rest of the body due to reduced blood flow.

Choice D reason :Edema is not a common finding in PAD. Instead, PAD can lead to decreased skin temperature, loss of hair, shiny skin, and non-healing wounds on the extremities due to poor circulation.

Choice A reason : Hepatomegaly, or the enlargement of the liver, is a common finding in right-sided heart failure. This condition occurs because the heart does not pump blood effectively, leading to congestion and increased pressure in the venous system, including the hepatic veins. As a result, the liver becomes engorged with blood, causing it to enlarge. The normal liver span in adults is about 10-12 cm in the midclavicular line, and any measurement above this can indicate hepatomegaly.

Choice B reason : Orthopnea, which is shortness of breath while lying flat, is more commonly associated with left-sided heart failure. In right-sided heart failure, symptoms are more related to systemic congestion, such as swelling in the legs and abdomen, rather than pulmonary symptoms like orthopnea.

Choice C reason : Dyspnea, or difficulty breathing, can be a symptom of both left and right-sided heart failure. However, in the context of right-sided heart failure, dyspnea is usually due to the accumulation of fluid in the abdominal cavity (ascites) and the increased pressure in the abdominal veins, which can compress the diaphragm and make breathing difficult.

Choice D reason : Frothy sputum is typically not a symptom of right-sided heart failure. It is more indicative of pulmonary edema, which is associated with left-sided heart failure. In right-sided heart failure, the primary issues are related to the systemic circulation and venous congestion.