A nurse is caring for a patient immediately following a cardiac catheterization with a femoral artery approach. Which action should the nurse take?

Choice A rationale:

Avoiding crossing legs at the knees is a correct practice for people with PVD. It helps to prevent constriction of blood flow in the legs. When legs are crossed, pressure is applied to the veins in the lower leg, which can impede blood flow. This can lead to several problems, including:

Increased risk of blood clots Worsening of swelling in the legs Increased pain and discomfort Potential skin damage

Reinforcing this practice with the client is important.

Choice B rationale:

Not going barefoot is also a correct practice for people with PVD. It helps to protect the feet from injuries and infections. People with PVD may have reduced sensation in their feet, making them more susceptible to injuries they may not notice. Additionally, PVD can impair wound healing, so even minor injuries can become serious problems.

Reinforcing this practice with the client is important.

Choice C rationale:

Using a thermometer to check bath water temperature is not directly relevant to PVD management. While it's generally a good safety practice to avoid excessively hot water, which can burn the skin, it's not specifically related to the blood flow issues associated with PVD.

This statement indicates a need for further teaching to focus on PVD-specific self-care measures.

Choice D rationale:

Wearing stockings with elastic tops is generally recommended for people with PVD. These stockings, often referred to as compression stockings, help to improve blood flow in the legs by applying gentle pressure. This can help to reduce swelling, pain, and the risk of blood clots.

Reinforcing this practice with the client is important.

Choice A rationale:

Painful urination (dysuria) can be a sign of several conditions that could potentially affect the client's IVP or indicate a need for further assessment. These conditions include:

Urinary tract infection (UTI): UTIs are common in clients with recurrent kidney stones, and they can cause inflammation and pain in the urinary tract. If a client has a UTI, it's important to treat it before the IVP to reduce the risk of spreading the infection to the kidneys.

Kidney stone passage: The client's history of kidney stones makes it possible that the pain could be due to the passage of a stone. This would be important information for the healthcare team to know, as it could affect the interpretation of the IVP results.

Other urological conditions: There are other urological conditions, such as bladder or urethral strictures, that can also cause painful urination. These conditions might also need to be considered and assessed for.

It's important for the nurse to collect more data about the client's painful urination to determine the underlying cause and whether it could impact the IVP. This might include asking questions about:

The severity and duration of the pain

Any other associated symptoms, such as fever, urgency, or frequency The client's history of UTIs or kidney stones

Any recent changes in urinary habits

Based on this additional information, the nurse can then collaborate with the healthcare team to determine the best course of action, which might include:

Further assessment, such as a urinalysis or urine culture Treatment for a UTI, if present

Pain management

Rescheduling the IVP, if necessary