A nurse is developing a discharge teaching plan for a patient diagnosed with peripheral arterial disease. Which instruction will the nurse include in the plan?

Apply a heating pad to the lower extremities for pain.

Always wear sot shoes or slippers when out of bed.

Wear knee high sight socks

Put cream or lotion between the toes

Answer and Explanation

The Correct Answer is B

A. Apply a heating pad to the lower extremities for pain: Heat application can increase vasodilation and worsen symptoms in patients with peripheral arterial disease (PAD). Therefore, it is not recommended as a pain management strategy for PAD.

B. Always wear soft shoes or slippers when out of bed: This instruction is important for patients with PAD to protect their feet from injury and provide adequate support. Soft shoes or slippers help prevent trauma and pressure ulcers, which are common complications in patients with reduced peripheral circulation.

C. Wear knee-high tight socks: Tight socks can restrict blood flow and exacerbate symptoms in patients with PAD. It is important to encourage patients to wear loose-fitting socks to promote adequate circulation.

D. Put cream or lotion between the toes: Moisture between the toes can increase the risk of fungal infections, which can be particularly problematic in patients with compromised circulation. It is important to keep the feet clean and dry and avoid applying cream or lotion between the toes.

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Correct Answer is D

Explanation

A. Oral candidiasis and nausea: Oral candidiasis (thrush) and nausea are common manifestations in patients with AIDS, particularly when the CD4 count is low. While these symptoms require intervention, they are not typically considered emergent or immediately life-threatening.

B. Genital ulcer and vomiting: Genital ulcers and vomiting can occur in patients with AIDS due to various opportunistic infections and conditions. While these symptoms may warrant intervention, they are not typically indicative of an immediate life-threatening situation.

C. Memory deficit and apathy: Memory deficits and apathy can occur in patients with AIDS, particularly as the disease progresses. While these cognitive and behavioral changes may impact the patient's quality of life and require intervention, they are not typically considered emergent or immediately life-threatening.

D. Progressive dyspnea and fever: Progressive dyspnea (difficulty breathing) and fever are concerning findings in a patient with AIDS, especially with a CD4 count less than 200. These symptoms may indicate the presence of opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP), which can rapidly progress and lead to respiratory failure and death if not promptly treated. Therefore, these assessment findings require immediate intervention to assess for and manage potential respiratory compromise and systemic infection.

A. Loss of hair over toes. B. Tenderness in the thigh. C. Rest pain. D. Auscultation of bruit over pedal pulse.

Correct Answer is B

Explanation

A. Loss of hair over toes:
Loss of hair over the toes is not typically associated with deep vein thrombosis (DVT). Instead, it may be indicative of peripheral arterial disease (PAD) or poor peripheral circulation. In DVT, symptoms are more related to venous congestion and inflammation rather than hair loss.

B. Tenderness in the thigh:
Tenderness in the thigh is a common clinical manifestation of deep vein thrombosis (DVT). It occurs due to the presence of a thrombus within the deep veins of the thigh, causing local inflammation and irritation of the vessel wall. This tenderness may be elicited by palpation along the course of the affected vein.

C. Rest pain:
Rest pain is not typically associated with deep vein thrombosis (DVT). Rest pain is more commonly seen in conditions such as peripheral arterial disease (PAD), where inadequate blood supply to the extremities leads to ischemic pain at rest, especially during periods of reduced blood flow.

D. Auscultation of bruit over pedal pulse:
Auscultation of a bruit over the pedal pulse is not typically associated with deep vein thrombosis (DVT). A bruit is an abnormal sound caused by turbulent blood flow through a narrowed or obstructed vessel, commonly heard in arterial conditions such as atherosclerosis. In DVT, venous obstruction does not typically produce bruits.

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A nurse is developing a discharge teaching plan for a patient diagnosed with peripheral arterial disease. Which instruction will the nurse include in the plan?

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