A nurse is planning care for a client who has peripheral venous disease. Which of the following interventions should the nurse include in the plan of care? (Select All that Apply.)

Intermittent pneumatic compression pumps

Ankle-brachial index test

Layered wraps

Elevation of legs

Exercise

Answer and Explanation

Correct Answer : A,C,D,E

A. Intermittent pneumatic compression pumps: Intermittent pneumatic compression pumps can help improve circulation in the lower extremities by assisting with venous return. These devices inflate and deflate sequentially, promoting venous blood flow and reducing edema in clients with peripheral venous disease.

B. Ankle-brachial index test: The ankle-brachial index (ABI) test is a non-invasive vascular study used to assess peripheral arterial disease (PAD). It compares the blood pressure in the ankle with the blood pressure in the arm to evaluate arterial circulation.

C. Layered wraps: Layered wraps, such as compression bandages or stockings, are typically used in the management of venous insufficiency and venous ulcers. They are not as commonly utilized in peripheral venous disease, however, they may be beneficial for some clients with PVD.

D. Elevation of legs: Elevating the legs above the level of the heart can help reduce edema and improve venous return in clients with peripheral venous disease. Gravity assists in draining blood from the lower extremities back toward the heart, thereby reducing swelling and discomfort.

E. Exercise: Regular physical activity, particularly lower extremity exercises such as walking, can promote venous return and improve circulation in clients with peripheral venous disease. Exercise helps to pump blood back to the heart, reducing venous stasis and the risk of complications such as venous thrombosis.

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Correct Answer is B

Explanation

A. Pericardiocentesis: Pericardiocentesis is a procedure used to drain fluid from the pericardial sac, typically performed in cases of pericardial effusion or cardiac tamponade. It is not indicated for the treatment of hypertrophic cardiomyopathy (HCM), which involves structural abnormalities of the heart muscle rather than pericardial fluid accumulation.

B. Septal myectomy: Septal myectomy is a surgical procedure performed to treat hypertrophic obstructive cardiomyopathy (HOCM), a subtype of hypertrophic cardiomyopathy characterized by thickening of the interventricular septum and dynamic left ventricular outflow tract obstruction. Septal myectomy involves the surgical removal of a portion of the hypertrophied septum to relieve left ventricular outflow tract obstruction and improve symptoms.

C. Pericardial window: A pericardial window is a surgical procedure used to create a communication between the pericardial sac and the pleural space, typically performed in cases of recurrent pericardial effusion or tamponade to prevent fluid re-accumulation. It is not indicated for the treatment of hypertrophic cardiomyopathy.

D. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to restore normal sinus rhythm in patients with certain types of cardiac arrhythmias, such as atrial fibrillation or atrial flutter. It is not typically indicated for the treatment of hypertrophic cardiomyopathy, although patients with HCM may develop arrhythmias as a complication.

A. Comply with compression therapy. B. Monitor wounds on lower extremities. C. Take antiplatelet medications as ordered. D. Monitor for gradual onset of symptoms

Correct Answer is D

Explanation

A. Comply with compression therapy:

Compression therapy typically refers to the use of compression garments or devices to improve circulation and reduce swelling in the extremities, particularly in conditions such as venous insufficiency or deep vein thrombosis.

While compression therapy may be beneficial for certain circulatory disorders, it is not a standard treatment for cardiac tamponade.

Cardiac tamponade is a medical emergency characterized by the accumulation of fluid in the pericardial sac, leading to increased pressure on the heart and impaired cardiac function.

Treatment for cardiac tamponade involves prompt recognition and intervention to relieve the pressure on the heart, such as pericardiocentesis or surgical drainage of the pericardial effusion.

B. Monitor wounds on lower extremities:

Monitoring wounds on the lower extremities is essential for assessing healing, preventing complications such as infection, and promoting overall wound care.

However, monitoring wounds on the lower extremities is not directly related to the management or monitoring of cardiac tamponade.

In cardiac tamponade, the focus of monitoring is on assessing signs and symptoms of cardiac compromise, such as hypotension, tachycardia, dyspnea, and pulsus paradoxus, rather than wound care.

C. Take antiplatelet medications as ordered:

Antiplatelet medications, such as aspirin or clopidogrel, are commonly prescribed to prevent platelet aggregation and reduce the risk of thrombotic events, particularly in patients with cardiovascular disease or a history of myocardial infarction or stroke.

While antiplatelet medications may be part of the long-term management of certain cardiac conditions, they are not specific to the treatment or monitoring of cardiac tamponade.

The primary treatment for cardiac tamponade involves interventions to relieve the pressure on the heart and restore cardiac function, such as pericardiocentesis or surgical drainage of the pericardial effusion.

D. Monitor for gradual onset of symptoms:

Phase II of cardiac tamponade is characterized by a gradual onset of symptoms as the pressure within the pericardial sac increases, leading to impaired cardiac filling and decreased cardiac output.

Symptoms may include dyspnea, fatigue, orthopnea, tachycardia, and chest discomfort, which may develop gradually over time.

Early recognition of symptoms is crucial for prompt diagnosis and intervention to prevent further deterioration and improve outcomes in patients with cardiac tamponade.

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A nurse is planning care for a client who has peripheral venous disease. Which of the following interventions should the nurse include in the plan of care? (Select All that Apply.)

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