A nurse is reinforcing teaching with a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?
"incorporate walking into your daily routine."
"Elevate your legs while in bed."
"Shop for new shoes during the morning hours."
"Wear knee length stockings."
The Correct Answer is A
(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.
(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.
(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.
(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.
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Related Questions
Correct Answer is C
Explanation
(A) Treatment: While treatment is an important part of the client’s information, it is typically included in the “Recommendation” component of ISBARR, where the nurse would discuss the recommended treatment plan.
(B) List of medications: The list of medications a client is taking is crucial information, but it is usually included in the “Background” component of ISBARR, which provides context about the client’s medical history and current medications.
(C) Medical condition: This is the most appropriate answer. The “Situation” component of ISBARR is meant to provide a brief overview of the client’s current situation, which includes their current medical condition or reason for admission.
(D) Vital signs: Vital signs are typically included in the “Assessment” component of ISBARR, where the nurse would discuss the results of their assessment of the client, including vital signs.
Correct Answer is D
Explanation
A. Qualitative studies are considered to be one type of Level I evidence: Qualitative studies are not typically considered Level I evidence. The hierarchy of evidence is a rating system used to evaluate the strength of evidence presented in medical research. Level I evidence usually includes systematic reviews, meta-analyses, and randomized controlled trials.
B. Level Vil evidence comes from a meta-analysis of multiple peer-reviewed studies: This statement is not accurate. Meta-analyses and systematic reviews are usually considered Level I evidence, as they provide the highest level of evidence. They synthesize and analyze multiple studies on a topic to provide a comprehensive view of the current evidence.
C. Level I evidence includes evidence found in nursing textbooks: Nursing textbooks are not considered Level I evidence. They often include a mix of different levels of evidence, from expert opinion to systematic reviews. While they are a valuable resource for background information and clinical guidelines, they do not represent the highest level of evidence.
D. Level I evidence is considered to be the best evidence to support EBP: This is correct. Level I evidence, which includes systematic reviews, meta-analyses, and randomized controlled trials, is considered the highest level of evidence and provides the most reliable basis for decision-making in evidence-based practice
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