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."

Answer and Explanation

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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Correct Answer is D

Explanation

(A) Determine the client’s blood pressure 1 min after each position change: While it’s important to check the client’s blood pressure after each position change when assessing for orthostatic hypotension, this is not the first step. The nurse should first establish a baseline blood pressure reading with the client in a supine position.

(B) Place the client in a sitting position: Although the nurse will eventually need to check the client’s blood pressure in a sitting position, the first step is to get a baseline reading with the client in a supine position.

(C) Assist the client into a standing position: The nurse will eventually assist the client into a standing position to check for changes in blood pressure, but this is not the first step. The initial step is to get a baseline reading with the client in a supine position.

(D) Check the blood pressure with the client in a supine position: This is the most appropriate first step. When checking for orthostatic hypotension, the nurse should first check the client’s blood pressure while they are lying flat (supine). This provides a baseline reading against which subsequent readings (taken when the client is sitting and standing) can be compared. If there’s a significant drop in blood pressure upon standing, this could indicate orthostatic hypotension.

A. "A heating pad will be used on the operative site to help reduce pain." B. "You will use a continuous passive motion (CPM) machine several times a d s a day." C. "Expect to remain in bed for at least the first 24 hours." D. "You will use a special soap to shower with the evening before your surgery."

Correct Answer is D

Explanation

(A) "A heating pad will be used on the operative site to help reduce pain.":
Using a heating pad on the operative site is generally not recommended post-surgery, as it can increase bleeding and swelling. Cold therapy is usually preferred to help reduce pain and inflammation.

(B) "You will use a continuous passive motion (CPM) machine several times a day.":
Continuous passive motion machines are typically used after knee replacement surgeries, not hip replacement surgeries. Therefore, this statement would not be accurate for a total hip replacement.

(C) "Expect to remain in bed for at least the first 24 hours.":
Early mobilization is crucial after hip replacement surgery to prevent complications such as deep vein thrombosis and to promote recovery. Patients are usually encouraged to get out of bed and start moving with assistance as soon as possible, often within the first 24 hours.

(D) "You will use a special soap to shower with the evening before your surgery.":
Using a special antiseptic soap before surgery is a common preoperative instruction to help reduce the risk of infection. This statement is correct and should be included in the preoperative teaching.

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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?

Nursing Test Bank

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Correct Answer is D

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