A nursing student is reviewing medications used to treat a patient with Peripheral Artery Disease (PAD). Which of the following medications should the nurse identify as commonly prescribed for this condition? (Select all that apply)
Cilostazol (Pletal)
Ramipril (Altace)
Metoprolol (Lopressor)
Aspirin
Clopidogrel (Plavix)
Correct Answer : A,D,E
Choice A reason: Cilostazol inhibits phosphodiesterase III, increasing cyclic AMP, which dilates arteries and reduces platelet aggregation. This improves blood flow and reduces intermittent claudication in PAD, directly targeting vascular symptoms by enhancing circulation and preventing thrombosis, making it a primary treatment option.
Choice B reason: Ramipril, an ACE inhibitor, lowers blood pressure and protects vascular endothelium, benefiting PAD indirectly. It reduces cardiovascular strain but doesn’t directly improve limb perfusion or claudication, so it’s not a primary PAD medication despite its role in managing comorbidities like hypertension.
Choice C reason: Metoprolol, a beta-blocker, slows heart rate and reduces myocardial oxygen demand, useful in heart disease. In PAD, it may worsen claudication by reducing peripheral blood flow via vasoconstriction, making it less commonly prescribed specifically for PAD management.
Choice D reason: Aspirin inhibits cyclooxygenase, reducing thromboxane A2 and platelet aggregation. This antiplatelet action prevents clot formation in narrowed PAD arteries, improving outcomes by reducing thrombotic events, making it a standard, evidence-based therapy for symptom relief and risk reduction.
Choice E reason: Clopidogrel blocks ADP receptors on platelets, preventing aggregation and thrombus formation. In PAD, it reduces ischemic events and improves patency, often used alone or with aspirin, making it a key medication for managing vascular complications and symptoms.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Restricting fluids to 2 liters per day increases blood viscosity in sickle cell disease, promoting sickling and vaso-occlusion. Adequate hydration is critical to dilute hemoglobin S, so this instruction contradicts evidence-based management for crisis prevention.
Choice B reason: Iron supplements are contraindicated in sickle cell disease unless anemia is iron-deficient, which is rare. Most patients have normal or high iron from hemolysis, so a multivitamin with iron risks overload and organ damage.
Choice C reason: Avoiding caffeine lacks evidence in sickle cell crisis prevention; it’s not a trigger. Moderate intake doesn’t dehydrate significantly or affect sickling, making this instruction irrelevant to discharge teaching for this condition.
Choice D reason: Limiting crowd exposure reduces infection risk, a common sickle cell crisis trigger. Infections cause inflammation and hypoxia, promoting sickling, so this instruction aligns with preventing complications and maintaining patient stability post-discharge.
Correct Answer is ["B","C","E","F","G"]
Explanation
Choice A reason: Staying indoors may limit exposure but isn’t practical or evidence-based for pneumonia prevention. It’s less effective than vaccines or hygiene, as pathogens persist indoors, reducing its priority in teaching.
Choice B reason: Yearly flu vaccine prevents influenza, a pneumonia risk factor, by inducing immunity. It’s a cornerstone of prevention, reducing respiratory infections that predispose to bacterial pneumonia, per public health guidelines.
Choice C reason: Regular exercise and nutrition boost immunity, reducing pneumonia risk. Strong lungs and host defenses limit infection severity, making this a key lifestyle topic for long-term respiratory health protection.
Choice D reason: Using a fan circulates air but doesn’t prevent pneumonia pathogens effectively. It may dry mucosa, increasing susceptibility, so it’s not a standard recommendation compared to vaccines or hygiene.
Choice E reason: Staying away from crowds reduces exposure to respiratory pathogens causing pneumonia. It’s practical during outbreaks, complementing vaccines and hygiene as a behavioral strategy to lower infection risk.
Choice F reason: Handwashing removes pathogens, preventing pneumonia transmission via contact. It’s a simple, evidence-based habit, critical in breaking infection chains, making it essential in patient education for prevention.
Choice G reason: Pneumonia vaccine (e.g., PCV13, PPSV23) protects against Streptococcus pneumoniae, a top cause. It’s a primary prevention tool, reducing incidence, strongly recommended for at-risk patients in teaching plans.
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