A patient taking an angiotensin receptor blocker (AR) to control blood pressure is now complaining of muscle cramps which action will the nurse implement?

Review serum electrolytes

Request the patient's food diary

Place the patent on bed rest

Observing vital signs

Answer and Explanation

The Correct Answer is A

A. Review serum electrolytes: Muscle cramps can be associated with electrolyte imbalances, such as hypokalemia (low potassium levels), which can occur as a side effect of ARB medications. Therefore, reviewing the patient's serum electrolyte levels, including potassium, can help identify any abnormalities that may be contributing to the muscle cramps. If hypokalemia is present, appropriate interventions such as potassium supplementation or adjustment of the ARB dosage may be necessary to alleviate the muscle cramps.

B. Request the patient's food diary: While assessing the patient's food diary may provide information about their dietary habits and potential factors contributing to muscle cramps (such as dehydration or inadequate nutrient intake), it may not directly address the potential electrolyte imbalance associated with ARB use. Therefore, while obtaining a food diary may be relevant, it is not the priority action in this scenario.

C. Place the patient on bed rest: Placing the patient on bed rest is not indicated solely based on complaints of muscle cramps. Muscle cramps can have various causes, and restricting the patient's activity may not address the underlying issue. Additionally, bed rest could lead to other complications such as deconditioning or venous thromboembolism, which are not warranted in this situation.

D. Observing vital signs: While monitoring vital signs is a routine nursing intervention, it may not directly address the patient's complaint of muscle cramps. Vital signs may be relevant in assessing overall health status, but they may not provide specific information about the cause of muscle cramps or guide appropriate interventions.

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Correct Answer is D

Explanation

A. Having the primary provider prescribe a CT:
Prescribing a CT scan is not the initial action for assessing nonpalpable pedal pulses. CT scans are typically used for imaging purposes and are not the primary diagnostic tool for assessing peripheral pulses.

B. Apply a tourniquet for 3 to 5 minutes and then reassess:
While applying a tourniquet may increase the visibility of pulses in some cases, it is not the recommended method for assessing pedal pulses, especially if they are nonpalpable. Tourniquet use carries risks, such as tissue damage or ischemia, and is not a standard practice for assessing pulses.

C. Elevate the extremity and attempt to palpate the pulses:
Elevating the extremity may improve blood flow and make pulses easier to palpate, but if the pulses are nonpalpable, simply elevating the extremity may not be sufficient for assessment. Additionally, palpation alone may not accurately detect pulses in some cases.

D. Use the doppler ultrasound to detect pedal pulses:
This is the most appropriate action. Doppler ultrasound is a non-invasive diagnostic tool commonly used to assess peripheral pulses, especially when they are nonpalpable. It uses sound waves to detect blood flow and can provide accurate information about the presence and strength of pedal pulses. Using a doppler ultrasound can help confirm the status of pedal pulses and guide further management.

A. Sedentary lifestyle B. Diabetes C. Cigarette smoking D. Hyperlipidemia

Correct Answer is C

Explanation

A. Sedentary lifestyle: While a sedentary lifestyle can contribute to the development and progression of peripheral arterial disease (PAD), it is not the highest risk factor compared to other options listed. Regular physical activity is important for cardiovascular health and can help reduce the risk of PAD, but other risk factors may have a greater impact on disease development.

B. Diabetes: Diabetes is a significant risk factor for PAD, especially when poorly controlled. High blood sugar levels can damage blood vessels and nerves, leading to atherosclerosis and reduced blood flow to the limbs. However, compared to cigarette smoking, diabetes may not be considered the highest risk factor for PAD.

C. Cigarette smoking: Cigarette smoking is the highest risk factor for peripheral arterial disease (PAD). Tobacco smoke contains numerous harmful chemicals that damage blood vessels and promote atherosclerosis, narrowing the arteries and reducing blood flow to the limbs. Smoking not only increases the risk of developing PAD but also accelerates its progression and worsens symptoms. Quitting smoking is one of the most important interventions for preventing and managing PAD.

D. Hyperlipidemia: Elevated levels of cholesterol and triglycerides (hyperlipidemia) contribute to the development of atherosclerosis, which is a key mechanism underlying peripheral arterial disease (PAD). However, while hyperlipidemia is a significant risk factor, it may not be considered the highest risk factor compared to cigarette smoking. Controlling cholesterol levels through lifestyle changes and medications is essential for managing PAD and reducing cardiovascular risk.

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A patient taking an angiotensin receptor blocker (AR) to control blood pressure is now complaining of muscle cramps which action will the nurse implement?

Nursing Test Bank

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