The client's chart indicates the diagnosis of stage III peripheral arterial disease. Which nursing assessment finding correlates with this diagnosis?

Complaints of muscle cramps with exercise

Complaints of burning pain during the night

Pedal pulses are +1 bilaterally

Tissue that is blackened on the great toe

Answer and Explanation

The Correct Answer is B

A.   While claudication (muscle cramps with exercise) is common in earlier stages of PAD, it typically occurs in stage II. In stage III, pain often occurs at rest rather than with exertion.
B.   In stage III PAD, patients often report rest pain, which can manifest as burning pain in the legs or feet, particularly at night when lying down. This is a hallmark symptom of advanced PAD due to inadequate blood flow.
C.   While diminished pulses (like +1) can be found in PAD, this finding alone is not specific to stage III. In advanced stages, pulses may be even weaker or absent.
D.   Blackened tissue (necrosis or gangrene) indicates a more severe stage (stage IV) of PAD, where there is critical limb ischemia and tissue death due to a lack of blood flow. Stage III may involve severe pain but usually does not have necrosis.

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Correct Answer is C

Explanation

A. A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B. A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C. A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D. A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

A. maintenance of a healthy weight. B. use of low doses of insulin regular. C. oral hypoglycemic agents. D. self-monitoring of blood glucose.

Correct Answer is A

Explanation

A. Teaching the client about maintaining a healthy weight is crucial, as weight management is a key factor in preventing the progression from prediabetes to type 2 diabetes. Losing even a small percentage of body weight can significantly improve insulin sensitivity and reduce the risk of developing diabetes.

B. At a fasting plasma glucose level of 120 mg/dL, the client is not at the stage where insulin therapy is indicated. Insulin is typically reserved for those with diabetes who require it for glycemic control. The focus should be on lifestyle changes rather than pharmacological treatment at this time.
C. Similar to insulin, oral hypoglycemic agents are generally not prescribed for clients with prediabetes. The goal is to manage blood glucose levels through lifestyle changes, and medication is typically introduced only if the client progresses to diabetes.
D. While self-monitoring of blood glucose is important for individuals with diabetes, it may not be necessary for someone with a fasting plasma glucose level of 120 mg/dL unless specifically indicated by a healthcare provider. Education could include how to monitor if they develop diabetes in the future, but the immediate focus should be on prevention strategies.

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The client's chart indicates the diagnosis of stage III peripheral arterial disease. Which nursing assessment finding correlates with this diagnosis?

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