The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of their extremities due to peripheral arterial disease. The nurse determines that there is a need for further teaching if the client makes which statement?

"I should cut my toenails straight across when clipping them."

"I should wear shoes and socks instead of open toed shoes."

1 should inspect my feet daily for any cuts."

"I should raise my legs above the level of my heart periodically."

Answer and Explanation

The Correct Answer is D

A. Cutting toenails straight across is an appropriate action for PAD clients because it prevents injury or infection, as clipping nails too short or rounding the edges can cause cuts or ingrown nails.

B. Wearing shoes and socks instead of open-toed shoes is recommended to protect the feet from injury, as individuals with PAD have decreased sensation in their feet, increasing the risk of unnoticed injury.

C. Inspecting the feet daily for cuts is a crucial step in PAD management to detect early signs of infection or injury, which can lead to complications such as gangrene or amputation.

D. Raising the legs above the heart level can worsen symptoms in PAD by further reducing arterial blood flow to the lower extremities, where circulation is already compromised. This technique is typically used in venous insufficiency, not PAD.

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Correct Answer is D

Explanation

A. Antihistamines can raise blood pressure, but this is less likely to be the primary cause compared to medication non-adherence.

B. Acetaminophen is generally safe for use in hypertensive patients and is unlikely to contribute to the high blood pressure in this scenario.

C. Stress can contribute to elevated blood pressure, but non-adherence to medications is a more likely cause of the severe BP elevation in this case.

D. Poor medication adherence is a common cause of elevated blood pressure despite treatment. If the client has not been consistently taking their antihypertensive medications, this could explain the elevated BP and symptoms (headache, blurred vision).

A. AST and ALT B. Prothrombin time (PT) C. Activated partial thromboplastin time (aPTT) D. International normalized ratio (INR)

Correct Answer is C

Explanation

A. AST and ALT are liver enzymes, primarily used to assess liver function, not directly related to monitoring heparin therapy.

B. Prothrombin time (PT) is used to monitor warfarin therapy, not heparin. Heparin therapy is typically monitored with aPTT, whereas warfarin is monitored with PT/INR.

C. Heparin is an anticoagulant that works by inhibiting clotting factors, and the aPTT is used to monitor its effectiveness. The aPTT measures the time it takes for blood to clot and helps ensure the heparin dose is therapeutic without causing excessive bleeding. The typical therapeutic range for aPTT on heparin therapy is 1.5 to 2.5 times the normal value.

D. INR is used to monitor warfarin therapy, not heparin. Heparin does not affect INR levels.

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The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of their extremities due to peripheral arterial disease. The nurse determines that there is a need for further teaching if the client makes which statement?

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Correct Answer is D

Explanation

The nurse is reviewing laboratory values for a client receiving a continuous heparin infusion. Which of the following laboratory values should the nurse monitor?

Correct Answer is C

Explanation

A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?

A patient who has recently started taking simvastatin (Zocor) reports several symptoms to the nurse. Which assessment finding is most important to communicate to the health care provider?

The nurse is assessing a client diagnosed with peripheral arterial disease. The client reports leg pain and cramping after walking 3 blocks, which is relieved when the client stops and rests. The nurse documents that the client is experiencing which clinical manifestation?

The nurse has finished teaching a patient diagnosed with chronic stable angina about the use of sublingual nitroglycerin (Nitrostat). Which patient statement indicates that the teaching has been effective?

The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of their extremities due to peripheral arterial disease. The nurse determines that there is a need for further teaching if the client makes which statement?

A nurse is admitting a client who reports chest pain. Exhibits The nurse is preparing the client for the cardiac catheterization (coronary angiography). Which of the following actions should the nurse take? (Select all that apply.)