The nurse is teaching a client who is diagnosed with peripheral arterial disease about the benefits of walking to exercise. What information should the nurse reinforce with this client?

Continue walking to the point of pain

Do not walk if a leg ulcer develops

Elevate the feet for 30 minutes after walking

Avoid exercise that places the feet in a dependent position

Answer and Explanation

The Correct Answer is A

A.   Clients with PAD often experience claudication (pain in the legs due to inadequate blood flow) during exercise. They should be encouraged to walk to the point of pain, then rest until the pain subsides, and then continue walking. This approach can improve circulation over time.
B.   While it’s crucial to monitor leg ulcers, exercise can still be beneficial unless advised otherwise by a healthcare provider. Walking can promote circulation, which is important for healing. However, if a leg ulcer is present, the client should consult their healthcare provider about appropriate activity levels.
C.   While elevating the feet can help reduce swelling, it's generally more beneficial for clients with PAD to keep their legs in a dependent position after walking. This position encourages blood flow to the legs, which can help alleviate symptoms and improve circulation.
D.   Exercise that encourages movement and maintains blood flow to the legs is important for those with PAD. While certain positions may exacerbate symptoms, exercises like walking should be encouraged. Keeping the feet in a dependent position can help with blood flow post-exercise.

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Correct Answer is C

Explanation

A. While anxiety can exacerbate feelings of breathlessness, treating anxiety does not address the
underlying issue of respiratory distress. It is important to first stabilize the client’s respiratory condition
before managing anxiety.
B. Auscultating breath sounds can provide valuable information regarding the client’s respiratory status. However, in an emergency situation, immediate interventions to stabilize the client should take precedence over assessments, especially since the vital signs indicate significant distress.

C. Elevating the head of the bed can help improve respiratory effort by allowing better lung expansion and reducing the work of breathing. Given the client’s low oxygen saturation and signs of respiratory distress, this intervention can provide immediate relief and improve oxygenation.
D. While this may be necessary if the client's condition worsens or does not improve, it is not the first action to take. Preparing for mechanical ventilation is a more advanced intervention and should only occur after initial stabilization efforts have been made.

A. Platelet count of 148,000 uL B. Prothrombin Time (PT) of 14 seconds C. Activated Partial Thromboplastin Time (aPTT) of 25 seconds D. D-dimer of 500 ng/mL

Correct Answer is D

Explanation

A. This is a normal platelet count and is not directly related to DVT.
B. This is a normal PT result and does not indicate a clotting disorder that would predispose the client to DVT.
C. This is a normal aPTT result and does not indicate a clotting disorder that would predispose the client to DVT.
D. D-dimer is a marker of blood clot breakdown. An elevated D-dimer level suggests the presence of a blood clot, making it the most concerning laboratory result in this case.

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The nurse is teaching a client who is diagnosed with peripheral arterial disease about the benefits of walking to exercise. What information should the nurse reinforce with this client?

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