TPN 2,000 mL is ordered to infuse from 1900 to 0700.

Using an IV controller, how many milliliters per hour should be infused?

Choice A rationale

Peripheral arterial disease causes reduced blood flow to the extremities, making them highly susceptible to thermal injury. A heating pad can cause a severe burn because the compromised circulation prevents adequate heat dissipation, and the impaired sensation often associated with PAD means the client may not feel the excessive heat.

Choice B rationale

Crossing legs compresses the popliteal artery and other vessels, further impeding already compromised arterial blood flow to the lower extremities. This action increases resistance and reduces tissue perfusion, exacerbating the ischemic symptoms and potentially worsening the disease progression.

Choice C rationale

Wearing warm, heavy socks is a safe and effective way to promote warmth and vasodilation in the feet without the risk of burns. By maintaining warmth, it helps to prevent vasospasm and promotes better collateral blood flow to the affected extremities, improving comfort and circulation.

Choice D rationale

Smoking causes intense vasoconstriction through nicotine's effects on the sympathetic nervous system and damages the endothelial lining of blood vessels, accelerating the atherosclerotic process. Quitting smoking is the single most effective intervention to slow the progression of PAD and reduce cardiovascular risk.

Choice A rationale

An elevated low-density lipoprotein (LDL-C) level is a significant risk factor for atherosclerosis because LDL-C is the primary carrier of cholesterol to the tissues. High levels lead to the deposition of cholesterol within the arterial walls, forming atherosclerotic plaques. These plaques narrow arteries, impede blood flow, and can rupture, leading to thrombosis and acute cardiovascular events. A normal LDL-C level is typically less than 100 mg/dL.

Choice B rationale

Decreased levels of high-density lipoprotein cholesterol (HDL-C) are concerning because HDL-C plays a protective role in the cardiovascular system. HDL-C is responsible for reverse cholesterol transport, a process where it removes excess cholesterol from the arterial walls and transports it back to the liver for excretion. Low levels impair this protective mechanism, allowing cholesterol accumulation and plaque formation. A normal HDL-C level is typically above 40 mg/dL for men and 50 mg/dL for women.

Choice C rationale

Asian ethnicity is not considered an independent risk factor for atherosclerosis. While certain populations may have varying risk profiles due to genetic and lifestyle factors, ethnicity alone does not directly predispose an individual to the condition in the same manner as modifiable factors like dyslipidemia or smoking. A comprehensive risk assessment relies on established clinical and lifestyle factors, not solely on a person’s racial background.

Choice D rationale

A history of smoking is a major, modifiable risk factor for atherosclerosis. The chemicals in cigarette smoke damage the endothelium, the inner lining of blood vessels, making it more permeable to cholesterol. Smoking also increases inflammation, promotes platelet aggregation, and lowers HDL-C levels. These combined effects accelerate the formation and progression of atherosclerotic plaques, significantly increasing the risk of cardiovascular events like myocardial infarction and stroke.

Choice E rationale

A single blood pressure reading of 142/92 mm Hg, while elevated, is not sufficient for a diagnosis of hypertension or to be considered a definitive risk factor. Hypertension is diagnosed based on multiple elevated readings over time. While this reading is concerning, a single measurement can be influenced by various factors. The finding warrants further monitoring, but it does not represent a chronic risk factor until a pattern of sustained high blood pressure is established