Chapter 37: Vascular Disorders Lewis:
Medical-Surgical Nursing, 10th Edition
A patient in the outpatient clinic has a new diagnosis of peripheral artery disease
(PAD). Which group of drugs will the nurse plan to include when teaching about
PAD management?
a. Statins
b. Antibiotics
c. Thrombolytics
d. Anticoagulants - ✔✔- ANS: A
Research indicates that statin use by patients with PAD improves multiple
outcomes. There is no research that supports the use of the other drug
categories in PAD.
Peripheral artery disease (PAD) involves thickening of artery walls.
PAD prevalence increases with age.
In people with DM, PAD occurs earlier.
Etiology and Pathophysiology
-the leading cause of PAD is atherosclerosis.
-THis results from the deposit of cholesterol and lipids within the vessel walls and
leads to progressive narrowing of the artery.
-TObacco use increases risk - ✔✔-
An older patient with chronic atrial fibrillation develops sudden severe pain,
pulselessness, pallor, and coolness in the right leg. The nurse should notify the
health care provider and immediately
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position. - ✔✔- ANS: D
The patient's history and clinical manifestations are consistent with acute arterial
occlusion, and resting the leg will decrease the O2 demand of the tissues and
minimize ischemic damage until circulation can be restored. Elevating the leg or
,applying an elastic wrap will further compromise blood flow to the leg. Exercise
will increase oxygen demand for the tissues of the
Peripheral Artery Disease of the Lower Extremities
Lower ext PAD may affect the iliac, femoral, popliteal, tibial or peroneal arteries
or any combination of these arteries.
THe femoral poplitial is the most common site in nondiabetic pts.
Pts with PAD tend to develop PAD in the arteries below: - ✔✔- the knee
A patient at the clinic says, "I always walk after dinner, but lately my leg cramps
and hurts after just a few minutes of starting. The pain goes away after I stop
walking, though." The nurse should
a. look for the presence of tortuous veins bilaterally on the legs.
b. ask about any skin color changes that occur in response to cold.
c. assess for unilateral swelling, redness, and tenderness of either leg.
d. palpate for the presence of dorsalis pedis and posterior tibial pulses. - ✔✔-
ANS: D
The nurse should assess for other clinical manifestations of peripheral arterial
disease in a patient who describes intermittent claudication. Changes in skin
color that occur in response to cold are consistent with Raynaud's phenomenon.
Tortuous veins on the legs suggest venous insufficiency.term-29 Unilateral leg
swelling, redness, and tenderness indicate venous thromboembolism.
Peripheral artery disease PAD
clinical manifestations - ✔✔- classic sx is : intermittent claudication (ischemic
muscle pain) resolves within 10 minutes or less with rest and is reproducable.
PAD of the iliac arteries produces claudication in the buttocks and thighs
popliteal artery will have pain in the Calf
The nurse performing an assessment of a patient who has chronic peripheral
artery disease (PAD) of the legs and an ulcer on the right second toe would
expect to find
a. dilated superficial veins.
b. swollen, dry, scaly ankles.
, c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer - ✔✔- ANS: C
Capillary refill is prolonged in PAD because of the slower and decreased blood
flow to the periphery. The other listed clinical manifestations are consistent with
chronic venous disease
paresthesia or numbness or tingling in the toes or feet may result from nerve
tissue ischemia.
The limb's physical appearance provides important information about blood flow.
The skin becomes thin, shiny, taut and hair loss occurs on the lower legs.
Pedal , popliteal or femoral pulses are diminished or absent
Pallor (blanching of the foot) develops in response to leg elevation (elevation
pallor)
conversely reactive hyperemia (redness of the foot) develops when the limb is in
a dependent position
As PAD progresses and involves multiple arterial segments, continuous pain
develops at rest.
REst pain most often occurs in the foot or toes and is aggrevated by limb
elevation. - ✔✔-
When evaluating the discharge teaching for a patient with chronic peripheral
artery disease (PAD), the nurse determines a need for further instruction when
the patient says, "I will
a. use a heating pad on my feet at night to increase the circulation."
b. buy some loose clothes that do not bind across my legs or waist."
c. walk to the point of pain, rest, and walk again for at least 30 minutes 3 times a
week."
d. change my position every hour and avoid long periods of sitting with my legs
crossed." - ✔✔- ANS: A
Because the patient has impaired circulation and sensation to the feet, the use of
a heating pad could lead to burns. The other patient statements are correct and
indicate that teaching has been successful.
Interventional Radiology Catheter-based procedures
Medical-Surgical Nursing, 10th Edition
A patient in the outpatient clinic has a new diagnosis of peripheral artery disease
(PAD). Which group of drugs will the nurse plan to include when teaching about
PAD management?
a. Statins
b. Antibiotics
c. Thrombolytics
d. Anticoagulants - ✔✔- ANS: A
Research indicates that statin use by patients with PAD improves multiple
outcomes. There is no research that supports the use of the other drug
categories in PAD.
Peripheral artery disease (PAD) involves thickening of artery walls.
PAD prevalence increases with age.
In people with DM, PAD occurs earlier.
Etiology and Pathophysiology
-the leading cause of PAD is atherosclerosis.
-THis results from the deposit of cholesterol and lipids within the vessel walls and
leads to progressive narrowing of the artery.
-TObacco use increases risk - ✔✔-
An older patient with chronic atrial fibrillation develops sudden severe pain,
pulselessness, pallor, and coolness in the right leg. The nurse should notify the
health care provider and immediately
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position. - ✔✔- ANS: D
The patient's history and clinical manifestations are consistent with acute arterial
occlusion, and resting the leg will decrease the O2 demand of the tissues and
minimize ischemic damage until circulation can be restored. Elevating the leg or
,applying an elastic wrap will further compromise blood flow to the leg. Exercise
will increase oxygen demand for the tissues of the
Peripheral Artery Disease of the Lower Extremities
Lower ext PAD may affect the iliac, femoral, popliteal, tibial or peroneal arteries
or any combination of these arteries.
THe femoral poplitial is the most common site in nondiabetic pts.
Pts with PAD tend to develop PAD in the arteries below: - ✔✔- the knee
A patient at the clinic says, "I always walk after dinner, but lately my leg cramps
and hurts after just a few minutes of starting. The pain goes away after I stop
walking, though." The nurse should
a. look for the presence of tortuous veins bilaterally on the legs.
b. ask about any skin color changes that occur in response to cold.
c. assess for unilateral swelling, redness, and tenderness of either leg.
d. palpate for the presence of dorsalis pedis and posterior tibial pulses. - ✔✔-
ANS: D
The nurse should assess for other clinical manifestations of peripheral arterial
disease in a patient who describes intermittent claudication. Changes in skin
color that occur in response to cold are consistent with Raynaud's phenomenon.
Tortuous veins on the legs suggest venous insufficiency.term-29 Unilateral leg
swelling, redness, and tenderness indicate venous thromboembolism.
Peripheral artery disease PAD
clinical manifestations - ✔✔- classic sx is : intermittent claudication (ischemic
muscle pain) resolves within 10 minutes or less with rest and is reproducable.
PAD of the iliac arteries produces claudication in the buttocks and thighs
popliteal artery will have pain in the Calf
The nurse performing an assessment of a patient who has chronic peripheral
artery disease (PAD) of the legs and an ulcer on the right second toe would
expect to find
a. dilated superficial veins.
b. swollen, dry, scaly ankles.
, c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer - ✔✔- ANS: C
Capillary refill is prolonged in PAD because of the slower and decreased blood
flow to the periphery. The other listed clinical manifestations are consistent with
chronic venous disease
paresthesia or numbness or tingling in the toes or feet may result from nerve
tissue ischemia.
The limb's physical appearance provides important information about blood flow.
The skin becomes thin, shiny, taut and hair loss occurs on the lower legs.
Pedal , popliteal or femoral pulses are diminished or absent
Pallor (blanching of the foot) develops in response to leg elevation (elevation
pallor)
conversely reactive hyperemia (redness of the foot) develops when the limb is in
a dependent position
As PAD progresses and involves multiple arterial segments, continuous pain
develops at rest.
REst pain most often occurs in the foot or toes and is aggrevated by limb
elevation. - ✔✔-
When evaluating the discharge teaching for a patient with chronic peripheral
artery disease (PAD), the nurse determines a need for further instruction when
the patient says, "I will
a. use a heating pad on my feet at night to increase the circulation."
b. buy some loose clothes that do not bind across my legs or waist."
c. walk to the point of pain, rest, and walk again for at least 30 minutes 3 times a
week."
d. change my position every hour and avoid long periods of sitting with my legs
crossed." - ✔✔- ANS: A
Because the patient has impaired circulation and sensation to the feet, the use of
a heating pad could lead to burns. The other patient statements are correct and
indicate that teaching has been successful.
Interventional Radiology Catheter-based procedures
