Peripheral Vascular Disorders – Qs & As
A postoperative patient is receiving enoxaparin. The nurse identifies that the
medication is not being effective when what assessment finding is noted?
Generalized weakness and fatigue
Crackles bilaterally in the lung bases
Pain and swelling in the lower extremity
Abdominal pain with decreased bowel sounds ✔️Ans - Pain and swelling in
the lower extremity
Enoxaparin is a low-molecular-weight heparin used to prevent the
development of deep vein thromboses (DVTs) in the postoperative period.
Pain and swelling in the lower extremity can indicate development of DVT and
therefore may signal ineffective medication therapy. Generalized weakness,
fatigue, abdominal pain, and crackles in the bases of the lungs would not
necessitate the use of enoxaparin.
pp. 820-821
A nurse is caring for a patient with a diagnosis of deep venous thrombosis
(DVT). The patient receives a prescription for 30 mg enoxaparin. Which
injection site should the nurse use to administer this medication safely?
Buttock, upper outer quadrant
Abdomen, anterior-lateral aspect
Back of the arm, 2 inches away from a mole
Anterolateral thigh, with no scar tissue nearby ✔️Ans - Abdomen, anterior-
lateral aspect
Enoxaparin is a low-molecular-weight (LMW) heparin that is given as a deep
subcutaneous injection in the right and left anterolateral abdomen.
,Enoxaparin will not be given in the upper quadrant of the buttock. All
subcutaneous injections should be given away from scars, lesions, or moles.
p. 820
A patient reports pain and itchiness in a lower extremity. Upon further
assessment, a nurse observes that the extremity is reddened and warm. The
patient's body temperature is 101° F. What complication does the nurse
suspect?
Aortic aneurysm
Raynaud's phenomenon
Peripheral artery disease
Superficial vein thrombosis ✔️Ans - Superficial vein thrombosis
The presence of an itchy, reddened, painful, and warm lower extremity
characterizes a superficial vein thrombosis. A patient with superficial vein
thrombosis may also have an elevated body temperature. Altered bowel
elimination, abdominal and chest pain are symptoms of an aortic aneurysm.
Bluish fingers and toes, pallor, rubor, throbbing, and aching pain due to
exposure to cold are symptoms of Raynaud's phenomenon. Atherosclerosis,
arterial stenosis, and decreased Doppler pressures are symptoms of
peripheral artery disease.
p. 818
Bluish fingers and toes, pallor, rubor, throbbing, and aching pain due to
exposure to cold ✔️Ans - Raynaud's phenomenon
presence of an itchy, reddened, painful, and warm lower extremity, elevated
body temperature characterizes ✔️Ans - superficial vein thrombosis
Altered bowel elimination, abdominal and chest pain are symptoms of
✔️Ans - aortic aneurysm
,The primary health care provider prescribes warfarin for a patient with
venous thromboembolism (VTE). Which information should the nurse include
in the patient's discharge teaching plan?
No routine laboratory monitoring is needed.
Avoid contact sports and high-risk activities.
Increase daily intake of dark leafy vegetables.
Continue to use garlic as a dietary supplement. ✔️Ans - Avoid contact
sports and high-risk activities.
Teaching for a patient prescribed warfarin includes avoiding any trauma or
injury that might cause bleeding, such as contact sports. Routine laboratory
monitoring is needed to assess the therapeutic effect of the medication and
whether a change in drug dose is needed. Do not increase daily intake of dark
leafy vegetables because these foods are high in vitamin K. Garlic may affect
blood clotting. Instruct the patient to consult with the health care provider
about the use of garlic supplements along with warfarin.
p. 820
The nurse reviews a patient's laboratory results before administering a
prescribed dose of vitamin K 1. The nurse determines that the medication is
both safe to give and is most needed when the international normalized ratio
(INR) is at which level?
1.0
1.2
1.6
2.1 ✔️Ans - 2.1
Phytonadione is the antidote to sodium warfarin (Coumadin), which the
patient had been taking before admission. Warfarin is an anticoagulant that
impairs the ability of the blood to clot. It is necessary to give phytonadione
, before surgery to reduce the risk of hemorrhage. The greatest value of the INR
indicates the greatest impairment of clotting ability, making 2.1 the correct
selection. Values of 1.0, 1.2, and 1.6 indicate lower INR results, which may not
require vitamin K 1.
pp. 820-821
The nurse provides discharge teaching to a patient with venous leg ulcers.
Which statement made by the patient indicates the need for further
education?
"I will take a walk daily."
"I will try to lose at least 20 pounds."
"I will put on my stockings after I get out of bed each day."
"I will not wear knee-high socks that are tight around my calf." ✔️Ans - "I
will put on my stockings after I get out of bed each day."
The patient should apply stockings in bed before rising in the morning (not
after rising). Emphasize the importance of periodic positioning of the legs
above the heart. Prevention is a key factor related to varicose veins. Instruct
the patient to avoid sitting or standing for long periods, maintain ideal body
weight, take precautions against injury to the extremities, avoid wearing
constrictive clothing, and walk daily. The overweight patient may need
assistance with weight loss. The patient with a job that requires long periods
of standing or sitting needs to frequently flex and extend the hips, legs, and
ankles and change positions.
p. 826
While caring for a patient, the nurse observes indications of warfarin toxicity.
The nurse expects that which medication will be prescribed?
Vitamin K
Lepirudin
A postoperative patient is receiving enoxaparin. The nurse identifies that the
medication is not being effective when what assessment finding is noted?
Generalized weakness and fatigue
Crackles bilaterally in the lung bases
Pain and swelling in the lower extremity
Abdominal pain with decreased bowel sounds ✔️Ans - Pain and swelling in
the lower extremity
Enoxaparin is a low-molecular-weight heparin used to prevent the
development of deep vein thromboses (DVTs) in the postoperative period.
Pain and swelling in the lower extremity can indicate development of DVT and
therefore may signal ineffective medication therapy. Generalized weakness,
fatigue, abdominal pain, and crackles in the bases of the lungs would not
necessitate the use of enoxaparin.
pp. 820-821
A nurse is caring for a patient with a diagnosis of deep venous thrombosis
(DVT). The patient receives a prescription for 30 mg enoxaparin. Which
injection site should the nurse use to administer this medication safely?
Buttock, upper outer quadrant
Abdomen, anterior-lateral aspect
Back of the arm, 2 inches away from a mole
Anterolateral thigh, with no scar tissue nearby ✔️Ans - Abdomen, anterior-
lateral aspect
Enoxaparin is a low-molecular-weight (LMW) heparin that is given as a deep
subcutaneous injection in the right and left anterolateral abdomen.
,Enoxaparin will not be given in the upper quadrant of the buttock. All
subcutaneous injections should be given away from scars, lesions, or moles.
p. 820
A patient reports pain and itchiness in a lower extremity. Upon further
assessment, a nurse observes that the extremity is reddened and warm. The
patient's body temperature is 101° F. What complication does the nurse
suspect?
Aortic aneurysm
Raynaud's phenomenon
Peripheral artery disease
Superficial vein thrombosis ✔️Ans - Superficial vein thrombosis
The presence of an itchy, reddened, painful, and warm lower extremity
characterizes a superficial vein thrombosis. A patient with superficial vein
thrombosis may also have an elevated body temperature. Altered bowel
elimination, abdominal and chest pain are symptoms of an aortic aneurysm.
Bluish fingers and toes, pallor, rubor, throbbing, and aching pain due to
exposure to cold are symptoms of Raynaud's phenomenon. Atherosclerosis,
arterial stenosis, and decreased Doppler pressures are symptoms of
peripheral artery disease.
p. 818
Bluish fingers and toes, pallor, rubor, throbbing, and aching pain due to
exposure to cold ✔️Ans - Raynaud's phenomenon
presence of an itchy, reddened, painful, and warm lower extremity, elevated
body temperature characterizes ✔️Ans - superficial vein thrombosis
Altered bowel elimination, abdominal and chest pain are symptoms of
✔️Ans - aortic aneurysm
,The primary health care provider prescribes warfarin for a patient with
venous thromboembolism (VTE). Which information should the nurse include
in the patient's discharge teaching plan?
No routine laboratory monitoring is needed.
Avoid contact sports and high-risk activities.
Increase daily intake of dark leafy vegetables.
Continue to use garlic as a dietary supplement. ✔️Ans - Avoid contact
sports and high-risk activities.
Teaching for a patient prescribed warfarin includes avoiding any trauma or
injury that might cause bleeding, such as contact sports. Routine laboratory
monitoring is needed to assess the therapeutic effect of the medication and
whether a change in drug dose is needed. Do not increase daily intake of dark
leafy vegetables because these foods are high in vitamin K. Garlic may affect
blood clotting. Instruct the patient to consult with the health care provider
about the use of garlic supplements along with warfarin.
p. 820
The nurse reviews a patient's laboratory results before administering a
prescribed dose of vitamin K 1. The nurse determines that the medication is
both safe to give and is most needed when the international normalized ratio
(INR) is at which level?
1.0
1.2
1.6
2.1 ✔️Ans - 2.1
Phytonadione is the antidote to sodium warfarin (Coumadin), which the
patient had been taking before admission. Warfarin is an anticoagulant that
impairs the ability of the blood to clot. It is necessary to give phytonadione
, before surgery to reduce the risk of hemorrhage. The greatest value of the INR
indicates the greatest impairment of clotting ability, making 2.1 the correct
selection. Values of 1.0, 1.2, and 1.6 indicate lower INR results, which may not
require vitamin K 1.
pp. 820-821
The nurse provides discharge teaching to a patient with venous leg ulcers.
Which statement made by the patient indicates the need for further
education?
"I will take a walk daily."
"I will try to lose at least 20 pounds."
"I will put on my stockings after I get out of bed each day."
"I will not wear knee-high socks that are tight around my calf." ✔️Ans - "I
will put on my stockings after I get out of bed each day."
The patient should apply stockings in bed before rising in the morning (not
after rising). Emphasize the importance of periodic positioning of the legs
above the heart. Prevention is a key factor related to varicose veins. Instruct
the patient to avoid sitting or standing for long periods, maintain ideal body
weight, take precautions against injury to the extremities, avoid wearing
constrictive clothing, and walk daily. The overweight patient may need
assistance with weight loss. The patient with a job that requires long periods
of standing or sitting needs to frequently flex and extend the hips, legs, and
ankles and change positions.
p. 826
While caring for a patient, the nurse observes indications of warfarin toxicity.
The nurse expects that which medication will be prescribed?
Vitamin K
Lepirudin
